摘要
目的探讨甲状腺功能正常甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)阳性的妊娠期妇女应用左旋甲状腺素片(L-thyroxine tablets,L-T4)治疗后的妊娠结局情况。方法选择2016年3～12月于我院建册分娩的800例甲状腺功能正常TPOAb阳性的孕妇,按随机数表法平均分为两组,其中一组给予50μg/d的L-T4干预治疗(干预组),另一组给予相同剂量的安慰剂(单纯组)。将同期于我院建册分娩的103例正常孕妇为参照组。比较三组妊娠结局和新生儿情况,干预组和单纯组干预前后促甲状腺激素(thyroid stimulating hormone,TSH)水平。结果与单纯组比较,干预组和参照组早产、胎儿生长受限、胎儿窘迫、胎膜早破、妊娠期糖尿病、妊娠期高血压、妊娠贫血、产后出血和新生儿肺炎的发生率明显较低,Apagar和婴幼儿发育量表(bayley scales of infant development,BSID)评分明显较高(P<0.05)。干预2周后,干预组TSH水平明显下降,且明显低于单纯组(P<0.05),但两组FT3和FT4水平比较无明显差异(P>0.05)。结论 L-T4治疗甲状腺功能正常TPOAb阳性的妊娠期妇女可有效降低不良妊娠结局和新生儿并发症的发生率,改善新生儿的生长发育情况,还能进一步调整孕妇的TSH水平。
Objective To investigate the pregnancy outcomes of thyroid peroxidase antibody(TPOAb)-positive pregnant women with normal thyroid function after treatment with L-thyroxine tablets(L-T4). Methods 800 pregnant women with normal thyroid function who underwent delivery in our hospital from March to December 2016 were randomly divided into two groups according to the random number table method. One group was given 50 μg/d L-T4 intervention (intervention group), and the other group was given the same dose of placebo(simple group). 103 normal pregnant women who gave birth in our hospital during the same period were used as reference group. The pregnancy outcomes and neonates among three groups, and thyroid stimulating hormone(TSH)levels between the intervention group and the simple group before and after intervention were compared. Results The incidence of premature delivery, fetal growth restriction, fetal distress, premature rupture of membranes, gestational diabetes, gestational hypertension, gestational anemia, postpartum hemorrhage, and neonatal pneumonia was significantly lower in the intervention group and the refer ence group compared with that of the simple group. And the Apagar and Bayley scales of infant development(BSID) scores in the intervention group and the reference group were significantly higher(P<0.05). After 2 weeks of intervention, the level of TSH in the intervention group was significantly lower than that in the simple group(P<0.05), but there was no significant difference between the two groups(P>0.05). Conclusion L-T4 in the treatment of TPOAb positive pregnant women with normal thyroid function can effectively reduce the incidence of adverse pregnancy outcomes and neonatal complications, improve the growth and development of newborns, and further adjust the TSH level of pregnant women.
作者
董小跃
郑海雪
DONG Xiaoyue;ZHENG Haixue(Rui'an Maternal and Child Health Hospital in Zhejiang Province,Rui'an 325200,China)
出处
《中国现代医生》
2019年第5期64-67,共4页
China Modern Doctor
基金
浙江省温州市科技计划项目(Y20160356)
