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目的探析妊娠早期甲状腺功能异常对妊娠糖尿病的影响。方法随机选择本院2013年1月-2015年12月接收的3 408例12孕周妇女,通过化学发光法检测甲状腺功能,并于24周进行75 g糖耐量检测。按照甲状腺功能异常及治疗情况分组,将甲状腺功能正常的2 571例作为正常组,将临床甲状腺功能减退(简称“甲减”)治疗组、亚临床甲减治疗组、亚临床甲减未治疗组、单纯低FT4血症与甲亢组837例孕妇作为异常组,分析甲状腺功能异常与妊娠糖尿病的关系。结果亚临床甲减未治疗组、单纯低FT4血症组与甲亢组妊娠妇女发生妊娠糖尿病明显高于正常组,差异有统计学意义(P<0.05),而亚临床甲减治疗组、临床甲减治疗组与正常组比较,差异无统计学意义(P>0.05)。结论妊娠早期甲状腺功能异常、单纯低FT4血症、甲亢要尽早治疗,以减少对妊娠糖尿病的影响及不良妊娠结局的发生。
Objective To investigate the effect of abnormal thyroid function during pregnancy on gestational diabetes mellitus. Methods A total of 3 408 12-week-old pregnant women received from January 2013 to December 2015 in our hospital were randomly selected to detect thyroid function by chemiluminescence assay and 75 g glucose tolerance test at 24 weeks. According to the thyroid function abnormalities and treatment groups, 2571 patients with normal thyroid function as the normal group, the clinical hypothyroidism (“hypothyroidism”) treatment group, subclinical hypothyroidism treatment group, subclinical hypothyroidism Treatment group, simple low FT4 hyperlipidemia and hyperthyroidism group of 837 pregnant women as an abnormal group, analysis of thyroid dysfunction and gestational diabetes mellitus. Results Compared with the normal group, gestational diabetes mellitus was significantly higher in the subclinical hypothyroidism untreated group than in the hypothyroidism hypothyroidism group and the hyperthyroidism group (P <0.05). However, in the subclinical hypothyroidism treatment group and the clinical A There was no significant difference between the treatment group and the normal group (P> 0.05). Conclusions In the first trimester of pregnancy, thyroid dysfunction, simple low FT4 hyperlipidemia and hyperthyroidism should be treated as soon as possible to reduce the influence on gestational diabetes and adverse pregnancy outcome.