摘要
目的:探讨不同剂量左旋甲状腺素片对妊娠合并亚临床甲状腺功能减退者甲状腺功能及妊娠结局的影响。方法:本院就诊的妊娠合并亚临床甲状腺功能减退患者120例,其中80例按照随机数字表法分为大剂量组和小剂量组各40例,分别给予大剂量(75μg/d、100μg/d、125μg/d)或小剂量(50μg/d、75μg/d、100μg/d)的左旋甲状腺素片治疗。另外40例未服用药物者作为对照组,给予饮食控制,不予药物治疗。检测3组患者治疗前后甲状腺功能变化,观察并记录并发症发生情况及妊娠结局。并于新生儿出生后6个月,采用婴幼儿发育量表(BSID)评估婴儿发育情况,包括智能发育指数(MDI)和运动发育指数(PDI)。结果:治疗后3组促甲状腺激素(TSH)、抗甲状腺过氧化物酶抗体(TPOAb)均明显降低(P<0.05);且TSH、TPOAb改善情况大剂量组>小剂量组>对照组(P<0.05);3组婴儿BSID、MDI、PDI评分大剂量组>小剂量组>对照组(P<0.05);大剂量组和小剂量组的高血压、胆汁淤积与对照组无差异(P>0.05),但糖代谢异常发生率低于对照组(P<0.05);大剂量组和小剂量组的剖宫产、新生儿窒息、新生儿畸形、胎死宫中发生率与对照组无差异(P>0.05),但极低体重发生率低于对照组,且大剂量组<小剂量组(P<0.05)。结论:左旋甲状腺素片能显著改善妊娠合并亚临床甲状腺功能减退患者的甲状腺功能及妊娠结局,大剂量效果优于小剂量。
Objective：To investigate the effect of different doses of levothyroxine tablets on thyroid function and pregnancy outcome of pregnant women with hypothyroidism.Methods：120 pregnant women with hypothyroidism were selected in this study,and among them,80 pregnant women were randomized divided into high dose group and low close group（doses of levothyroxine tablets：75ug/d vs.50ug/d,100ug/d vs.75ug/d,125ug/d 100ug/d）by random number table.Other 40 pregnant women without given any drug except given diet treatment were in control group.The changes of thyroid function indexes of women before and after treatment in three groups were detected,and rate of complica-tions and pregnancy outcome were compared among the three groups.The neonatal development scale（BSID）was used to assess neonatal development at 6 months after birth,which included intelligence development index（MDI）and mo-tor development index（PDI）.Results：After treatment,the level of TSH and TPOAb of women in the three groups decreased significantly（P〈0.05）.The decreased degree of TSH,TPOAb level of women in high dose group was sig-nificantly better than that of women in low dose group,and the decreased degree of TSH,TPOAb level of women in low close group was significantly better than that of women in control group（P〈0.05）.The score of BSID,MDI and PDI of newborns in high dose group were significantly higher than those of newborns in low dose group,and the score of BSID,MDI and PDI of newborns in low dose group were significantly higher than those of newborns in control group（P〈0.05）.The rate of hypertension and cholestasis of women in the high dose group and low dose group were similar to those of women in control group（P〉0.05）,but the rate of abnormal glucose metabolism of women in high dose group and low dose group was significantly lower than that of women in control group（P〉0.05）.The rate of ce-sarean section,neonatal asphyxia,neonatal malformation and fetal death in high dose group and low dose group had no significant difference when compared to those of women in control group（P〉0.05）.The rate of extremely low body weight of infants in high dose group and low dose group was significantly lower than that in control group（P〈0.05）,and the rate of extremely low body weight of infants in high dose group was also significantly lower than that in low dose group（P 〈 0.05）.Conclusion：levothyroxine tablet can significantly improve the thyroid function and pregnancy outcome of pregnant women with hypothyroidism,and the effect of high dose of levothyroxine is better than that of low dose of levothyroxine.
作者
周晓丽
李梅
贾晓慧
ZHOU Xiaoli;LI Mei;JIA Xiaohui(Zhengzhou People＇s Hospital of Henan Province, Zhengzhou, Henan, 45000)
出处
《中国计划生育学杂志》
2018年第4期270-273,282,共5页
Chinese Journal of Family Planning
