CAJ | 학술논문

目的：探讨妊娠期合并亚临床甲状腺功能减退（ SCH）对胎儿宫内发育及妊娠结局的影响。方法以在榆林市第一医院妇产科进行孕期体检确诊为SCH的孕妇96例为研究对象，其中56例接受左旋甲状腺素治疗的孕妇设为观察组，40例未接受治疗的孕妇设为对照组，随机抽取同期孕检的60例健康孕妇设为健康对照组，分别于孕期进行监测，并比较3组孕妇血清促甲状腺激素（TSH）及胎儿双顶径发育情况，比较3组母婴并发症发生情况。结果观察组孕后期TSH低于对照组（t＝0．723，P＜0．05），胎儿双顶径大于对照组（t＝1．673，P＜0．05），妊娠期高血压、妊娠期贫血、胎盘早剥及早产发生率低于对照组（χ2值分别为6．748、6．181、9．412、7．001，均P＜0．05），观察组胎儿宫内窘迫、低出生体质量儿发生率低于对照组（χ2值分别为2．551、5．325，均P＜0．05）。观察组妊娠期高血压、妊娠期贫血、胎盘早剥及早产发生率与健康对照组比较各项指标差异均无统计学意义（χ2值分别为0．139、0．254、0．102、0．002，均P＞0．05）。对照组孕后期TSH高于健康对照组（t＝0．851，P＜0．05），胎儿双顶径低于健康对照组（t＝1．355，P＜0．05）；胎儿宫内窘迫、低出生体质量儿发生率均高于健康对照组（χ2值分别为2．927、4．166，均P＜0．05）。结论 SCH可影响胎儿宫内发育，易引发母婴并发症的发生，早期进行左旋甲状腺素治疗可改善胎儿宫内发育，降低母婴并发症的发生，改善妊娠结局。
목적：탐토임신기합병아림상갑상선공능감퇴（ SCH）대태인궁내발육급임신결국적영향。방법이재유림시제일의원부산과진행잉기체검학진위SCH적잉부96례위연구대상，기중56례접수좌선갑상선소치료적잉부설위관찰조，40례미접수치료적잉부설위대조조，수궤추취동기잉검적60례건강잉부설위건강대조조，분별우잉기진행감측，병비교3조잉부혈청촉갑상선격소（TSH）급태인쌍정경발육정황，비교3조모영병발증발생정황。결과관찰조잉후기TSH저우대조조（t＝0．723，P＜0．05），태인쌍정경대우대조조（t＝1．673，P＜0．05），임신기고혈압、임신기빈혈、태반조박급조산발생솔저우대조조（χ2치분별위6．748、6．181、9．412、7．001，균P＜0．05），관찰조태인궁내군박、저출생체질량인발생솔저우대조조（χ2치분별위2．551、5．325，균P＜0．05）。관찰조임신기고혈압、임신기빈혈、태반조박급조산발생솔여건강대조조비교각항지표차이균무통계학의의（χ2치분별위0．139、0．254、0．102、0．002，균P＞0．05）。대조조잉후기TSH고우건강대조조（t＝0．851，P＜0．05），태인쌍정경저우건강대조조（t＝1．355，P＜0．05）；태인궁내군박、저출생체질량인발생솔균고우건강대조조（χ2치분별위2．927、4．166，균P＜0．05）。결론 SCH가영향태인궁내발육，역인발모영병발증적발생，조기진행좌선갑상선소치료가개선태인궁내발육，강저모영병발증적발생，개선임신결국。
Objective To study the effect of subclinical hypothyroidism (SCH) on fetal growth and pregnancy outcomes .Methods The study cases were 96 pregnant women who were diagnosed with SCH in the obstetrics and gynecology department of the First Hospital of Yulin City during pregnancy examination .Among those study cases , observation group included 56 patients receiving levothyroxine treatment, and the other untreated 40 cases were included in control group .Sixty cases of healthy pregnant women receiving pregnancy examination at the same period were randomly selected as healthy control group .During pregnancy three groups were monitored , and maternal serum thyroid stimulating hormone ( TSH) and fetal biparietal diameter growth condition as well as maternal and fetal complications were compared among three groups .Results The concentration of TSH in the observation group was lower than that in the control group ( t=0.723, P<0.05) at late pregnancy, and fetal biparietal diameter was greater than the control group (t=1.673,P<0.05).The incidence rate of gestational hypertension , anemia in pregnancy , placental abruption and premature birth was lower in the observation group than the control group (χ2 value was 6.748, 6.181, 9.412 and 7.001, respectively, all P<0.05).In the observation group, the incidence rate of fetal distress in uterus and low birth weight infants was lower (χ2 value was 2.551 and 5.325, respectively, both P<0.05).There was no significant difference in the incidence rate of gestational hypertension , anemia in pregnancy , placental abruption and premature birth between the observation group and the healthy control group (χ2 value was 0.139, 0.254, 0.102 and 0.002, respectively, all P>0.05). Compared with the healthy control group , the concentration of TSH at late pregnancy was higher ( t=0.851,P<0.05) and fetal biparietal diameter was smaller (t=1.355,P<0.05) in the control group.The incidence rate of fetal distress in uterus and low birth weight infants was higher in control group than in healthy control group (χ2 value was 2.927 and 4.166, respectively, both P<0.05).Conclusion SCH during pregnancy may affect fetal growth and easily cause maternal and fetal complications .Early levothyroxine therapy can improve fetal growth, reduce the incidence of maternal and fetal complications and improve pregnancy outcomes .