妊娠期亚临床甲状腺功能减退症应用L-T_4治疗探讨  

Clinical effect study of L-thyroxine in the treatment of pregnancy with subclinical hypothyroidism

作　　者：邱惠明[1] 刘晓玲[1] 刘玲[1] 陈映婷[1] 

机构地区：[1]广东省珠海市妇幼保健院成人内科,广东珠海519000

出　　处：《中国当代医药》2015年第14期73-75,共3页China Modern Medicine

基　　金：广东省珠海市卫生局医学科研立项(2014092)

摘　　要：目的探讨妊娠期亚临床甲状腺功能减退症（SCH）应用左旋甲状腺素（L-T4）的治疗效果。方法选取2013年1月-2014年6月本院收治的150例妊娠合并SCH孕妇,根据甲状腺过氧化物酶抗体（TPOAb）检查及是否给予L-T4治疗分为A、B、C三组,A组50例为SCH/TPOAb阳性给予L-T4治疗,B组50例为SCH/TPOAb阴性,给予L-T4治疗,C组为SCH/TPOAb阴性,未给予L-T4治疗,选取同期正常妊娠孕妇50例作为D组。经治疗后比较四组妊娠并发症和胎儿智能发育情况。结果 C组妊娠并发症发生率为16.00%明显高于A、B、D组,差异有统计学意义（P〈0.05）;C组新生儿MDI和PDI评分均低于A、B、D组,差异有统计学意义（P〈0.05）。结论妊娠期SCH采用L-T4治疗可减少妊娠并发症发生,提高新生儿智能发育,对SCH合并甲状腺过氧化物酶抗体阴性者同样需要治疗。Objective To study the clinical effect of L-thyroxine （L-T4） on pregnancy subclinical hypothyroidism（SCH）. Methods 150 pregnancy women with SCH in our hospital from January 2013 to June 2014 were selected and divided into group A,group B,group C according to thyroid peroxidase antibody （TPOAb） test and L-T4 therapy.50 patients in group A was TPOAb positive and treated by L-T4,50 patients in group B were TPOAb negative and treated by L-T4,50 patients in group B were TPOAb negative and was not treated by L-T4.50 healthy pregnant were set as a healthy con-trol（group D）.The pregnancy complications and fetal intellectual development situation was compared between four groups respectively. Results The pregnancy complications in group C was 16.0%,which was significantly higher than that in group A,group B and group D （P〈0.05）.The MDI and PDI in group C were significantly lower than that in group A,group B and group D （P〈0.05）. Conclusion L-T4 can reduce pregnancy complications and improve fetal intellectual development in the treatment of SCH.SCH patient combined with TPOAb negative also need treatment.

关 键 词：妊娠 亚临床甲状腺功能减退症 左旋甲状腺素 

分 类 号：R581.2[医药卫生—内分泌]