目的：探讨妊娠期甲状腺功能减退对妊娠结局的影响及药物干预效果。方法选择180例妊娠期甲状腺功能减退孕妇作为研究对象，其中120例按医嘱接受规范的左甲状腺素钠片补充治疗(甲减治疗组)，60例未系统接受治疗(甲减未治疗组)；按照1：1比例随机选择同期180例健康孕妇作为正常妊娠组。比较三组孕妇母体及围生儿情况的差异。结果母体各种并发症三组之间差异有统计学意义(P<0.05)，甲减未治疗组贫血(15.00%)、胎盘早剥(11.67%)、前置胎盘(13.33%)、先兆流产及流产(15.00%)、早产(13.33%)发生率及产后出血量[(245.89±40.67)mL]高于正常妊娠组[3.33%、1.11%、1.67%、1.67%、1.11%、(169.32±32.34)mL]，差异有统计学意义(P <0.05)；围生儿情况三组之间差异有统计学意义(P<0.05)，甲减未治疗组胎儿窘迫(10.00%)、低体重儿(30.00%)、胎儿生长受限(16.67%)、新生儿患病率(20.00%)高于正常妊娠组(1.11%、5.00%、1.67%、3.33%)，差异有统计学意义(P<0.05)；上述指标甲减治疗组与正常妊娠组比较差异均无统计学意义(均P>0.05)。结论妊娠期甲状腺功能减退对妊娠结局具有不良影响，及时进行替代治疗能够改善预后，提倡妊娠早期常规检查甲状腺功能指标，对有甲减的孕妇使用甲状腺素治疗应贯穿整个妊娠过程。%Objective To discuss the effect of gestational thyroid dysfunction on the outcome of pregnancy and drug in-tervention effect. Methods 180 cases of pregnant women with thyroid dysfunction were selected as research objects. 120 cases were given the normative levothyroxine sodium supplementation treatment (gestational thyroid dysfunction treatment group), 60 cases were not given the systemic treatment (gestational thyroid dysfunction non-treatment group). According to the 1:1 ratio, 180 cases of healthy pregnant women were selected as normal pregnancy group. Maternal and perinatal infant conditions were compared. Results The differences of maternal complications among the three groups had statistically significant (P<0.05). In gestational thyroid dysfunction non-treatment group, the incidence of anemia, placental abruption, placenta previa, threatened abortion and abortion, premature delivery and postpartum hem-orrhage [15.00%, 11.67%, 13.33%, 15.00%, 13.33%, (245.89±40.67) mL] were higher than those of normal pregnancy group [3.33%, 1.11%, 1.67%, 1.67%, 1.11%, (169.32±32.34) mL], the differences were statistically significant (P<0.05). The differences of perinatal infant conditions among the three groups had statistically significant (P< 0.05). In gesta-tional thyroid dysfunction non-treatment group, the incidence of fetal distress (10.00%), low birth weight (30.00%), fe-tal growth restriction (16.67%), neonatal prevalence rate (20.00%) were higher than those of the normal pregnancy group (1.11%、5.00%、1.67%、3.33%), the differences were statistically significant (P<0.05). The above indicators were compared between the gestational thyroid dysfunction treatment group and normal pregnancy group, the differences were not statistically significant (P> 0.05). Conclusion Gestational thyroid dysfunction has an adverse effect on the outcome of pregnancy, timely replacement therapy can improve the prognosis, advocate routine check thyroid function indexes in early pregnancy, and thyroxine treatment for gestational thyroid dysfunction should run through the whole process of pregnancy.
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