针对不同初始剂量左旋甲状腺素片治疗妊娠期亚临床甲状腺功能减退症的临床价值评估  

Evaluation of the Clinical Value of Different Initial Doses of Levothyroxine Tablets in the Treatment of Subclinical Hypothyroidism during Pregnancy

作　　者：黄一赫 毕慧超 石旭颖 HUANG Yihe;BI Huichao;SHI Xuying(Department of Internal Medicine,Qiqihar Hospital of Traditional Chinese Medicine,Qiqihar,Heilongjiang Province,161100 China)

机构地区：[1]齐齐哈尔市中医院内科,黑龙江齐齐哈尔161100

出　　处：《系统医学》2021年第11期93-95,共3页Systems Medicine

摘　　要：目的评估不同初始剂量的左旋甲状腺素片治疗妊娠期亚临床甲状腺功能减退症的临床价值。方法遵从“平衡序贯法”分组,择该院2018年2月—2019年12月内的妊娠期亚临床甲状腺功能减退症产妇94例分为对照组(46例,低剂量)和观察组(48例,高剂量),观察甲状腺功能、血脂、妊娠并发症以及新生儿不良结局发生率。结果治疗后观察组产妇促甲状腺激素(TSH)、血清游离三碘甲腺原氨酸(FT3)、胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平较低,游离甲状腺素(FT4)、高密度脂蛋白胆固醇(HDL-C)水平较高,优于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率(4.1%),显著较对照组的(21.7%)低,妊娠结局较好,差异有统计学意义(χ^(2)=6.513,P=0.011)。观察组新生儿不良结局发生率为2.1%,显著较对照组的13.0%低,差异有统计学意义(χ^(2)=4.094,P=0.043)。结论高剂量的左旋甲状腺素片治疗妊娠期亚临床甲状腺功能减退效果显著,可改善妊娠结局并降低新生儿不良结局发生率。Objective To evaluate the clinical value of different initial doses of levothyroxine tablets in the treatment of subclinical hypothyroidism during pregnancy.Methods Following the"balance sequential method"grouping,94 cases of pregnant women with subclinical hypothyroidism during pregnancy in the hospital from February 2018 to December 2019 were divided into control group(46 cases,low dose)and observation group(48 cases,high dose),to observe the incidence of thyroid function,blood lipids,pregnancy complications and adverse neonatal outcomes.Results After treatment,the observation group had lower levels of thyroid-stimulating hormone(TSH),serum free triiodothyronine(FT3),cholesterol(TC),triacylglycerol(TG),and low-density lipoprotein cholesterol(LDL-C),Free thyroxine(FT4),high-density lipoprotein cholesterol(HDL-C)levels were higher.The difference was statistically significant(P<0.05).The incidence of complications in the observation group was 4.1%,which was significantly lower than the 21.7%in the control group.The pregnancy outcome was better,and the difference was statistically significant(χ^(2)=6.513,P=0.011).The incidence of adverse neonatal outcomes in the observation group was 2.1%,which was significantly lower than 13.0%in the control group,and the difference was statistically significant(χ^(2)=4.094,P=0.043).Conclusion High-dose levothyroxine tablets are effective in treating subclinical hypothyroidism during pregnancy,which can improve pregnancy outcomes and reduce the incidence of adverse neonatal outcomes.

关 键 词：初始剂量 左旋甲状腺素片 妊娠期亚临床甲状腺功能减退症 临床价值 

分 类 号：R581[医药卫生—内分泌]