探讨妊娠晚期妇女甲状腺疾病的患病率、患病特点和甲状腺自身抗体的变化

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目的:观察分析妊娠晚期妇女甲状腺疾病的发病率、患病特点和甲状腺自身抗体的变化情况。方法:选择该院妊娠晚期妇女2 200例为妊娠组和非妊娠妇女428例为对照组进行研究。统计两组妇女甲状腺功能亢进症(甲亢)、甲状腺功能减退症(甲减)的发病情况,测定两组妇女甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、人促甲状腺素(TSH)、血糖及总胆固醇、甘油三酯两种血脂水平。结果:妊娠组妇女甲亢发病率为1.09%,明显低于对照组的3.74%,差异有统计学意义(P<0.05)。而妊娠妇女甲减的发病率为5.86%,明显高于对照组的2.10%,差异有统计学意义(P<0.05)。两组妇女TPOAb、TGAb两种抗体阳性率比较差异无统计学意义(P>0.05)。妊娠组妇女TSH平均值为(1.73±1.0)U/m L低于对照组妇女的(1.86±1.1)U/m L,差异有统计学意义(P<0.05)。妊娠组妇女的平均空腹血糖为(4.44±0.5)mmol/L,明显低于对照组的(4.72±0.7)mmol/L,差异有统计学意义(P<0.05)。妊娠组妇女总胆固醇值和甘油三酯值均明显高于对照组妇女相应值,差异有统计学意义(P<0.05)。结论:妊娠晚期妇女甲状腺疾病的患病率以甲亢减少,甲减增多为主,患者自身甲状腺抗体变化并不明显,但患者的空腹血糖和TSH水平降低,血脂水平明显增高。 OBJECTIVE: To observe and analyze the incidence of thyroid diseases, the prevalence of thyroid diseases and the changes of thyroid autoantibodies in the third trimester of pregnancy. Methods: A total of 2 200 pregnant women in the third trimester of pregnancy were enrolled as pregnant women and 428 non-pregnant women as the control group. Thyroid hypothyroidism (Hypothyroidism) and hypothyroidism (Hypothyroidism) were measured in two groups. The levels of thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), human thyrotropin (TSH), blood glucose and total cholesterol, triglyceride two lipid levels. Results: The incidence of hyperthyroidism in pregnancy group was 1.09%, which was significantly lower than that in control group (3.74%) (P <0.05). The incidence of hypothyroidism in pregnant women was 5.86%, significantly higher than the control group 2.10%, the difference was statistically significant (P <0.05). There was no significant difference in the positive rates of TPOAb and TGAb between the two groups (P> 0.05). The mean TSH in pregnant women was (1.73 ± 1.0) U / m L lower than that in control women (1.86 ± 1.1) U / m L, with significant difference (P <0.05). The average fasting blood glucose of pregnant women was (4.44 ± 0.5) mmol / L, which was significantly lower than that of the control group (4.72 ± 0.7) mmol / L, the difference was statistically significant (P <0.05). The total cholesterol and triglyceride levels in pregnant women were significantly higher than those in the control group, the difference was statistically significant (P <0.05). Conclusions: The prevalence of thyroid disease in late pregnancy is mainly due to the reduction of hyperthyroidism and hypothyroidism. The thyroid antibody changes are not obvious in patients with early pregnancy, but the fasting blood glucose and TSH levels are decreased and the blood lipid levels are significantly increased.
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