摘要
目的:观察不同剂量左甲状腺素治疗妊娠合并亚临床甲状腺功能减退患者疗效及对妊娠结局影响。方法:2016年1月—2018年1月本院治疗的妊娠合并亚临床甲状腺功能减退患者210例,随机数字表法分为低剂量组、中剂量组和高剂量组,分别予以50μg/d、100μg/d、150μg/d剂量左甲状腺素钠维持治疗,观察各组治疗期间药物不良反应,治疗前后患者血清TSH、FT3、FT4和叶酸水平,不良妊娠结局及围产期并发症情况。结果:中剂量组和高剂量组血清TSH水平均低于低剂量组,而血清叶酸水平均高于低剂量组(均P=0.000);不良妊娠结局和围产期并发症发生率中剂量组和高剂量组均低于低剂量组(P<0.05),高剂量组与中剂量组上述指标无差异(P>0.05)。低剂量组和中剂量组药物不良反应发生率均低于高剂量组水平(P<0.05)。结论:较低剂量和高剂量比较,中剂量左甲状腺素(100μg/d)治疗妊娠合并亚临床甲状腺功能减退可有效降低患者血清TSH水平,促进叶酸合成,预防妊娠不良事件发生,改善妊娠结局,降低药物不良反应发生率,安全性较高。
Objective:To observe the clinical effect of different doses of levothyroxine for treating pregnant women with subclinical hypothyroidism,and to analyze its influence on their pregnancy outcomes.Methods:210 pregnant women with subclinical hypothyroidism were enrolled as research subjects,and were divided into were divided into low dose group,middle dose group,and high dose group from January 2016 to January 2018.The women in the low dose group were given 50μg/d levothyroxine,the women in the middle dose group were given 100μg/d levothyroxine,and the women in the high dose group were given 150μg/d levothyroxine.The incidence of adverse drug reactions during treatment,the adverse pregnancy outcomes,and the perinatal complications was observed,and the levels of serum TSH,FT3,FT4 and folic acid were compared before and after treatment.Results:The serum TSH levels of women in the middle dose group and high dose group were significant lower than those of women in the low dose group,while serum folic acid level was significant lower than that of women in the low dose group(P=0.000).The incidence of adverse pregnancy outcomes and the perinatal complications of women in the middle dose group and the high dose group were significant lower than those of women in the low dose group(P<0.05).There were no significant difference in serum TSH and folic acid levels,and the incidences of adverse pregnancy outcomes and perinatal complications between the high dose group and the middle dose group after treatment(P>0.05).The incidence of adverse drug reactions of women in the low dose group and the middle dose group were significant lower than that of women in the high dose group(P<0.05).Conclusion:Compared with those of women who using low dose(50μg/d)and high dose(150μg/d)of levothyroxine,middle dose of levothyroxine(100μg/d)can effectively reduce the serum TSH level of pregnant women with subclinical hypothyroidism,promote folic acid synthesis,prevent adverse pregnancy events,improve pregnancy outcome,and reduce the incidence
作者
董黎淑
DONG Lishu(Luzhou Maternal and Child Health Care Hospital,Sichuan Province,646000)
出处
《中国计划生育学杂志》
2019年第6期721-724,共4页
Chinese Journal of Family Planning
