左旋甲状腺素片治疗妊娠并发甲状腺功能减退患者的效果分析  

Effect of levothyroxine tablets on pregnant patients with hypothyroidism

作　　者：杜裴 Du Pei(Kaifeng Maternity Hospital,Henan 475000)

机构地区：[1]开封市妇产医院,河南475000

出　　处：《天津药学》2021年第2期57-59,共3页Tianjin Pharmacy

摘　　要：目的:探讨左旋甲状腺素片治疗妊娠并发甲状腺功能减退患者的效果。方法:选取2017年4月—2019年4月本院妊娠并发甲状腺功能减退患者90例,按随机数字表法分为观察组(n=45)与对照组(n=45)。对照组予以常规治疗和饮食干预,如适量摄入碘食盐、无机盐等补充营养,合理控制脂肪摄入量,并指导患者行规律性运动;观察组在对照组的基础上加用左旋甲状腺素片,依据促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)水平调整剂量,初始剂量25~100μg/d,2周后复查,使TSH尽快降至2.5 mIU/L以下。两组均持续治疗4周。比较两组疗效、子代智力发育水平[语言发育商(LQ)、大运动发育商(GMQ)]、妊娠结局和治疗前后甲状腺功能[TSH、游离甲状腺素(FT4)、TPOAb水平]。结果:观察组总有效率(95.56%)较对照组(80.00%)高(P<0.05)。治疗前,两组TSH、FT4和TPOAb水平比较无显著差异(P>0.05);治疗后,两组TSH和TPOAb水平均较治疗前降低,FT4均较治疗前升高,且观察组TSH和TPOAb水平较对照组低,FT4水平较对照组高(P<0.05);产后12、18和24个月,观察组LQ和GMQ水平均较对照组高(P<0.05)。观察组剖宫产发生率(17.78%)和早产发生率(6.67%)与对照组(31.11%和15.56%)比较无显著差异(P>0.05)。结论:采用左旋甲状腺素片治疗妊娠并发甲状腺功能减退患者可提高疗效,改善甲状腺功能,改善妊娠结局,提高子代智力发育水平。Objective:To investigate the effect of levothyroxine tablets in the treatment of pregnant women with hypothyroidism.Methods:A total of 90 cases of pregnancy complicated with hypothyroidism in our hospital from April 2017 to April 2019 were selected and randomly divided into observation group(n=45)and control group(n=45)according to the random number table method.The control group was given routine treatment,dietary intervention,such as appropriate intake of iodized salt,inorganic salt,and other supplementary nutrition,reasonable control of fat intake,and guide patients to do regular exercise.Levothyroxine tablets were added to the observation group based on the control group.The dose was adjusted according to the levels of thyroid-stimulating hormone(TSH)and thyroid peroxidase antibody(TPOAb).The initial dose was 25~100μg/d,and the TSH was lowered to below 2.5 mIU/L as soon as possible after two weeks of reexamination.Both groups were treated continuously for four weeks.The curative effect,intellectual development level of offspring[language developmental quotient(LQ)and grand motor developmental quotient(GMQ)],pregnancy outcome and thyroid functions[TSH,free thyroxine(FT4),and TPOAb]before and after treatment were compared between the two groups.Results:The total effective rate of the observation group(95.56%)was higher than that of the control group(80.00%,P<0.05).Before treatment,there was no significant difference in TSH levels,FT4,and TPOAb between the two groups(P>0.05).After treatment,the TSH and TPOAb in both groups were lower than before treatment,and FT4 levels in both groups were higher than before treatment.In addition,the levels of TSH and TPOAb in the observation group were lower than those in the control group,while the level of FT4 was higher than that in the control group(P<0.05).The LQ and GMQ in the observation group were higher than those in the control group at 12,18,and 24 months postpartum(P<0.05).There was no significant difference in the incidence of cesarean section and premature delive

关 键 词：妊娠并发甲状腺功能减退 左旋甲状腺素片 疗效 子代智力发育 妊娠结局 

分 类 号：R977.14[医药卫生—药品]