| 李金鸽,贺译平,徐叶红,冯卫红,王艳霞.不同剂量左旋甲状腺素对妊娠合并甲减患者胎儿发育的影响[J].,2019,19(7):1321-1324 |
| 不同剂量左旋甲状腺素对妊娠合并甲减患者胎儿发育的影响 |
| Effects of Different Doses of Levothyroxine on the Fetal Development in Patients with Pregnancy Combined with Hypothyroidism |
| 投稿时间：2018-07-12 修订日期：2018-08-08 |
| DOI：10.13241/j.cnki.pmb.2019.07.027 |
| 中文关键词: 左旋甲状腺素 甲减 剂量 妊娠 胎儿 |
| 英文关键词: Levothyroxine Hypothyroidism Dose Pregnancy Fetus |
| 基金项目:陕西省社会发展科技攻关项目（2015SF135） |
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| 中文摘要: |
| 摘要 目的：探讨不同剂量左旋甲状腺素对妊娠合并甲减患者胎儿发育的影响。方法：选择2012年5月至2016年6月在我院诊治的妊娠合并甲减孕妇72例作为研究对象，根据随机数字表法抽签分为观察组与对照组各36例，两组都给予左旋甲状腺素治疗，对照组应用剂量为低剂量，观察组应用剂量为高剂量，两组均治疗观察3个月，对比两组的临床疗效、治疗前后游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)、血清促甲状腺激素(TSH)水平的变化及并发症的发生情况。结果：治疗后，观察组的总有效率[97.2%(35/36)]显著高于对照组[83.3%(30/36)](P<0.05)，两组TSH值显著低于治疗前(P<0.05)，FT3与FT4值均显著高于治疗前(P<0.05)，且观察组的FT3、FT4值均明显高于对照组(P<0.05)，而血清TSH值显著低于对照组(P<0.05)。治疗期间，观察组的早产、产后出血、宫内窘迫、妊娠高血压等并发症发生率为11.1%，对照组为30.6%，观察组显著低于对照组(P<0.05)。所有孕妇都顺利分娩，新生儿都存活，观察组新生儿的智力发育与精神运动发育评分都显著高于对照组(P<0.05)。结论：高剂量左旋甲状腺素治疗妊娠合并甲减患者的临床效果明显高于低剂量左旋甲状腺素，其可有效促进甲状腺激素分泌平衡，减少妊娠并发症的发生，促进新生儿的发育。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of different doses of levothyroxine on the fetal development in patients with preg- nancy combined with hypothyroidism. Methods: From May 2012 to June 2016, 72 cases of gravida combined with hypothyroidism were treated as research subjects. According to the random number table method, they were divided into the observation group and control group with 36 cases in each group. Both groups were treated with levothyroxine. The control group was given a low dose, while the ob- servation group was given a high dose. The treatment lasted for 3 months. The clinical efficacy, changes of free triiodothyronine (FT3), free thyroid hormone (FT4), serum thyroid stimulating hormone (TSH) levels before and after treatment and incidence of complications were compared between the two groups. Results: After treatment, the total effective rate of observation group [97.2% (35/36)] was signif- icantly higher than that in the control group [83.3% (30/36)] (P<0.05). The serum TSH level of both groups were significantly lower than those before treatment(P<0.05), the FT3 and FT4 levels were significantly higher than those before treatment(P<0.05), and the FT3 and FT4 levels in observation group were significantly higher than those in the control group(P<0.05). The serum TSH level was significantly lower than that of the control group (P<0.05). During the treatment period, the incidence of complications such as preterm delivery, post- partum hemorrhage, intrauterine distress and pregnancy-induced hypertension was 11.1% in the observation group and 30.6% in the con- trol group. It was significantly lower in the observation group than that of the control group (P<0.05). All pregnant women delivered well and newborns were alive. The intelligence development and mental development scores of newborns in the observation group were sig- nificantly higher than those in the control group (P<0.05). Conclusion: The clinical effect of high-dose levothyroxine was significantly higher than that of low-dose levothyroxine in the treatment of patients with pregnancies with hypothyroidism, which can effectively pro- mote the balance of thyroid hormone secretion, reduce the occurrence of pregnancy complications, and promote the development of new- borns. |
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