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目的探究孕妇亚临床甲状腺功能减退对婴幼儿神经心理发育的影响,降低因母体甲状腺功能减退引起的甲状腺激素不足对子代发育商的影响。方法随机选取2014年12月-2015年12月该院收治的72例妊娠早中期亚临床甲状腺功能低下孕妇的子代为观察组,同期选取72例身体健康孕妇的子代为对照组。观察两组孕妇子代在新生儿期、12、24、36个月龄时的甲状腺功能,即游离三碘甲状腺原氨酸水平(FT_3)、游离甲状腺素水平(FT_4)、促甲状腺激素水平(TSH),并对其子代在6个月龄时进行神经心理发育评估,并对比评估结果。结果新生儿期观察组子代的TSH水平显著高于对照组,血清FT_4、FT_3水平明显低于对照组(P<0.05)。12、24、36个月龄时两组的TSH、FT_4、FT_3水平比较差异无统计学意义(P>0.05)。观察组子代综合发育商低于对照组(P<0.05),大运动和精细运动单项发育商低于对照组,差异有统计学意义(P<0.05)。结论妊娠早中期孕妇亚临床甲状腺功能减低影响子代的神经心理发育,提示应在妊娠早中期对孕妇进行亚临床甲状腺功能减退的筛查,并给予积极的治疗,将对优生优育发挥重要作用。
Objective To investigate the effect of subclinical hypothyroidism on the neuropsychological development in infants and young children and to reduce the influence of hypothyroidism caused by hypothyroidism on the offspring development. Methods Seventy-two offspring of 72 pregnant women with subclinical hypothyroidism who were treated in our hospital from December 2014 to December 2015 were selected as the observation group and 72 healthy pregnant women were selected as the control group. The thyroid function of two groups of pregnant women in the neonatal period, 12, 24, and 36 months of age was observed. The levels of free triiodothyronine (FT_3), free thyroxine (FT_4), thyroid-stimulating hormone TSH), and neuropsychological assessment of their offspring at 6 months of age, and compared the results of the assessment. Results TSH levels in the neonatal observation group were significantly higher than those in the control group, and serum levels of FT 4 and FT 3 were significantly lower than those in the control group (P <0.05). There were no significant differences in TSH, FT 4 and FT 3 between the two groups at 12, 24 and 36 months (P> 0.05). The comprehensive developmental quotient of offspring of observation group was lower than that of control group (P <0.05). The single developmental trader of large movement and fine movement was lower than that of control group. The difference was statistically significant (P <0.05). Conclusion trimester of pregnancy pregnant women with subclinical hypothyroidism affect neuropsychological development in offspring, suggesting that pregnant women should be in the early second trimester subclinical hypothyroidism screening, and given aggressive treatment, prenatal and postnatal care will play an important role.