妊娠期糖尿病患者甲状腺功能减退情况及对妊娠结局的影响研究

摘要

目的 探讨妊娠期糖尿病患者甲状腺功能减退情况及对妊娠结局的影响. 方法 首先根据75g糖耐量试验将入选的464例妊娠中期孕妇分为妊娠期糖尿病组(122例)、正常组(342例),比较两组产妇甲状腺功能. 将同期入院的妊娠晚期妊娠期糖尿病孕妇分为单纯妊娠期糖尿病组(290例)、妊娠期糖尿病合并甲减组(41例),比较两组妊娠结局. 结果 妊娠期糖尿病组中血清FT4水平明显低于正常组,差异有显著统计学意义(P<0.01). TPOAb阳性妊娠中期妇女的血清TSH水平明显高于TPOAb阴性者,差异有显著统计学意义(P<0.01).妊娠期糖尿病组低甲状腺素血症率明显高于正常组,差异有统计学意义(P<0.05);妊娠期糖尿病组总甲状腺功能减退率明显高于正常组,差异有统计学意义(P<0.05). 妊娠期糖尿病合并甲减组子痫前期、剖宫产率明显高于单纯妊娠期糖尿病组,差异均有统计学意义(P<0.05).妊娠期糖尿病合并甲减组巨大儿发生率明显高于单纯妊娠期糖尿病组,差异均有统计学意义(P<0.05).结论 妊娠期糖尿病患者出现甲状腺功能减退的风险提升,且合并甲减孕妇不良妊娠结局的发生率增加.%Objective To investigate the effect of hypothyroidism on the outcome of pregnancy in patients with gestational diabetes mellitus. Methods According to 75g glucose tolerance test, 464 cases of pregnant women were divided into gesta-tional diabetes mellitus group (122 cases) and normal group (342 cases), and the thyroid function of the two groups were compared. Will in the same hospital in the same period in late pregnancy pregnancy gestational diabetes pregnant women divided into simple pregnancy (gestational diabetes mellitus group (29 cases), pregnancy with gestational diabetes mellitus (hypothyroidism group (41 cases), compared two groups of pregnancy outcome. Results The levels of serum FT4 in the pa-tients with gestational diabetes were significantly lower than that in the normal group (P<0.01). TPOAb positive pregnant women's serum TSH levels were significantly higher than those in TPOAb negative, the difference was statistically signifi-cant (P<0.01). The rate of hypothyroidism was significantly higher than that in the normal group (P<0.05). The rate of total thyroid dysfunction in the diabetic group was significantly higher than that in the normal group (P<0.05). With gestational diabetes mellitus (hypothyroidism group preeclampsia pregnancy, cesarean section rate was significantly higher than that of simple gestational diabetes mellitus group (P<0.05). Pregnancy period diabetes complicated with hypothyroidism group macrosomia incidence was significantly higher than that of simple gestational diabetes mellitus group (P<0.05). Conclusion Pregnancy gestational diabetes mellitus appeared hypothyroidism risk increased, and the increase in the incidence of ad-verse pregnancy outcomes among the pregnant women with hypothyroidism complicated with.