| 摘要 |
摘 要 目的: 研究亚临床型甲状腺功能减退症(SHT)对妊娠期孕妇焦虑、抑郁情绪的影响，以及探讨左甲状腺素钠片对新生儿临床转归的影响。方法: 选择2014年1月至2017年1月我院收治的150例患有SHT的孕妇作为研究组，并将其随机分成A组和B组（每组各75例），其中A组采用左甲状腺素钠片进行治疗，B组经患者及家属同意，未给予药物治疗,只是定期监测甲状腺功能情况，观察A、B两组孕妇妊娠期并发症、妊娠结局及新生儿情况。同时选择年龄、性别与研究组匹配的同期健康孕妇80例作为对照组，比较入院时研究组和对照组汉密尔顿抑郁量表(HAMD) 、汉密尔顿焦虑量表(HAMA)评分情况。结果: 研究组HAMA评分为（15.13±3.22）分，明显高于对照组HAMA评分（7.68±1.04）分（P﹤0.05）; 研究组HAMD评分为（22.06±2.71）分，明显高于对照组HAMD评分（8.93±1.65）分（P﹤0.05）。A组妊娠期并发症发生率为20.0%，明显低于B组妊娠期并发症发生率34.7% （P＜0.05）。A组早产率及流产率均低于B组（P﹤0.05）;A组剖宫产率为39.2% ，低于B组剖宫产率47.8%(P>0.05),A组新生儿出生体重为(3.18±0.94) Kg，明显高于B组新生儿出生体重(2.67±0.71) Kg（P＜0.05）;A组新生儿Apgar评分为(9.04±0.53)分 ，与B组新生儿Apgar评分（8.86±0.85）分比较差异无统计学意义（P>0.05）。结论: SHT对妊娠期孕妇可能会产生一定的焦虑、抑郁情绪障碍，应给予重视。SHT孕妇实施左甲状腺素钠片治疗，可以有效降低不良妊娠结局的发生，减少妊娠期并发症的发生，提高新生儿出生体重，改善新生儿Apgar 评分。
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| Abstract |
Abstract Objective: To study the influence of subclinical hypothyroidism (SHT) on pregnancy and to investigate the effect of Levothyroxine Sodium Tablets on the clinical outcome of neonates. Methods: From January 2014 to January 2017 in our hospital 150 cases of pregnant women with SHT as the study group, and were randomly divided into A group and B group (n = 75), group A were treated by Levothyroxine Sodium Tablets, B group of patients and their families agree, drug treatment is not given, only regular monitoring of thyroid function. To observe the effects of A, B two groups of pregnant women, pregnancy complications, pregnancy outcome and neonatal situation. At the same time, age, gender and the study group over the same period 80 cases of healthy pregnant women as control group, group of admission control group and Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) score.Results: HAMA study group score (15.13 ± 3.22) points, HAMA score was significantly higher than the control group (7.68 ± 1.04)% (P < 0.05); HAMD group score (22.06 ± 2.71) points, HAMD score was significantly higher than the control group (8.93 ± 1.65)% (P < 0.05).The complication rate of the observation group was 20%, which was lower than that of the control group, and the complication rate was 34.7% (P < 0.05). The observation group premature birth rate and abortion rate were lower than the control group (P < 0.05); observation group cesarean section rate was 39.2% lower than that of the control group, the cesarean section rate was 47.8% (P>0.05), the observation group of neonatal birth weight was (3.18 + 0.94) Kg, significantly higher than the control group of neonatal birth weight (2.67 + 0.71 Kg (P) < 0.05); observation group of neonatal Apgar score was (9.04 + 0.53), and the control group of neonatal Apgar score (8.86 + 0.85) there was no significant difference between the points (P>0.05).Conclusion: SHT may have certain anxiety and depressive mood disorder in pregnant women, so attention should be paid to it.The implementation of Levothyroxine Sodium Tablets in SHT pregnant women can effectively reduce the incidence of adverse pregnancy outcomes, reduce the incidence of pregnancy complications, improve neonatal birth weight, and improve neonatal Apgar score.
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