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目的探讨亚临床甲状腺功能减退症(亚甲减)与自然流产史的相关性及治疗亚甲减对降低自然流产率的作用。方法 2011年1月—2012年12月在浙江省绍兴市妇幼保健院生殖中心就诊的210例早孕期妇女作为研究对象,其中复发性流产史患者50例作为A组,有1次自然流产史患者80例为B组,无自然流产史患者80例为C组。用电化学发光法检测促甲状腺素(TSH)、游离甲状腺素(FT4)。用左旋甲状腺素片(优甲乐)进行治疗。结果 A组、B组、C组患者的年龄分别为(28.5±4.7)岁、(27.9±3.9)岁和(29.2±4.1)岁,3组年龄均符合正态分布,差异无统计学意义(χ2=2.246,P>0.05)。亚甲减患病率A组为26.00%,B组为18.75%,C组为5.00%。A组和B组亚甲减患病率差异无统计学意义,A组和B组亚甲减患病率均高于C组,差异有统计学意义(Pearsonχ2=11.740,P<0.05)。经过左旋甲状腺素片(优甲乐)治疗后,A组流产率为23.08%,B组13.33%,而C组无1例流产。C组流产率明显低于A组和B组,提示亚甲减与妊娠不良结局具有一定相关性。结论亚甲减与自然流产有明显相关性,但亚甲减经过左旋甲状腺素治疗后可降低再次流产的发生率。
Objective To investigate the relationship between subclinical hypothyroidism (methylene hypothyroidism) and spontaneous abortion history and the effect of treatment of methylenecretin on the reduction of spontaneous abortion rate. Methods From January 2011 to December 2012, 210 early pregnant women treated in Reproductive Center of MCH Hospital of Shaoxing City, Zhejiang Province were enrolled in this study. Among them, 50 patients with recurrent spontaneous abortion were treated as group A and 1 patient with spontaneous abortion 80 cases of group B, 80 cases of spontaneous abortion in patients with C group. The thyroxine (TSH) and free thyroxine (FT4) were detected by electrochemiluminescence. With levothyroxine tablets (Euthyrox) treatment. Results The age of group A, group B and group C were (28.5 ± 4.7) years, (27.9 ± 3.9) and (29.2 ± 4.1) years, respectively. All the three groups were in normal distribution with no significant difference χ2 = 2.246, P> 0.05). The prevalence of hypothyroidism was 26.00% in group A, 18.75% in group B and 5.00% in group C, respectively. There was no significant difference in the prevalence of methylene blue in group A and group B, and the prevalence of methylene blue in group A and group B was higher than that in group C (Pearsonχ2 = 11.740, P <0.05). After levothyroxine tablets (Euthyrox) treatment, abortion rate was 23.08% in group A, 13.33% in group B, while none in group C was aborted. Abortion rate in group C was significantly lower than that in group A and group B, suggesting that there was a certain correlation between methylenecretin reduction and poor outcome in pregnancy. Conclusion Methylene hypothyroidism is significantly associated with spontaneous abortion, but methylenetetrazole after levothyroxine treatment can reduce the incidence of recurrent miscarriage.