摘要
目的分析不同剂量左旋甲状腺素钠片治疗妊娠合并甲状腺功能减退症(甲减)的效果及对母婴结局的影响。方法选择200例妊娠合并甲减孕妇,采用随机数字表法分为小剂量组与大剂量组,每组100例。小剂量组孕妇给予25μg左旋甲状腺素钠片治疗,大剂量组孕妇给予75μg左旋甲状腺素钠片治疗。比较两组甲状腺功能恢复正常时间、乏力症状消失时间、治疗前、临产前甲状腺激素指标、临床疗效及母婴结局情况。结果大剂量组甲状腺功能恢复正常时间、乏力症状消失时间均明显短于小剂量组,差异具有统计学意义(P<0.05)。治疗前,两组患者血清游离三碘甲腺原氨酸、游离四碘甲状腺原氨酸、促甲状腺激素指标比较,差异无统计学意义(P>0.05);临产前,两组血清游离三碘甲腺原氨酸、游离四碘甲状腺原氨酸指标均明显高于治疗前,促甲状腺激素低于治疗前,且大剂量组优于小剂量组,差异具有统计学意义(P<0.05)。大剂量组治疗总有效率为98.0%,明显高于小剂量组的85.0%,差异具有统计学意义(P<0.05)。大剂量组不良母婴结局发生率为17.00%,明显低于小剂量组的31.00%,差异具有统计学意义(P<0.05)。结论妊娠合并甲减孕妇应用大剂量左旋甲状腺素钠片治疗,可显著改善甲状腺激素水平,降低不良母婴结局发生,值得临床推广与应用。
Objective To analyze the effects of diff erent doses of levothyroxine sodium tablets in the treatment of pregnancy with hypothyroidism(hypothyroidism)and the effects on maternal and infant outcomes.Methods A total of 200 pregnant women with hypothyroidism were selected and divided into low-dose group and high-dose group by random number table,100 cases in each group.Pregnant women in the low-dose group were treated with 25μg levothyroxine sodium tablets,and those in the high-dose group were treated with 75μg levothyroxine sodium tablets.The time for thyroid function to return to normal,the time for fatigue symptoms to disappear,thyroid hormone indexes before and after treatment,clinical effi cacy and maternal and infant outcomes were compared between the two groups.Results The recovery time of thyroid function and the disappearance time of fatigue symptoms in the high-dose group were signifi cantly shorter than those in the low-dose group,and the diff erences were statistically signifi cant(P<0.05).Before treatment,there were no signifi cant diff erences in serum indices of free triiodothyronine,free tetraiodothyronine and thyrotropin between 2 groups(P>0.05).Before parturient,the indexes of free triiodothyronine and free tetraiodothyronine in serum of the two groups were signifi cantly higher than before treatment,and the thyrotropin was lower than before treatment,and the high-dose group was better than the low-dose group,with statistical signifi cance(P<0.05).The total effective rate of high-dose group was 98.0%,which was signifi cantly higher than that of low-dose group(85.0%),and the diff erence was statistically signifi cant(P<0.05).The incidence of adverse maternal and child outcomes in the high-dose group was 17.00%,which was signifi cantly lower than that in the low-dose group(31.00%),and the diff erence was statistically signifi cant(P<0.05).Conclusion The application of levothyroxine sodium tablets in pregnant women with hypothyroidism can signifi cantly improve the level of thyroid hormone and reduce the occurrence of adverse maternal and infant outcomes,which is worthy of clinical promotion and application.
作者
朱春芹
Zhu Chunqin(Department of Obstetrics and Gynecology,the Second People's Hospital of Xiangcheng District,Suzhou 215143,Jiangsu,China)
出处
《实用妇科内分泌电子杂志》
2021年第2期55-58,共4页
Electronic Journal of Practical Gynecological Endocrinology
关键词
甲状腺功能减退症
左旋甲状腺素钠片
母婴结局
不同剂量
Hypothyroidism
Levothyroxine sodium tablets
Maternal and infant outcomes
Diff erent doses
