甲状腺功能减退与妊娠期高血压疾病关系探讨

发布时间：2018-07-06 10:20

本文选题：甲状腺功能减退 + 治疗　；参考：《吉林大学》2014年硕士论文

【摘要】：目的：研究甲状腺功能减退与妊娠期高血压疾病之间的关系，比较分析应用甲状腺素治疗后妊娠期高血压疾病的进展、愈后及妊娠结局的分析。方法：回顾性分析2012年1月—2013年12月在我院产科分娩的甲状腺功能减退伴妊娠期高血压疾病（包括亚临床甲状腺功能减退）患者118例病例资料。针对甲状腺功能减退用药的治疗情况（甲状腺素）分为治疗组和非治疗组，并随机抽取在此期间患妊娠期高血压疾病（不伴有甲状腺功能减退）的患者80例做为对照组。结果：⑴流产情况。非治疗组的平均流产次数显著高于对照组，差异有统计学意义（P0.05）；非治疗组的平均流产次数高于治疗组，差异具有统计学意义（P0.05）；治疗组的平均流产次数略高于对照组，差异不具有统计学意义（P0.05）。⑵终止妊娠时间：治疗组的平均终止妊娠周数显著晚于非治疗组，差异具有统计学意义（P0.05）。治疗组终止妊娠时间略晚于对照组。差异无统计学意义（P0.05）。非治疗组的终止妊娠时间早于对照组，差异有统计学意义（P0.05）。⑶治疗组的平均新生儿体重显著高于非治疗组，差异有统计学意义（P0.05）；非治疗组的平均新生儿体略低于对照组，差异无统计学意义（P0.05）；治疗组的平均新生儿体重略略高于对照组，差异无统计学意义（P0.05）。⑷非治疗组患者（血压》160/100mmHg尿蛋白：3+）既重度子痫前期患者比例显著高于治疗组，差异有统计学意义（P0.05）；非治疗组患者（血压》160/100mmHg尿蛋白：3+）既重度子痫前期患者比例显著高于对照组，，差异有统计学意义（P0.05）；治疗组重度子痫前期患者比例与对照组无显著差异，差异无统计学意义（P0.05）。⑸新生儿体重：非治疗组体重略低于治疗组，差异有统计学意义（P0.05）；治疗组新生儿体重与对照组新生儿体重无明显区别，差异无统计学意义（P0.05）。统计中发现妊娠期高血压疾病伴甲状腺功能减退患者的年龄在25岁年龄≤35岁的人数较多，平均年龄30岁。结论：1、妊娠期甲状腺功能减退症可诱发一系列的产前、产时和产后并发症，导致不良的妊娠结局。2、妊娠期甲状腺功能减退症流产次数增多。3、妊娠期高血压疾病的发生率增高：高血压的严重程度与甲减的严重程度相关。妊娠期甲状腺功能减退症者患妊娠期高血压疾病的发生率增高，提示妊娠期甲状腺功能的异常是诱发妊娠期高血压疾病的危险因素之一。4、患有妊娠期甲状腺功能减退伴妊娠期高血压疾病的妇女，其妊娠期高血压的发病时间、症状严重程度、终止妊娠的周数与及时、有效的补充甲状腺素有关，积极纠正甲状腺功能减退，可减轻妊娠期高血压疾病的症状、适当延长孕周，提高新生儿存活率。5、提高人们对妊娠期甲状腺功能普查的意识，积极做到尽早发现、及时治疗。
[Abstract]:Aim: to study the relationship between hypothyroidism and hypertensive disorder complicating pregnancy, and to compare and analyze the progress, recovery and outcome of hypertensive disorder complicating pregnancy after thyroxine therapy. Methods: the data of 118 cases of hypothyroidism and hypertensive disorder complicating pregnancy (including subclinical hypothyroidism) delivered in our hospital from January 2012 to December 2013 were retrospectively analyzed. According to the treatment of hypothyroidism (thyroxine), the patients were divided into treatment group and non-treatment group, and 80 patients with hypertensive disorder complicating pregnancy (without hypothyroidism) were randomly selected as control group. The result was: 1 abortion. The average number of abortions in the non-treatment group was significantly higher than that in the control group, the difference was statistically significant (P0.05); the average number of abortions in the non-treatment group was higher than that in the treatment group (P0.05); the average number of abortions in the treatment group was slightly higher than that in the control group (P0.05). The difference was not statistically significant (P0.05) .2 termination of pregnancy: the average number of weeks of termination of pregnancy in the treatment group was significantly later than that in the non-treatment group, the difference was statistically significant (P0.05). The termination of pregnancy in the treatment group was slightly later than that in the control group. The difference was not statistically significant (P0.05). The termination time of pregnancy in the non-treatment group was earlier than that in the control group, the difference was statistically significant (P0.05). 3. The average neonatal weight in the treatment group was significantly higher than that in the non-treatment group (P0.05), and the average neonatal body mass in the non-treatment group was slightly lower than that in the control group (P0.05). The average neonatal weight in the treatment group was slightly higher than that in the control group (P0.05). The proportion of severe preeclampsia patients in the non-treatment group (blood pressure > 160 / 100 mmHg urine protein: 3) was significantly higher than that in the treatment group. The proportion of patients with severe preeclampsia in non-treatment group (blood pressure > 160 / 100mmHg urine protein: 3) was significantly higher than that in control group (P0.05). The proportion of patients with severe preeclampsia in the treatment group and the control group had no significant difference (P0.05). 5. Neonatal weight: the weight of the non-treatment group was slightly lower than that of the treatment group (P0.05). There was no significant difference in neonatal weight between the treatment group and the control group (P0.05). It was found that the age of hypertensive disorder complicating pregnancy with hypothyroidism was more than 25 years old and less than 35 years old, with an average age of 30 years. Conclusion gestational hypothyroidism can induce a series of complications before, during and after delivery. The incidence of hypertension complicating pregnancy was increased. The severity of hypertension was related to the severity of hypothyroidism. The incidence of hypertensive disorder complicating pregnancy was increased in patients with hypothyroidism during pregnancy. It is suggested that abnormal thyroid function during pregnancy is one of the risk factors to induce hypertensive disorder complicating pregnancy. The onset time and severity of symptoms of hypertensive disorder complicating pregnancy in women with hypothyroidism complicating pregnancy and hypertensive disorder complicating pregnancy. The number of weeks of termination of pregnancy is related to the timely and effective supplement of thyroxine and the positive correction of hypothyroidism, which can alleviate the symptoms of hypertensive disorder complicating pregnancy and extend the gestational week appropriately. Improve neonatal survival rate. 5. Improve people's awareness of gestational thyroid function survey, actively achieve early detection and timely treatment.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R581.2;R714.246

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