摘要
目的:探究伴甲状腺过氧化物酶抗体(Thyroid peroxidase antibody,TPOAb)阳性的复发性流产患者使用左旋甲状腺素片的效果及对母儿结局的影响。方法:采用抽签法将2016年9月至2018年3月在我科就诊85例有复发性流产史伴TPOAb阳性产妇随机分为2组,其中常规组患者42例,两组均采用达肝素钠50000 IU每次皮下注射、口服阿司匹林25 mg·次^(-1)、钙尔奇600 mg·次^(-1)、叶酸片0.4 mg·次^(-1),Qd等常规治疗,联合组43例患者在此基础上加服左旋甲状腺素片25μg·次^(-1),Qd,均用药至分娩结束(流产、早产或自然生产等),治疗前后清晨分别取两组患者周静脉血液,分离血清后,酶联免疫吸附法检测两组甲状腺过氧化物酶(Thyroid peroxidase,TPO)、游离甲状腺素(Free thyroxine,FT_4)及促甲状腺激素(Thyroid stimulating hormone,TSH)血清水平,其中治疗前两组上述指标水平差异无统计学意义(P>0.05),对比治疗后两组上述指标水平及妊娠结局。结果:联合组治疗后胎膜早破、早产及TPO和TSH水平均低于常规组(P<0.05);新生儿1 min及5 min评分、体重、身高及FT_4水平两组无统计学差异(P>0.05)。结论:左旋甲状腺素片应用于复发性流产患者伴TPOAb阳性患者,可改善患者甲状腺功能,降低流产率,且对新生儿健康无影响。
Objective: To investigate the effects of levothyroxine tablets on maternal and fetal outcomes in patients with thyroid peroxidase antibody(TPOAb). Methods: Eighty-five patients with a history of recurrent miscarriage with TPOAb positive admitted to our hospital from September 2016 to March 2018 were randomly divided into two groups, the conventional group and the combined group. Each patient was administered with dalteparin sodium, aspirin, calcium, folic acid, and other conventional treatment. Forty three patients of the combined group additionally took levothyroxine tablets 25 μg·d-1 until the end of delivery. The serum levels of thyroid peroxidase(TPO), free thyroxine(FT4) and thyroid stimulating hormone(TSH) were detected by enzyme-linked immunosorbent assay. The pregnancy outcomes were compared between the two groups after treatment. Results: The premature rupture of membranes, premature delivery, TPO, and TSH levels in the combined group were lower than those in the conventional group(P<0.05). Conclusion: Levothyroxine tablets is effective to patients with recurrent spontaneous abortion with TPOAb positive.
作者
段雪娇
Duan Xue-jiao(Infertility Department of Pingdingshan Family Planning Hospital Pingdingshan, Henan Pingdingshan 467000)
出处
《四川生理科学杂志》
2019年第1期22-24,共3页
Sichuan Journal of Physiological Sciences
