摘要
目的 探讨用左甲状腺素钠片治疗妊娠合并亚临床甲状腺功能减退症对患者甲状腺功能及妊娠结局的影响。方法 选取妊娠合并亚临床甲状腺功能减退症患者198例作为研究对象,随机分为对照组和观察组,每组99例。对照组孕妇给予饮食指导,保证碘摄入,并且避免接触放射性物质。治疗组孕妇口服左旋甲状腺素钠片,治疗前及产前1 d抽血,检测血清促甲状腺激素(thyroid stimulating hormone,TSH)、游离三碘甲状腺原氨酸(free triiodothyronine,FT_3)、游离四碘甲状腺原氨酸(free tetraiodothyronine,FT_4)和甲状腺过氧化物酶抗体(thyroid peroxidase antibodies,TPOAb)水平,比较2组患者的妊娠结局和产后并发症的发生情况。结果 治疗后,观察组的血清TSH和TPOAb水平较对照组显著降低(P<0.05),FT_3和FT_4水平较对照组显著升高(P<0.05);观察组流产、死胎、早产、出生低体质量儿和新生儿窒息的发生率较对照组略有降低,但差异无统计学意义(P>0.05),总发生率较对照组显著降低(P<0.05);观察组产后出血、高血压、糖代谢异常和产后贫血的发生率较对照组略有降低,但差异无统计学意义(P>0.05),总发生率较对照组显著降低(P<0.05)。结论 左甲状腺素钠片可改善妊娠合并亚临床甲状腺功能减退症患者的甲状腺功能,可降低不良妊娠结局和产后并发症的发生率。
Objective To investigate the effect of Levothyroxine Sodium Tablets on thyroid function and clinical pregnancy outcome in pregnant patients with subclinical hypothyroidism.Methods A total of 198 pregnant women with subclinical hypothyroidism were divided into control group and observation group randomly.The pregnant women in the control group were given dietary guidance,guaranteed iodine intake and avoided contact with radioactive substances.The pregnant women in the treatment group were orally treated with levothyroxine sodium.Fasting venous blood was collected in the morning before treatment and on the 1st day before delivery,and serum thyrotropin(TSH),free triiodothyronine(FT3),free tetriodothyronine(FT4)and thyroid peroxidase antibody(TPOAb)were detected by immunoluminescence method.The clinical pregnancy outcomes and postpartum complications of both groups were compared.Results After treatment,the level of TSH and TPOAb in serum of observation group was significantly lower than that in control group(P<0.05),the level of FT3 and FT4 was significantly higher than that of control group(P<0.05).The incidence of abortion,stillbirth,premature delivery,low birth weight and neonatal asphyxia in observation group had a downward trend compared with that in control group(P>0.05),and the total incidence was significantly lower than that of the control group(P<0.05).The incidence of postpartum hemorrhage,hypertension,abnormal glucose metabolism and postpartum anemia in the observation group had a downward trend compared with that in the control group(P>0.05),and the total incidence was significantly lower than that of the control group(P<0.05).Conclusion Levothyroxine Sodium Tablets can improve the thyroid function of pregnant patients with subclinical hypothyroidism and reduce the incidence of adverse pregnancy outcomes and postpartum complications.
作者
颜俭
赵开孙
贝妮
YAN Jian;ZHAO Kaisun;BEI Ni(Department of Obstetrics,Guangxi Nanning Second People’s Hospital,Nanning 530031,China)
出处
《西北药学杂志》
CAS
2024年第5期180-184,共5页
Northwest Pharmaceutical Journal
基金
南宁市科学研究与技术开发计划项目(编号:zc20203003)。
