左甲状腺素钠对妊娠早期甲状腺过氧化物酶抗体阴性的亚临床甲状腺功能减退患者围产结局的影响  

Effects of levothyroxine sodium on perinatal outcome women during early trimester of pregnancy with subclinical hypothyroidism and TPoAb-negative

作　　者：张洁芳[1] 李远[1] 曹彦敏[1] 刘东立[1] 马敏[1] 许红[2] 赵保敬 

机构地区：[1]石家庄市第四医院内科,河北石家庄050011 [2]石家庄市第四医院检验科,河北石家庄050011

出　　处：《临床荟萃》2016年第3期293-295,共3页Clinical Focus

摘　　要：目的探讨左甲状腺素钠(L-T4)对妊娠早期伴甲状腺过氧化物酶抗体(TPoAb)阴性的亚临床甲状腺功能减退(甲减)患者围产结局的影响。方法选择就诊的妊娠早期亚临床甲减伴TPoAb阴性患者1 140例,随机分为L-T4组(n=570)和对照组(n=570),L-T4组给予L-T4治疗并达到目标值[促甲状腺素(TSH)<2.5mU/L],对照组不进行相应治疗。观察两组患者妊娠高血压、贫血、流产、早产及新生儿体质量等相关指标。结果对照组妊娠高血压、贫血、流产率及早产率等指标显著高于L-T4组(P<0.05),顺产率显著低于L-T4组,并且L-T4组患者治疗达目标值所需L-T4剂量与患者的TSH水平呈明显正相关(r=0.763,P<0.05)。结论 L-T4可以明显改善妊娠早期伴TPoAb抗体阴性的亚临床甲状腺功能减退患者的围产结局。Objective To investigate the effects of levothyroxine sodium on perinatal outcome women during early trimester of pregnancy with subclinical hypothyroidism and TPoAb-negative.Methods One thousand one hundred and forty patients during early trimester of pregnancy with subclinical hypothyroidism and TPoAb-negative were enrolled.All the patients were divided into control group（n=570）and levothyroxine sodium group（n=570）randomly.Patients in levothyroxine sodium group were given levothyroxine sodium treatment,rate of premature delivery,pregnancy induced hypertension,abortion,anaemia and neonatal body mass were observed.Results Rate of premature delivery,pregnancy induced hypertension,abortion and anaemia in control group were higher than those in levothyroxine sodium group（P 〈0.05）.The rate of spontaneous delivery,hemoglobin and neonatal body mass in control group were lower than those in levothyroxine sodium group（P〈 0.05）.The dosage of L-T4 was positively correlated with the TSH level in levothyroxine sodium group（r =0.763,P〈 0.05）.Conclusion Levothyroxine sodium can improve the pregnancy outcome in the patients during early trimester of pregnancy with subclinical hypothyroidism and TPoAb-negative.

关 键 词：甲状腺功能减退症 妊娠 过氧化物酶类 甲状腺素 

分 类 号：R581.2[医药卫生—内分泌]