摘要
目的探讨左旋甲状腺素片对妊娠期亚临床甲状腺功能减退的疗效。方法选择我院分娩的亚临床甲状腺功能减退产妇共120例并分成四组，分别为亚临床甲状腺功能减退＋甲状腺过氧化物酶（TPOAb）（＋）治疗组（A组）39例、亚临床甲状腺功能减退＋TPOAb（＋）未治疗组（B组）15例、亚临床甲状腺功能减退＋TPOAb（一）治疗组（C组）26例，亚临床甲状腺功能减退＋TPOAb（一）组未治疗组（D组）40例。治疗组采用左甲状腺素片治疗。结果A组在治疗16周后促甲状腺素（TSH）（16～20周，28—32周）显著降低，与B组比较差异均有统计学意义（t值分别为5．671、6．661，P均〈0．001），并且A组平均分娩孕周、胎儿体质量与B组比较差异均有统计学意义[（39．3±1．6）周与（37．9±1．4）周、（3524±562）g与（3101±351）g；￡值分别为4．561、7．834，P均〈0．001）。B组早产、妊娠期高血压、胎盘早剥的发生率显著高于A组（26．67％与2．56％，X2=7．490，P〈0．001；5．13％与40．00％，∥=10．438，P〈0．001；O与13．33％，x2=5．400，P=0．020）。C组在治疗16周后的TSH（16～20周，28～32周）显著降低，与D组比较差异均有统计学意义（t值分别为4．980、5．432，P均〈0．001），而C组与D组妊娠结局比较差异均无统计学意义（P均〉0．05）。结论妊娠期亚甲状腺功能减退患者如合并TPOAb（＋）须及时治疗，及时治疗后可显著降低不良妊娠结局的发生率，但如合并的是TPOAb（-）可考虑不治疗。
Objective To investigate the effect of levothyroxine tablets on subclinical hypothyroidism in pregnancy.Methods One hundred and twenty patients with the subclinical hypothyroidism in hospital were divided into four groups,subclinical hypothyroidism + TPOAb (+) treatment group (39 cases),subclinical hypothyroidism + TPOAb(+) untreated group (15 cases),subclinical hypothyroidism + TPOAb (-) treatment group(26 cases) and subclinical hypothyroidism + TPOAb (-) untreated group (40 cases).Patients in the treatment groups were administrated with levothyroxine tablets.Results The levels of thyroid stimulating hormone(TSH) in subclinical hypothyroidism and TPOAb(+) treatment group were significantly lower(16-20 weeks and 28-32 weeks) at after treatment,which was also lower than that in B group(t =5.671,6.661,P ＜ 0.001).Compared with the untreated group,there was a significant difference in terms of average gestational age,fetal weight ((39.3 ± 1.6) weeks vs.(37.9 ± 1.4) weeks ; (3524 ± 562) g vs.(3101 ± 351) g,t =4.561,7.834,P ＜ 0.001) between A and B groups.In B group,premature birth,gestational hypertension,incidence of placental abruption were significantly higher than that in A group (26.67％ and 2.56％,x2 =7.490,P ＜ 0.001 ; 5.13％ and 40.00％,x2 =10.438,P ＜ 0.001 ; 0 and 13.33％,x2 =5.400,P =0.020).In C group after 16 weeks of treatment,TSH levels at (16-20) weeks and (28-32) weeks were significantly decreased.Compared with the D group,the differences were statistically significant (t =4.980 and 5.432,both P ＜ 0.001).There was no significant difference in C group and D group in terms of pregnancy outcome (P ＞ 0.05).Conclusion Patients with gestational subclinical hypothyroidism such as mergers TPOAb(+) should be treated in time.Prompt treatment can significantly reduce the incidence of adverse pregnancy outcomes,but if patient with TPOAb(-),It is recommended not to conduct any treatment.
出处
《中国综合临床》
2013年第10期1104-1107,共4页
Clinical Medicine of China
