摘要
目的探讨甲状腺过氧化物酶抗体(TPOAb)阳性的复发性流产患者采用左旋甲状腺素片治疗的效果及对妊娠结局的影响。方法选取瑞安市人民医院2015年1月至2017年1月妊娠4~6周且既往具有复发性流产病史的妊娠妇女100例,采用随机数字表法分为A组、B组各50例,A组采用左旋甲状腺素片+基础治疗,B组仅给予基础治疗;对比两组治疗前后的血清促甲状腺激素(TSH)、游离甲状腺素(FT4)、甲状腺过氧化物酶(TPO)的水平变化及妊娠结局。结果治疗前,A组和B组妊娠妇女的血清TSH、FT4、TPO水平差异无统计学意义(t值分别为1.061、0.963、0.581,均P>0.05),治疗后A组的TSH、TPO水平均显著低于B组(t值分别为2.979、5.813,均P<0.05),A组和B组的FT4水平差异无统计学意义(t=0.881,P>0.05)。A组和B组妊娠妇女的早产率、胎膜早破的发生率均显著低于B组(χ2值分别为4.000、4.574,均P<0.05),A组和B组的流产率、胎儿生长受限率差异无统计学意义(χ2值分别为1.515、2.174,均P>0.05);A组和B组新生儿的身高、体质量、1min及5min Apgar评分比较,差异无统计学意义(t值分别为0.487、0.662、0.724、0.767,均P>0.05)。结论 TPOAb阳性的复发性流产患者采用左旋甲状腺素片治疗能进一步降低TSH、TPO的水平,对于降低不良妊娠结局发生率具有积极作用。
Objective To investigate the effect of levothyroxine on recurrent spontaneous abortion patients with thyroid peroxidase antibody（TPOAb）positive and its influence on pregnancy outcomes.Methods A total of 100 pregnant women at 4 to 6 weeks of pregnancy with history of recurrent miscarriage visiting Ruian People＇s Hospital from January 2015 to January 2017 were enrolled in this study and randomly divided into group A and group B,with 50 cases in each group.Patients in group A were treated with levothyroxine plus basic treatment,and patients in group B were given only basic treatment.Serum thyroid stimulating hormone（TSH）,free thyroxine（FT4）,thyroid peroxidase（TPO）levels before and after treatment and pregnancy outcomes were compared between two groups.Results Before treatment,serum TSH,FT4 and TPO levels in pregnant women in group A and group B were not significantly different（t value was 1.061,0.963,0.581 respectively,all P〉0.05）.Levels of TSH and TPO after treatment in group A were significantly lower than those in group B（t value was 2.979,5.813 respectively,both P〈0.05）.There was no significant difference in FT4 level between group A and group B（t=0.881,P〉0.05）.Preterm birth rate and premature rupture of membranes of pregnant women in group A were significantly lower than those in group B（χ2 value was 4.000,4.574 respectively,both P〉0.05）.There were no significant differences in abortion rate and fetal growth restriction rate between group A and group B（χ2 value was 1.515,2.174 respectively,both P〈0.05）.There were no differences in neonatal height,body weight and Apgar scores at 1 minute and 5 minutes between groups A and B（t value was 0.487,0.662,0.724,0.767 respectively,all P〈0.05）.Conclusion TPOAb-positive recurrent spontaneous abortion patients treated with levothyroxine can further reduce levels of TSH and TPO,which has positive effect on reduction of adverse pregnancy outcomes.
作者
李秀敏
戴洁
LI Xiu-min;DAI lie(Obstetrics Department,Ruian People＇s Hospital,ZhejianR Ruian 325200,China)
出处
《中国妇幼健康研究》
2018年第9期1097-1100,共4页
Chinese Journal of Woman and Child Health Research
关键词
甲状腺过氧化物酶抗体
复发性流产
左旋甲状腺素片
妊娠结局
thyroid peroxidase antibody （TPOAb）
recurrent spontaneous abortion
levothyroxine tablets
pregnancy outcome
