CAJ | 학술논문

目的：对育龄期女性格雷夫斯甲状腺功能亢进(Graves甲亢)进行131I治疗后妊娠以及新生儿生长发育情况进行随访与分析，探讨131I治疗对其生育及新生儿生长发育的影响。方法：回顾性分析2008年1月至2011年1月在我院因患Graves甲亢，并于维持治疗期间成功妊娠并分娩者85例。按不同治疗方法将患者分为131I治疗组(49例)和非131I治疗组(36例)，记录其治疗后3、6个月、1年、妊娠全程的甲状腺功能及新生儿出生情况。采用SPSS19.0软件分析数据，计量数据以x±s表示，采用字2检验、Fisher确切概率法、两独立样本T检验对比分析两组病例的生育情况。结果：85例患者中有83例正常分娩。131I治疗组和非131I治疗组比较，治疗后怀孕时间(6个月内/6个月后分别为：7/42，4/32，P>0.05)、生育状况(正常分娩/流产分别为：49/0，34/2，P>0.05)、足月情况(足月/早产分别为：47/2，33/3，P>0.05)，婴儿性别(男性/女性分别为：32/17，23/13，P>0.05)、体质量[(3.22±0.31)kg和(3.27±1.87)kg，t=0.185，P>0.05]，差异均无统计学意义。两组新生儿筛查时足跟血、TSH均正常，婴幼儿在生长发育方面与对应各期的婴幼儿无明显区别。结论：育龄期女性Graves甲亢131I治疗的安全性好，不会影响生育能力，也不会导致遗传损害；在妊娠期间需要定期复查甲状腺功能，维持甲状腺功能正常，就可以达到优生优育的目的。
목적：대육령기녀성격뢰부사갑상선공능항진(Graves갑항)진행131I치료후임신이급신생인생장발육정황진행수방여분석，탐토131I치료대기생육급신생인생장발육적영향。방법：회고성분석2008년1월지2011년1월재아원인환Graves갑항，병우유지치료기간성공임신병분면자85례。안불동치료방법장환자분위131I치료조(49례)화비131I치료조(36례)，기록기치료후3、6개월、1년、임신전정적갑상선공능급신생인출생정황。채용SPSS19.0연건분석수거，계량수거이x±s표시，채용자2검험、Fisher학절개솔법、량독립양본T검험대비분석량조병례적생육정황。결과：85례환자중유83례정상분면。131I치료조화비131I치료조비교，치료후부잉시간(6개월내/6개월후분별위：7/42，4/32，P>0.05)、생육상황(정상분면/유산분별위：49/0，34/2，P>0.05)、족월정황(족월/조산분별위：47/2，33/3，P>0.05)，영인성별(남성/녀성분별위：32/17，23/13，P>0.05)、체질량[(3.22±0.31)kg화(3.27±1.87)kg，t=0.185，P>0.05]，차이균무통계학의의。량조신생인사사시족근혈、TSH균정상，영유인재생장발육방면여대응각기적영유인무명현구별。결론：육령기녀성Graves갑항131I치료적안전성호，불회영향생육능력，야불회도치유전손해；재임신기간수요정기복사갑상선공능，유지갑상선공능정상，취가이체도우생우육적목적。
Objectives: Through follow-up analysis of the pregnancy of women in childbearing age with Graves'hyperthyroidism and their babies'neonatal growth and development after they had accepted 131I treatment, we aim to explore the impact of 131I treatment on their pregnancy and neonatal growth and development of their babies. Methods: 85 female cases of Graves'hyperthyroidism who accepted treatment in Luzhou Medical College Affiliated Hospital from 2008 to 2010,then conceived and delivered successfully during maintenance therapy are retrospectively analyzed by us. The subjects were divided into 131I treatment group (n =49) and non-131I treatment group (n=36). The thyroid functions throughout pregnancy and neonatal conditions of their babies are recorded 3 months, 6 months and 1 year later after they have accepted treatment. SPSS19.0 software is used to analyze data and data measurement is indicated with x±s. Pregnancy and Childbirth between the 2 group were compared by X 2 test、Fisher exact test and two-sample t test. Results: 85 cases of women who all had successful pregnancies are patients of Graves'hyperthyroidism before pregnancy. 83 cases of normal delivery. Comparison of the 131I treatment group and 131I treatment group:after the treatment of gestation time(within 6 months/after 6 months7/42 vs 4/32, P>0.05), fertility status(normal delivery /abortion49/0 vs 34/2, P> 0.05),full-term status(full-term/preterm birth47/2 vs 33/3, P>0.05),Gender composition(male/female32/17 vs 23/13, P>0.05),body weight ((3.22 ± 0.31) kg vs (3.27 ± 1.87) kg, t = 0.185, P> 0.05)), there were no significant differences. The blood of heel and TSH examined in neonatal screening are normal. What's more, the situation of their babies' growth and development have no significant differences compared with those of infants in corresponding period. Conclusion:For female patients in childbearing age with Graves'hyperthyroidism, the 131I treatment is of great safety, of less bad impact on reproductive ability and of no genetic damage caused. However, during pregnancy, they need for regular reexaminations of thyroid function to make sure it normal so that we can achieve the purpose of better prenatal and postnatal care.