不同剂量左旋甲状腺素治疗妊娠合并甲减的临床观察  

Clinical Observation of Different Doses of Levothyroxine in the Treatment of Pregnancy Complicated with Hypothyroidism

作　　者：李金朋 LI Jin-peng(Department of Obstetrics and Gynecology,Yanshi People's Hospital,Yanshi 471900,Henan Province,China)

机构地区：[1]偃师市人民医院产一科,河南偃师471900

出　　处：《罕少疾病杂志》2022年第6期29-30,38,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨不同剂量左旋甲状腺素治疗妊娠合并甲减的临床效果。方法选取2017年1月至2019年5月我院收治的妊娠合并甲减患者100例,按随机数字表法分为两组,各50例。对照组口服小剂量左旋甲状腺素治疗,试验组口服大剂量左旋甲状腺素治疗,治疗期间两组均限制脂肪摄入量,日常补充蛋白质、碘,控制体重,注意休息。比较两组血脂、甲状腺激素水平,新生儿神经智力发育情况和妊娠并发症发生情况。结果试验组治疗总胆固醇(TC)为(4.32±0.49)mmol/L、低密度脂蛋白胆固醇(LDL-C)为(2.56±0.24)mmol/L、三酰甘油(TG)为(1.30±0.10)mmol/L,低于对照组的(4.89±0.46)mmol/L、(2.88±0.20)mmol/L、(1.52±0.13)mmol/L,高密度脂蛋白胆固醇(HDL-C)为(1.69±0.17)mmol/L,高于对照组的(1.27±0.14)mmol/L,差异有统计学意义(P<0.05);试验组促甲状腺激素(TSH)为(2.65±0.84)mU/L,低于对照组的(5.60±1.89),mU/L,游离甲状腺激素(FT4)为(12.83±3.62)pmol/L、游离三碘甲状腺原氨酸(FT3)为(4.60±0.32)pmol/L,高于对照组的(10.86±3.54)pmol/L、(3.33±0.26)pmol/L,差异有统计学意义(P<0.05);试验组精神运动发育为(121.01±19.78)分、智力发育为(123.95±23.06)分,高于对照组的(110.79±20.57)分、(112.30±21.87)分,差异有统计学意义(P<0.05);试验组妊娠并发症发生率为4.00%,低于对照组的20.00%,差异有统计学意义(P<0.05)。结论大剂量左旋甲状腺素治疗妊娠合并甲减患者可更好地调节血脂、甲状腺激素水平,促进新生儿神经智力发育,降低妊娠并发症发生率。Objective To investigate the clinical effect of different doses of levothyroxine in the treatment of pregnancy complicated with hypothyroidism.Methods 100 patients with pregnancy complicated with hypothyroidism treated in our hospital from January 2017 to May 2019 were randomly divided into two groups with 50 cases in each group.The control group was treated with low-dose levothyroxine and the experimental group was treated with high-dose levothyroxine.During the treatment,both groups limited fat intake,supplemented protein and iodine daily,controlled body weight and paid attention to rest.The levels of blood lipid and thyroid hormone,the development of neonatal neurointelligence and the incidence of pregnancy complications were compared between the two groups.Results Total cholesterol(TC)(4.32±0.49)mmol/L),low density lipoprotein cholesterol(LDL-C)(2.56±0.24)mmol/L,triglyceride(TG)(1.30±0.10)mmol/L in the experimental group were lower than those in the control group(4.89±0.46)mmol/L,(2.88±0.20)mmol/L,(1.52±0.13)mmol/L,and high density lipoprotein cholesterol(HDL-C)(1.69±0.17)mmol/L was higher than(1.27±0.14)mmol/L in the control group(P<0.05);thyroid stimulating hormone(TSH)was(2.65±0.84)mu/L,lower than(5.60±1.89)mu/L,free thyroid hormone(FT4)was(12.83±3.62)pmol/L,free triiodothyronine(FT3)was(4.60±0.32)pmol/L,higher than(10.86±3.54)pmol/L and(3.33±0.26)pmol/L in the control group(P<0.05);the scores of psychomotor development and intellectual development in the experimental group were(121.01±19.78)and(123.95±23.06),which were significantly higher than those in the control group(110.79±20.57)and(112.30±21.87)(P<0.05);the incidence of pregnancy complications in the experimental group was 4.00%,which was lower than 20.00%in the control group(P<0.05).Conclusion High dose levothyroxine in the treatment of pregnancy complicated with hypothyroidism can better regulate the levels of blood lipid and thyroid hormone,promote the development of neonatal neurointelligence and reduce the incidence of pregnan

关 键 词：妊娠合并甲减 左旋甲状腺素 新生儿发育 血脂 

分 类 号：R714.256[医药卫生—妇产科学]