L-T4对妊娠期亚临床甲状腺功能减退妇女后代神经智力发育的影响研究

摘要

目的：研究妊娠期亚临床甲状腺功能减退（SCH）妇女采用左旋甲状腺素（L-T4）干预后对后代神经智力发育的影响作用。方法：收集我院2009年3月至2013年3月86例确诊为妊娠期SCH的妇女作为研究对象，其中愿意接受治疗的有52例（治疗组， L-T4替代治疗）、不愿意接受治疗的有34例（非治疗组）、甲状腺功能检查正常孕妇64例（正常组），分别检测治疗组干预治疗后的甲状腺功能指标与正常组、非治疗组的差异，并对比三组子代在半岁、1岁时的智力发育及神经心理发育情况差异。结果：治疗组治疗后的血清TSH、FT4、TPOAb（%）、TgAb（%）检测值与正常组、非治疗组比较差异均具有统计学意义（P＜0.05），治疗组治疗后的血清TSH显著的降低、FT4、TPOAb（%）、TgAb（%）显著的提高较治疗前（P＜0.05）。在子代发育至6个月、12个月时治疗组、正常组的GMQ、LQ测定分数显著的高于非治疗组（P＜0.05），治疗组和正常组的GMQ、LQ、ABQ、ISBQ、FMQ测定分数差异无统计学意义（P＞0.005）。结论：妊娠期SCH妇女采用L-T4干预有利于甲状腺功能恢复，同时对于促进子代智力发育具有积极作用。%Objective: To study the effect of (L-T4) on the development of neural intelligence in the offspring of pregnant women with subclinical hypothyroidism (SCH).Methods:Collected in our hospital from March 2009 to March 2013 86 cases diagnosed as gestational SCH women as research subjects, which are willing to accept treatment, 52 patients (treatment group, L-T4 replacement therapy), are unwilling to accept treatment 34 cases (non-treatment group), thyroid function tests normal pregnant women, 64 cases (control group), group differences were detected indicators of normal thyroid function and non-intervention in the treatment group treatment group after treatment and compared three groups of offspring in six months, mental development and neuropsychological development of the situation 1 year of age difference.Results:The treatment group after treatment serum TSH, FT4, TPOAb (%), TgAb (%) detected value with the normal group, the non-treatment group differences were statistically significant (P<0.05), serum TSH treatment group, significant front lower, FT4, TPOAb (%), TgAb (%) significantly improved compared with before treatment (P<0.05). In the development of offspring to 6 months, 12 months, the treatment group, GMQ normal group was significantly higher than the LQ scores GMQ determination of non-treatment group (P<0.05), the treatment group and the normal group, LQ, ABQ, ISBQ, FMQ measurement scores showed no significant difference (P>0.05).Conclusion:SCH pregnant women using L-T4 thyroid function recovery in favor of the intervention, while promoting the intellectual development of the offspring have a positive effect.