摘要
目的观察分析不同剂量左旋甲状腺素(Levothyroxine,L-T_(4))用于妊娠合并甲状腺功能减退(简称甲减)治疗中的临床疗效。方法方便选取2021年3月—2023年2月期间于宁德市妇幼保健院接受左旋甲状腺素治疗的74例妊娠合并甲减患者作为研究对象,根据患者就诊先后顺序分成低剂量组与高剂量组(各37例),低剂量组应用低剂量L-T_(4)(起始剂量25μg/次),高剂量组应用高剂量L-T_(4)(起始剂量50μg/次)。比较两组患者血清促甲状腺激素(Thyroid Stimulating Hormone,TSH)、三碘甲状腺原氨酸(Triiodothyronine,T_(3))、四碘甲状腺氨酸(Tetraiodothyronine,T_(4))、游离三碘甲状腺原氨酸(Free Triiodothyronine,FT_(3))、游离甲状腺氨酸(Free Tetraiodothyronine,FT_(4))以及妊娠结局。结果在L-T_(4)治疗后,相较于低剂量组,高剂量组TSH水平显著下降,FT_(3)、FT_(4)、T_(3)、T_(4)上升,差异有统计学意义(P均<0.05)。高剂量组早产率为5.41%,低于低剂量组的27.03%,差异有统计学意义(χ^(2)=4.874,P<0.05)。组间的产后出血、新生儿窒息发生率对比,差异无统计学意义(P均>0.05)。结论相对于低剂量L-T_(4)治疗的妊娠合并甲减患者而言,较高剂量更有助于调节孕妇甲状腺激素的水平,并改善其妊娠结局,有利于母婴健康。
Objective To observe and analyze the clinical effect of different doses of levothyroxine(L-T_(4))in the treat-ment of pregnancy complicated with hypothyroidism.Methods A total of seventy-four pregnant patients with hypothy-roidism who received levothyroxine treatment in Ningde Maternal and Child Health Hospital from March 2021 to February 2023 were conveniently selected as the study objects.Patients were divided into low-dose group and high-dose group(37 cases each)according to the order of treatment.The low-dose group was treated with low-dose L-T_(4)(initial dose 25μg/time),and the high-dose group was treated with high-dose L-T_(4)(initial dose 50μg/time).Thyroid Stimu-lating Hormone(TSH),Triiodothyronine(T_(3)),Tetraiodothyronin(T_(4)),Free Triiodothyronine(FT_(3)),Free Tetraiodothyro-nin(FT_(4))and pregnancy outcomes were compared between the two groups.Results After L-T4 treatment,compared with the low-dose group,the TSH level in the high-dose group was significantly decreased,and FT_(3),FT_(4),T_(3) and T_(4) were increased,and the differences were statistically significant(all P<0.05).The preterm birth rate of the high-dose group was 5.41%,which was lower than that of the low-dose group(27.03%),and the differences were statistically significant(χ^(2)=4.874,P<0.05).The incidence rates of postpartum hemorrhage and neonatal asphyxia were compared between groups,and the differences were not statistically significant(both P>0.05).Conclusion Compared with pregnant patients with hypothyroidism treated with low-dose L-T_(4),higher dose is more helpful to regulate the level of thyroid hormone in pregnant women and improve the pregnancy outcome,which is conducive to maternal and infant health.
作者
陈小凤
吴素玉
郑莉莉
CHEN Xiaofeng;WU Suyu;ZHENG Lili(Department of Gynecology and Obstetrics,Ningde Maternal and Child Health Hospital,Ningde,Fujian Province,352100 China)
出处
《中外医疗》
2024年第3期111-114,共4页
China & Foreign Medical Treatment
关键词
妊娠合并加减
左旋甲状腺素
高剂量
临床疗效
Pregnancy complicated with hypothyroidism
Levothyroxine
High-dose
Clinical effect
