左甲状腺素干预妊娠期亚临床甲状腺功能减退症对患者甲状腺功能及子代神经心理发育的短期影响  

The short-term effect of levothyroxine intervention of subclinical hypothyroidism during pregnancy on the thyroid function and neuropsychological development of offspring

作　　者：谭艳丽[1] 殷炽龙 陈云贞 TAN Yan-li;YIN Chi-long;CHEN Yun-zhen(Department of Obstetrics,Wuzhou Red Cross Hospital,Wuzhou Guangxi 543002,China;Department of Pediatrics,Wuzhou Red Cross Hospital,Wuzhou Guangxi 543002,China;Department of Laboratory,Wuzhou Red Cross Hospital,Wuzhou Guangxi 543002,China)

机构地区：[1]广西梧州市红十字会医院产科,广西梧州543002 [2]广西梧州市红十字会医院儿科,广西梧州543002 [3]广西梧州市红十字会医院检验科,广西梧州543002

出　　处：《临床和实验医学杂志》2021年第14期1504-1507,共4页Journal of Clinical and Experimental Medicine

基　　金：广西省卫生健康委员会自筹经费科研课题项目(编号:Z20200065)

摘　　要：目的探究左甲状腺素干预妊娠期亚临床甲状腺功能减退症(SCH)对患者甲状腺功能及子代神经心理发育的短期影响。方法前瞻性选取2018年6月至2019年9月梧州市红十字会医院收治的60例妊娠期SCH患者的病例资料,按照随机数字表法将其分为对照组与观察组,每组各30例,分别给予常规治疗与常规治疗加左甲状腺素干预治疗。比较2组患者治疗前后甲状腺功能、子代神经心理发育情况,随访患者妊娠期并发症以及妊娠结局。结果与治疗前比较,2组患者治疗后促甲状腺激素(TSH)水平、观察组患者血清游离三碘甲腺原氨酸(FT3)水平均明显降低,差异均有统计学意义(P<0.05),组间比较观察组患者血清FT3、TSH水平[(3.55±0.18)pmol/L、(2.15±0.14)mIU/L]明显低于对照组[(4.45±0.52)pmol/L、(3.74±0.24)mIU/L],差异均有统计学意义(P<0.05)。观察组患者子代3个月龄、6个月龄大运动、精细动作、适应能力等神经心理发育指标评分均明显高于对照组,差异均有统计学意义(P<0.05)。观察组患者妊娠期并发症发生率(13.33%)明显低于对照组(36.67%),差异有统计学意义(P<0.05);观察组患者不良妊娠结局发生率(6.67%)亦明显低于对照组(26.67%),差异有统计学意义(P<0.05)。结论左甲状腺素应用于妊娠期SCH,对患者甲状腺功能及子代神经心理发育具有显著改善作用,有利于减少妊娠期并发症、改善妊娠结局,可在临床广泛推广。Objective To explore the short-term effects of levothyroxine intervention in subclinical hypothyroidism(SCH)during pregnancy on patients'thyroid function and neuropsychological development of offspring.Methods The case data of 60 SCH patients during pregnancy admitted to Wuzhou Red Cross Hospital from June 2018 to September 2019 were selected prospectively.According to the random number table method,they were divided into control group and observation group,with 30 cases in each group.They were given conventional treatment and conventional treatment plus levothyroxine intervention treatment.The thyroid function and the neuropsychological development of the offspring were compared between the two groups of patients before and after treatment.The patients were followed up for pregnancy complications and pregnancy outcomes.Results Compared with before treatment,after treatment,the levels of thyroid-stimulating hormone(TSH)in the two groups and the serum free triiodothyronine(FT3)levels in the observation group were significantly reduced,and the differences were significant(P<0.05).The serum FT3 and TSH levels in the observation group[(3.55±0.18)pmol/L,(2.15±0.14)mIU/L]were significantly lower than those in the control group[(4.45±0.52)pmol/L,(3.74±0.24)mIU/L],and the differences were statistically significant(P<0.05).The thyroid function and the neuropsychological development of the offspring indicators such as 3-month-old and 6-month-old in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The incidence of pregnancy complications in the observation group(13.33%)was significantly lower than that in the control group(36.67%),the difference was statistically significant(P<0.05).The incidence of adverse pregnancy outcomes in the observation group(6.67%)was also significantly lower than that in the control group(26.67%),and the difference was statistically significant(P<0.05).Conclusion The application of levothyroxine in SCH du

关 键 词：妊娠期 亚临床甲状腺功能减退症 左甲状腺素 甲状腺功能 子代神经心理发育 

分 类 号：R714.256[医药卫生—妇产科学]