L-T4治疗妊娠期亚临床甲状腺功能减退患者疗效的影响因素  

Analysis of Influencing Factors of the Efficacy of L-T4 in the Treatment of Subclinical Hypothyroidism during Pregnancy

作　　者：段蓓[1] 陈蓓 连李斌[1] DUAN Bei;CHEN Bei;LIAN Li-bin(Department of Obstetrics,The Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang Shaanxi 712000)

机构地区：[1]陕西中医药大学第二附属医院产科,陕西咸阳712000

出　　处：《医学临床研究》2022年第12期1799-1802,共4页Journal of Clinical Research

摘　　要：【目的】探讨左旋甲状腺素(L-T4)治疗妊娠期亚临床甲状腺功能减退(SCH)患者疗效的影响因素。【方法】选取2019年10月至2021年8月本院收治的365例妊娠期SCH患者,依据L-T4治疗效果分为L-T4治疗有效组(有效组,n=278)和L-T4治疗无效组(无效组,n=87)。收集两组研究对象的相关病史、甲状腺功能指标、脂代谢指标、微量元素及彩色多普勒超声血流指标;采用多因素Logistic回归分析L-T4治疗妊娠期SCH患者疗效的影响因素。【结果】L-T4治疗妊娠期SCH患者的总有效率为76.16%。单因素分析结果显示:检测促甲状腺激素(TSH)时间、TSH水平、合并糖尿病、合并胃肠道疾病、铁元素(Fe)、锌元素(Zn)、甲状腺过氧化物酶抗体(TPO-Ab)阳性、甲状腺球蛋白抗体(TG-Ab)阳性、收缩期峰值流速(PSV)、舒张末期血流速度(EDV)是L-T4治疗妊娠期SCH患者疗效的影响因素。多因素分析结果显示:检测TSH时间、Fe、TSH水平、TG-Ab阳性、TPO-Ab阳性、合并胃肠道疾病、合并糖尿病、PSV是L-T4治疗妊娠期SCH患者疗效的影响因素(P<0.05)。【结论】L-T4治疗妊娠期SCH患者有效率有待提高,影响L-T4治疗效果的因素众多,应加强对妊娠期SCH治疗的重视,避免影响治疗的不利因素,提高L-T4的治疗效果。【Objective】To analyze the influencing factors of the efficacy of levothyroxine(L-T4)in the treatment of subclinical hypothyroidism(SCH)during pregnancy and optimize the L-T4 treatment plan.【Methods】A total of 365 patients with SCH during pregnancy from October 2019 to August 2021 were divided into the L-T4 treatment effective group(n=278)and the L-T4 treatment ineffective group(n=87)based on the clinical effects of L-T4 treatment.Data of medical history,the peripheral venous blood of the patients when fasting for index inspection,thyroid function-related indexes,lipid metabolism-related indexes,trace elements,thyroid ultrasound and spectral color Doppler blood flow-related indexes of the two groups were collected.Multivariate Logistic regression was used to analyze the influencing factors of the curative effect of L-T4 in the treatment of pregnant SCH patients.【Results】The effective rate of L-T4 in the treatment of SCH during pregnancy was 76.16%.The results of single factor analysis showed that the detection time of TSH,TSH level,diabetes complication,gastrointestinal diseases,iron(Fe),zinc(Zn),thyroid peroxidase antibody(TPO-Ab)(+),thyroid gland protein antibody(TG-Ab)(+),peak systolic flow velocity(PSV),end-diastolic blood flow velocity(EDV)were the influencing factors of the efficacy of L-T4 in the treatment of SCH during pregnancy(P<0.05).The results of multivariate analysis showed that the detection time of TSH,TSH level,TG-Ab(+),TPO-Ab(+),combined with intestinal disease,diabetes,and PSV were the influencing factors of the efficacy of L-T4 in the treatment of SCH in pregnancy(P<0.05).【Conclusion】The effective rate of L-T4 in the treatment of SCH during pregnancy needs to be improved.There are many factors that affect the effect of L-T4 treatment.The maternal and child health departments of hospitals should pay more attention to the treatment of SCH during pregnancy to avoid unfavorable factors that affect the treatment and improve L-T4 treatment effect.

关 键 词：甲状腺功能减退症/并发症 妊娠并发症 甲状腺素/治疗应用 

分 类 号：R581.2[医药卫生—内分泌]