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目的探讨妊娠合并甲状腺功能减退症(甲减)的临床特征、伴随其他妊娠合并症及糖脂代谢情况。方法以2013年1月至3月在产科门诊定期产前检查的767例孕妇为研究对象,筛查出妊娠合并甲减孕妇209例(观察组),以同期200例甲状腺功能正常孕妇为对照(对照组),比较观察甲减孕妇的妊娠合并症发病情况及血糖、血脂水平。结果 767例孕妇中有209例妊娠合并各类甲减,发病率27.25%,其中162例(77.51%)存在各类既往病史及产科并发症。与对照组相比,妊娠合并甲减患者的其他妊娠并发症比率明显增高(P均<0.05);甲减孕妇的空腹血糖和餐后1、2h血糖均显著增高(P均<0.05),且空腹血糖与TSH有相关性(r=0.39,P<0.05);甲减孕妇的血清总胆固醇、低密度脂蛋白胆固醇含量显著增高(P均<0.05),甘油三酯、高密度脂蛋白胆固醇含量与甲状腺功能正常孕妇比较差异无统计学意义(P均>0.05)。结论妊娠合并甲减的发生率较高,且并发其他妊娠合并症的概率高,常伴有糖脂代谢异常,应引起重视。
Objective To investigate the clinical features of pregnancy complicated with hypothyroidism (hypothyroidism), with other complications of pregnancy and glucose and lipid metabolism. Methods A total of 767 pregnant women with regular prenatal examination in obstetrics and gynecology clinic from January to March in 2013 were screened for 209 cases of pregnant women with hypothyroidism (observation group). 200 pregnant women with normal thyroid function as controls Control group). The incidences of pregnancy complications and the blood glucose and blood lipid levels of hypothyroidism pregnant women were compared. Results Among the 767 pregnant women, 209 cases were pregnant with various types of hypothyroidism, the incidence rate was 27.25%. Among them, 162 cases (77.51%) had all kinds of past medical history and obstetric complications. Compared with the control group, the rates of other complications of pregnancy were significantly increased in pregnant women with hypothyroidism (all P <0.05). The fasting blood glucose and 1,2 and postprandial 1,2 and postprandial blood glucose in pregnant women with hypothyroidism were significantly increased (P <0.05) The levels of serum total cholesterol and low density lipoprotein cholesterol in pregnant women with hypothyroidism were significantly increased (all P <0.05), triglyceride and high density lipoprotein cholesterol Compared with normal thyroid function pregnant women, there was no significant difference (all P> 0.05). Conclusion The incidence of hypothyroidism in pregnancy is high, and the probability of complicated other pregnancy complications is high. It is often associated with abnormal glucose and lipid metabolism, which should be paid more attention to.