摘要
目的对育龄期女性格雷夫斯甲状腺功能亢进症（Graves甲亢）131I治疗后随访中怀孕与生育的情况进行分析，探讨131I对其生育及出生婴儿健康的影响。方法回顾性分析2009年至2012年有Graves甲亢病史、于维持治疗期间怀孕的102例女性患者的妊娠及生育情况。按照治疗方式将患者分为131I治疗组（57例）、非131I治疗组（45例），记录治疗6个月后怀孕全程的甲状腺功能，维持治疗药量的调整情况，随访妊娠终止及婴儿出生情况。采用x2检验、Fisher确切概率法、Mann—Whitneyu检验、两独立样本t检验对2组病例的服药情况、生产方式、婴儿性别、婴儿体质量进行对比分析。结果102例患者中97例正常分娩。131I治疗组与非131I治疗组相比，怀孕期间服用丙基硫氧嘧啶（PTu）、左旋甲状腺素（优甲乐）及未服药比例相当，分别为15、31、11例和22、18、5例（X2=5．69，P〉0．05）；2组各药物间的用量构成差异也无统计学意义（PTu及优甲乐对应u值分别为163．50和233．50，均P〉0．05）。生产方式（顺产／剖宫产分别为36／19和28／14，X2=0．016）、婴儿性别构成（男／女分别为32／23和18／24，X2=2．239）、婴儿体质量[（3．18±0．47）和（3．07±4．17）kg，t=1．154；均P〉0．05]均相似。结论患有Graves甲亢的育龄期女性经131I治疗后可以正常妊娠。只要在妊娠前及妊娠期常规检查甲状腺功能，合理用药控制或维持甲状腺功能正常，可以达到优生优育。
Objective To analyze the pregnancy outcomes and effect on fertility in women with Graves＇ disease after 131I therapy and the health status of their newborns. Methods From year 2009 to 2012, a total of 102 female patients with Graves＇ disease, who were pregnant during propyhhiouracil （PTU）/L-thyroxine （euthyrox） maintenance treatment, were retrospectively recruited. The subjects were divided into 131I therapy group （ n = 57） and non- 131I therapy group （ n = 45 ）. The time interval between 131I （ non- 131 I） therapy and getting pregnant were at least 6 months. They were followed for their pregnancy outcomes. During the pregnancy period, recorded parameters included serum thyroid biochemistry, dose of PTU/euthyrox, health conditions of the newborns and termination of pregnancy. Medication compliance, de- livery mode, baby gender and body weight between the 2 groups were compared byX2 test, Mann-Whitney u test, Fisher exact test and two-sample t test. Results Ninety-seven patients had normal labor. In 131I therapy group and non-131I therapy group, 15 vs 22 patients were treated by PTU, 31 vs 18 by euthyrox and 11 vs 5 without any medication during pregnancy （X2= 5.69, P〉0.05）. The medical compliance （PTU and euthy- rox： u= 163.50, 233.50, both P〉0.05） was similar between the 2 groups. The delivery mode （natural labor/cesarean ： 36/19 vs 28/14, X2 = 0.016）, baby gender （ male/female ： 32/23 vs 18/24, X2 = 2.239） and body weight （（3.18±0.47） vs （3.07±4.17） kg, t= 1.154） were also similar between the 2 groups （all P〉 0.05）. Conclusion Women of reproductive age with Graves＇ disease were found to have normal pregnancy after 131I therapy, on the condition that their thyroid function could be reasonably controlled and maintained by the proper medication before and during pregnancy.
出处
《中华核医学与分子影像杂志》
CSCD
北大核心
2014年第1期5-7,共3页
Chinese Journal of Nuclear Medicine and Molecular Imaging
