Page 71 - 南京医科大学学报自然科学版

第41卷第2期 南京医科大学学报（自然科学版）
2021年2月 Journal of Nanjing Medical University（Natural Sciences） ·221 ·

·临床研究·

妊娠期甲亢类型分析及对母婴结局的影响

孙 璐 ，戴程婷 ，袁庆新 1*
1
1，2
1 南京医科大学第一附属医院内分泌科，江苏 南京 210029；江苏大学附属人民医院内分泌科，江苏 镇江 212002
2

［摘 要］ 目的：分析妊娠期甲亢的类型并探讨其对母婴结局的影响。方法：选取甲亢孕妇300例，进行甲亢类型的分析。根
据诊断标准确定 Graves’病（Graves’disease，GD）108 例（GD 组）、妊娠期一过性甲亢（gestational transient thyrotoxicosis，GTT）
104例（GTT组）和桥本甲亢33例（桥本甲亢组）作为最终研究对象，选取同期正常妊娠孕妇340例作为对照，分析孕妇甲状腺功
能变化及对母婴结局的影响。结果：①300 例甲亢孕妇中，有 36.00%（108/300）为 GD，34.67%（104/300）为 GTT，11.00%（33/
300）为桥本甲亢；②GD组持续甲亢的比例高于GTT组（P < 0.05）；③GD组出现妊娠期高血压、子痫前期、早产儿及新生儿甲减
的比例高于GTT组和对照组（P < 0.05）。结论：有活动性GD或既往甲亢病史的妇女，孕前合理咨询及计划妊娠可减少母婴不
良结局的发生。
［关键词］ 妊娠期甲亢；Graves’病；妊娠期一过性甲亢；桥本甲亢；妊娠结局
［中图分类号］ R581.1 ［文献标志码］ A ［文章编号］ 1007⁃4368（2021）02⁃221⁃05
doi：10.7655/NYDXBNS20210213

Analysis of types of hyperthyroidism in pregnancy and its effects on maternal and
neonatal outcomes

1
1，2
SUN Lu ，DAI Chengting ，YUAN Qingxin 1*
1 Department of Endocrinology，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029；
2 Department of Endocrinology，People’s Hospital Affiliated to Jiangsu University，Zhenjiang 212002，China

［Abstract］ Objective：This study aims to analyze the types of hyperthyroidism in pregnancy and to investigate its effects on
pregnancy outcomes. Methods：Total 300 pregnant women were enrolled，who were diagnosed as hyperthyroidism in this study. To
analyze the types of hyperthyroidism in pregnancy，according to the diagnostic criteria，there were 108 cases in Graves’disease（GD）
group，104 cases in gestationgal transient thyrotoxicosis（GTT）group，and 33 cases in hashitoxicosis group. Then 340 normal pregnant
women were selected for control. The changes of thyroid function in pregnancy and its effects on the adverse outcomes of mothers and
offspring in different groups were analyzed. Results：Of 300 pregnant women with hyperthyroidism，41.67% had hyperthyroidism
before pregnancy and 58.33% were diagnosed with hyperthyroidism during pregnancy. Among 300 women，36.00% were GD，34.67%
were GTT and 11.00% were hashitoxicosis. The proportion of pregnant women who have persistent hyperthyroidism was significantly
higher in GD group than in GTT group. The incidences of pregnancy⁃induced hypertension，preeclampsia，preterm birth，and neonatal
hypothyroidism were significantly higher in GD group than those in GTT group or in the control group. Conclusion：For women with
active GD or previous history of hyperthyroidism，reasonable pre ⁃ pregnancy counseling and pregnancy planning are of great
significance to reduce the occurrence of adverse outcomes of mothers and offspring.
［Key words］ hyperthyroidism in pregnancy；Graves’disease；gestational transient thyrotoxicosis；hashitoxicosis；pregnancy outcome
［J Nanjing Med Univ，2021，41（02）：221⁃225］

甲状腺功能亢进症（甲亢）是指甲状腺合成与

［基金项目］ 国家自然科学基金（81570697） 分泌甲状腺激素增多，引起神经、循环、消化等系统
∗ 兴奋性升高及代谢亢进的综合征 ［1-2］ 。甲亢在育龄
通信作者（Corresponding author），E⁃mail：yqx@njmu.edu.cn