目的 探讨甲状腺功能减低症(甲减)与流产的关系及其相关的病理机制.方法 对2010年10月-2012年7月于产科门诊就诊的有先兆流产症状的首诊孕妇进行血清孕酮测定及甲状腺功能检测,按甲状腺功能分为正常组117例和甲减组74例,甲减组给予左旋甲状腺素替代治疗,观察比较2组的妊娠结局.结果 甲减组患者及时给予左旋甲状腺素替代治疗后,其流产率与正常组差异无统计学意义(35.1% vs 28.2%,P＞0.05).保胎成功亚组(n=132)与难免流产亚组(n=59)孕酮水平差异有统计学意义(P<0.01),而正常组与甲减组孕酮水平比较差异无统计学意义(P＞0.05).结论 妊娠早期甲状腺功能筛查和治疗具有非常重要的临床意义,早期甲状腺替代治疗能够降低流产率.%Objective To evaluate the association between hypothyroidism and threatened abortion in early stage pregnancy and to explain the mechanism. Methods The patients admitted between October 2010 and July 2012 with threatened abortion in the first trimester were analyzed, levels of progesterones and thyroid hormons ( T3 ,T4 and TSH )were detected, then divided into normal group( n = 117 ) and hypothyroidism group( n =74 ) once hypothyroidism was diagnosed, patients were treated with sodium levothyroxine ( LT4 ) as substitution, and outcomes were oberved. Results The risk for abora-tion in hypothyroidism group in which LT4 substitution was similar to the level observed in the controls ( 35. 1% vs. 28. 2% , P >0.05 ). The levels of progesterones in successfully pregnancy subgroup ( n = 132 ) and inevitable abortion subgroup ( n = 59 ) had statistical difference ( P < 0. 01 ), while no difference between the normal group and hypothyroidism group ( P > 0. 05 ). Conclusion Screening of thyroid disorders has important clinical meaning in the early pregnancy, and substitution of LT4 could reduce the risk of abortion.
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