【摘要】 目的探讨妊娠合并甲状腺机能亢进患者的围产期发病率,药物治疗剂量及规范治疗后的母婴结局。方法收集我院1995年1月～2007年12月的妊娠合并甲亢患者的临床资料255例,分为控制组153例,未控制组102例,选择同期正常妊娠315例作为对照组,控制组均在我院产科高危门诊定期产前保健,每1～1.5月监测FT4,FT3,调整抗甲状腺药物(ATD)的剂量。对妊娠合并甲亢的发生率,控制组的抗甲状腺药物剂量以及3组母儿结局进行回顾性分析。结果(1)发病率:我院近13年来妊娠合并甲亢的发病率0.26%,呈逐年上升的趋势(0.17%～0.32%)。(2)抗甲状腺药物剂量(ATD):控制组(116例)ATD的平均剂量孕前、孕早期、孕中晚期分别为:126.27±109.92,174.58±121.42,125.21±110.77,孕前与孕早期比较,差异有统计学意义(P<0.05=;孕早期与孕中、晚期比较,差异有统计学意义(P<0.05);孕前与孕中、晚期比较,差异无统计学意义(P>0.05)。(3)母婴结局:未控制组的子痫前期、早产、胎儿生长不良、胎儿窘迫发生率与控制组比较,差异有统计学意义,控制组与正常妊娠比较,差异无统计学意义。结论妊娠合并甲亢的发病率逐年升高,孕期需及时调整抗甲状腺药物治疗量,规律治疗能明显改善母儿结局。更多还原

【Abstract】 Objective:To evaluate the perinatal morbidity of maternal hyperthyroidism during pregnancy,maternal and fetal outcome with antithyroid drug(ATD)and its therapeutic dose.Methods:255 pregnancies with maternal hyperthyroidism were evaluated retrospectively from Jan 1995 to December2008 in The third affiliated hospital of wenzhou medical college were divided into two groups:ATD treatment group(153 cases)and without ATD treatment group(102 cases),while 315 pregnancies without maternal hyperthyroidism were collected as control group.Study group were advice to antenatal care for monitoring FT3/FT4 and the adjustment of ATD in High-risk obstetric out-patient clinic every 1~1.5 months.The perinatal morbidity of maternal hyperthyroidism during pregnancy,maternal and fetal outcome with antithyroid drug(ATD)and its therapeutic dose in ATD treatment group were evaluated retrospectively.Results:1.The average perinatal morbidity of maternal hyperthyroidism during pregnancy was 0.26% in the past 13years,Showing a rising trend(from 0.17% to 0.32%).2.Dose of antithyroid drug(ATD):The average dose of Pre-pregnancy,early pregnancy,second and third trimesters are as follows:126.27±109.92,174.58±121.42,125.21±110.77,Pre-pregnancy were lower than early pregnancy(P<0.05);early pregnancy were higher than second and third trimesters(P<0.05);Pre-pregnancy were not difference with second and third trimesters(P>0.05).3.Maternal and fetal outcome:the incidence of Pre-eclampsia,prematurity,fetal growth and adverse,fetal distress in without ATD treatment group were significant differences with ATD treatment group.ATD treatment group were no significant differences with control group.Conclusion:The incidence of pregnancy with maternal hyperthyroidism were increased in the past 13years;pregnancy with maternal hyperthyroidism should be advice to antithyroid drug treatment and timely adjustment;the maternal and fetal outcome were significantly improved by regular treatment.更多还原