摘要
目的探讨左甲状腺素钠片(优甲乐,L-T4)剂量变化对妊娠合并甲状腺功能减退(甲减)或亚临床甲减患者不同作用效果。方法选取50例妊娠健康体检人员作为对照组,另取同期50例孕妇合并甲减或亚临床甲减患者作为研究组。统计不同妊娠时期L-T4剂量变化、血清促甲状腺激素(TSH)含量。结果对照组与研究组妊娠前、研究组妊娠前及分娩后TSH水平对比相当(P>0.05)。研究组妊娠早期、妊娠中期、妊娠晚期TSH水平分别为(1.07±0.30)、(0.63±0.12)、(0.47±0.14)mIU/L,与对照组(1.96±0.42)mIU/L相比明显较低(P<0.05),妊娠中期、妊娠晚期TSH水平和妊娠早期相比明显较低(P<0.05);相较妊娠前,研究组妊娠早期、妊娠中期、妊娠晚期L-T4需求剂量更大(P<0.05);相较妊娠早期,研究组妊娠中期、妊娠晚期L-T4需求剂量相对较多(P<0.05);研究组分娩后L-T4需求剂量和妊娠前相比相当(P>0.05)。结论基础治疗后的甲减或亚临床甲减患者妊娠期间随着妊娠期增加而给予大剂量L-T4可保持治疗水平,分娩后所需剂量明显减少,3个月后和妊娠前水平保持相齐。
Objective To investigate the different effects of levothyroxine sodium tablets(Umetolol,L-Ta)dose changes on pregnant patients with hypothyroidism(hypothyroidism)or subclinical hypothyroidism.Methods 50 pregnant women with hypothyroidism or subclinical hypothyroidism were selected as the control group and 50 pregnant women with hypothyroidism were selected as the study group.The dose changes of L-T4 and the content of serum thyroid stimulating hormone(TSH)were analyzed.Results The level of TSH before pregnancy,before pregnancy and after delivery was similar between the control group and the study group(P>0.05).TSH levels in the study group were(1.07±0.30)mIU/L,(0.63±0.12)mIU/L and(0.47±0.14)mIU/L in the first trimester,second trimester and third trimester,respectively,which were significantly lower than those in the control group(1.96±0.42)mIU/L(P<0.05).The TSH level in the second and third trimesters was significantly lower than that in the first trimester(P<0.05),and the L-T4 dose required in the first trimester,second trimester and third trimester was higher than that before pregnancy(P<0.05).Compared with the frst trimester,the L-T,dose in the second and third trimester of pregnancy was relatively higher in the study group(P<0.05).The required dose of L-T4 after delivery was similar to that before pregnancy in the study group(P>0.05).Conclusion In patients with hypothyroidism or subclinical hypothyroidism after basic treatment,the treatment level can be maintained by giving large dose of L-T4 with the increase of pregnancy period during pregnancy,and the dose required after delivery is significantly reduced,and the level remains the same after 3 months.
作者
汤小峰
Tang Xiaofeng(Department of Endocrinology,People's Hospital of Rugao,Rugao 226500,China)
出处
《实用妇科内分泌电子杂志》
2023年第6期85-87,共3页
Electronic Journal of Practical Gynecological Endocrinology
关键词
妊娠
左甲状腺素钠片
促甲状腺激素
甲状腺功能减退
治疗剂量
Pregnancy
Levothyroxine sodium tablets
Thyroid stimulating hormone
Hypothyroidism
Therapeutic dose
