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目的探讨佛山地区妊娠中、晚期妇女甲状腺疾病的特点。方法选择佛山地区妊娠中期(孕16~24周)孕妇222例为中孕组,妊娠晚期(孕37~41+6周)孕妇113例为晚孕组,另选择同期在本院进行健康体检的非妊娠育龄妇女为非孕妇组,共204例,应用电化学发光免疫检测技术检测血中游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及促甲状腺激素(TSH)的值。按如下标准确定诊断:TSH(0.34mIU/ml,FT3和/或FT4升高者,诊断为甲状腺功能亢进(甲亢);TSH(0.34mIU/ml,FT3和FT4正常者诊断为亚临床甲亢;TSH(4.8mIU/ml,FT3和/或FT4降低者诊断为甲状腺功能减退(甲减),TSH(4.8mIU/ml,FT3和FT4正常者诊断为亚临床甲减。结果①比较甲状腺疾病患病率,中孕组与非孕妇组比较,P(0.05,差异无统计学意义,晚孕组分别与中孕组及非孕妇组比较,P<0.05,差异有统计学意义,晚孕组的甲状腺疾病患病率明显高于中孕组及非孕妇组。②比较甲状腺疾病的类型,各组的甲状腺疾病类型不同,组内甲亢(含亚临床甲亢)与甲减(含亚临床甲减)的患病率比较,在非孕妇组中,P(0.05,差异无统计学意义;中孕组中,P<0.05,差异有统计学意义,甲亢患病率明显高于甲减;晚孕组中,P<0.05,差异有统计学意义,甲亢患病率明显高于甲减。③组间比较甲亢与甲减患病率,中孕组与晚孕组比较,P(0.05,差异无统计学意义;中孕组与非孕妇组比较,P(0.05,差异无统计学意义;晚孕组与非孕妇组比较甲亢患病率,P<0.05,差异有统计学意义,晚孕组甲亢的患病率明显高于非孕妇组,比较甲减患病率,P(0.05,差异无统计学意义。结论沿海城市孕中晚期妇女甲状腺疾病的类型以甲亢为主,建议通过孕中期开始定期检测甲状腺功能,及时发现和治疗甲状腺功能异常,从而减少对母胎的危害。
Objective To investigate the characteristics of thyroid disease in women in middle and late pregnancy in Foshan. Methods Totally 222 pregnant women in the second trimester of gestation (from 16 to 24 weeks gestation) in Foshan were enrolled in the study. One hundred and seventy pregnant women of the third trimester of pregnancy (37-41 + 6 weeks gestation) were in the second trimester pregnancy group. Non-pregnant women of childbearing age were non-pregnant women, with a total of 204 cases. The levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) in blood were detected by electrochemiluminescence immunoassay. Diagnoses were confirmed as follows: TSH (hyperthyroidism diagnosed as elevated TSH (0.34 mIU / ml, FT3 and / or FT4, TSH (0.34 mIU / ml, normal FT3 and FT4 diagnosed as subclinical hyperthyroidism; TSH (4.8mIU / ml, FT3 and / or FT4 decreased hypothyroidism (hypothyroidism, TSH (4.8mIU / ml, FT3 and FT4 normal sub-clinical hypothyroidism were diagnosed.Results ① The prevalence of thyroid disease , P <0.05), P <0.05, the difference was statistically significant (P <0.05), and the difference was statistically significant (P <0.05) between the pregnant group and the non-pregnant group The prevalence was significantly higher than that of the second trimester group and the non-pregnant women group.②To compare the types of thyroid disease, the types of thyroid disease in each group were different, hyperthyroidism (including subclinical hyperthyroidism) and hypothyroidism (subclinical hypothyroidism) In the non-pregnant women group, P (0.05, the difference was not statistically significant; in the pregnant group, P <0.05, the difference was statistically significant, the prevalence of hyperthyroidism was significantly higher than hypothyroidism; late pregnancy group, P <0.05, the difference was statistically significant, the prevalence of hyperthyroidism was significantly higher than that of hypothyroidism.③Comparison between hyperthyroidism and hypothyroidism prevalence among the two groups, P (0.05, P <0.05) Statistical significance; The pregnant group and non-pregnant women group, P (0.05, the difference was not statistically significant; late pregnant group compared with non-pregnant women group prevalence of hyperthyroidism, P <0.05, the difference was statistically significant, hyperthyroidism , The prevalence of hypothyroidism was significantly higher than that of non-pregnant women, P (0.05, the difference was not statistically significant.Conclusion The type of thyroid disease in pregnant women in coastal cities in the second trimester of pregnancy is mainly hyperthyroidism, Detection of thyroid function, timely detection and treatment of thyroid dysfunction, thereby reducing the risk of maternal fetal.