妊娠合并甲状腺功能亢进症孕妇糖脂代谢检测及妊娠结局分析

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[摘要] 目的 檢测妊娠合并甲状腺功能亢进症孕妇糖脂代谢，分析妊娠结局。方法 方便选择2015年1月—2016年3月医院妇产科收治的妊娠合并甲状腺功能亢进症孕妇32例设为观察组，按照1：1入选原则选取同期医院产检的无甲状腺功能异常的健康妊娠早期产妇作为对照组，取两组体检当天空腹静脉血，采用日立7600-020全自动生化分析仪检测空腹血糖（GLU）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（HDL-C）。随访至妊娠，观察两组出现的妊娠期并发症发生情况和围生儿结局。 结果 观察组GLU（5.01±0.64）mmol/L大于对照组（P<0.05），观察组TC（4.08±0.55）mmol/L、TG（1.28±0.23）mmol/L、HDL-C（1.77±0.48）mmol/L均小于对照组，差异有统计学意义（P<0.05），观察组LDL-C小于对照组，但差异无统计学意义（P>0.05）。观察组妊娠期糖尿病（34.38%）、早产发生率（18.75%）高于对照组，差异有统计学意义（P<0.05）；观察组妊娠期高血压疾病、新生儿窒息发生率高于对照组，新生儿体重低于对照组，差异无统计学意义（P>0.05）。结论 妊娠合并甲状腺功能亢进症孕妇存在糖脂代谢异常，且不良妊娠结局发生风险增大。

[关键词] 妊娠合并甲状腺功能亢进症；糖脂代谢；妊娠结局

[中图分类号] R714 [文献标识码] A [文章编号] 1674-0742（2017）05（b）-0034-03

[Abstract] Objective To analyze the glycolipid metabolism test and pregnant outcome of delivery women with pregnancy and hyperthyroidism. Methods Convenient selection 32 cases of delivery women with pregnancy and hyperthyroidism admitted and treated in our hospital from January 2015 to March 2016 were selected as the observation group and 32 cases of healthy early delivery women without thyroid dysfunction at the same period were selected as the control group， and the fasting venous blood on the day of the two groups was extracted and the GLU， TC， TG， HDL-C and HDL-C were tested by the Hitachi 7600-020 automatic biochemical analyzer， and the occurrence of complications during the pregnancy period and perinatal infant outcome of the two groups were observed. Results The GLU in the observation group was （5.01±0.64）mmol/L， which was bigger than that in the control group（P<0.05）， and the TC， TG and HDL-C in the observation group were respectively （4.08±0.55）mmol/L，（1.28±0.23）mmol/L and（1.77±0.48）mmol/L， which were fewer than those in the control group， and the differences between groups were statistically significant（P<0.05， and the LDL-C in the observation group was lower than that in the control group， and the difference was not statistically significant（P>0.05）， and the incidence rate of gestational diabetes and premature labor in the observation group was respectively 34.38% and 18.75%， which were higher than those in the control group， and the difference was statistically significant（P<0.05）， and the incidence rate of gestational hypertension and asphyxia neonatorum in the observation group was higher than that in the control group， and the weight of newborns was lower than that in the control group， but the difference was not statistically significant（P>0.05）. Conclusion The delivery women with pregnancy and hyperthyroidis have the lipid metabolism disorders， and the occurrence risk of adverse pregnant outcome increases.

[Key words] Pregnancy and hyperthyroidis； Lipid metabolism； Pregnant outcome

妊娠合并甲状腺功能亢进症是妊娠期间出现的甲状腺功能亢进症，是常见的妊娠期甲状腺疾病和产科代谢性疾病[1]。妊娠合并甲状腺功能亢进症具有较高的发病率，甲状腺素对胎儿生长发育具有至关重要的作用，因此妊娠期甲状腺素分泌和代谢异常会对胎儿生长发育造成影响，引起妊娠不良结局的发生[2]。研究认为[3]，甲状腺素能影响物质代谢，因此妊娠合并甲状腺功能亢进症孕妇可能还存在代谢异常。为此，该研究检测了2015年1月—2016年3月医院妇产科收治的32例妊娠合并甲状腺功能亢进症孕妇糖脂代谢，并分析了妊娠结局，现报道如下。……