左旋甲状腺素片治疗妊娠合并甲状腺功能减退患者的效果分析  

Effect analysis of levothyroxine tablets in the treatment of pregnancy with hypothyroidism

作　　者：阮丹丹 RUAN Dandan(Department of Obstetrics,Suixian Maternal and Child Health Hospital,Shangqiu Henan 476900,China)

机构地区：[1]睢县妇幼保健院产科,河南商丘476900

出　　处：《临床研究》2023年第9期47-49,共3页Clinical Research

摘　　要：目的探讨左旋甲状腺素片治疗妊娠合并甲状腺功能减退患者的临床效果。方法回顾性分析2021年1月至2022年12月在睢县妇幼保健院实施产检以并进行分娩的66名甲状腺功能减退孕产妇数据资料。依据妊娠期间是否接受左旋甲状腺素片治疗进行分组,对照组(n=33)未接受药物治疗,观察组(n=33)接受左旋甲状腺素片治疗。比较两组孕产妇在干预前及干预后3个月的甲状腺功能指标[游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)]。比较两组孕产妇的不良结局情况(妊娠期高血压、妊娠期糖尿病、贫血、胎膜早破、产后出血)。比较两组胎儿的异常情况(流产、胎儿畸形、生长受限、发育迟缓)。比较两组孕产妇的分娩方式及在干预期间的不良反应发生情况。结果干预前,两组孕产妇的TSH、FT4、FT3数据比较,差异无统计学意义(P>0.05)。干预后3个月,两组孕产妇的TSH均降低,FT4、FT3均增高,差异有统计学意义(P<0.05);且观察组TSH低于对照组,FT4、FT3高于对照组,差异有统计学意义(P<0.05)。观察组孕产妇不良结局发生率及胎儿异常情况发生率均低于对照组,差异有统计学意义(P<0.05)。观察组剖宫产比例明显低于对照组,差异有统计学意义(P<0.05)。两组孕产妇干预期间不良反应发生率的数据比较,差异无统计学意义(P>0.05)。结论在妊娠合并甲状腺功能减退的孕妇人群中采用左旋甲状腺素片干预,能够改善甲状腺功能指标,降低孕产妇以及胎儿的不良结局发生率,提升自然分娩的比例,且不增加异常反应的风险。Objective To investigate the clinical effect of levothyroxine tablets in the treatment of pregnancy with hypothyroidism.Methods The data of 66 hypothyroidism pregnant women in Suixian Maternal and Child Health Hospital from January 2021 to December 2022 were retrospectively analyzed.The patients were divided into two groups according to whether they received levothyroxine tablets during pregnancy.The control group(n=33)did not receive drug treatment,and the observation group(n=33)received levothyroxine tablets.The thyroid function indexes(free triiodothyronine(FT3),free thyroxine(FT4),and thyrotropin(TSH))of the two groups were compared before and 3 months after the intervention.The adverse outcomes(gestational hypertension,gestational diabetes,anemia,premature rupture of membranes,and postpartum hemorrhage)of the two groups were compared.Fetal abnormalities(abortion,fetal malformation,growth restriction,developmental delay)were compared between the two groups.The methods of delivery and the occurrence of adverse reactions during the intervention were compared between the two groups.Results Before the intervention,there was no significant difference in TSH,FT4,and FT3 data between the two groups(P>0.05).3 months after intervention,TSH in both groups decreased,while FT4 and FT3 increased,the difference was statistically significant(P<0.05).TSH in the observation group was lower than the control group,and FT4 and FT3 were higher than the control group,the difference was statistically significant(P<0.05).The incidence of adverse maternal outcomes and fetal abnormalities in the observation group was lower than those in the control group,and the difference was statistically significant(P<0.05).The proportion of cesarean sections in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during the intervention(P>0.05).Conclusion The use of levothyrox

关 键 词：左旋甲状腺素片 妊娠 甲状腺功能减退 能量代谢 流产 神经发育 

分 类 号：R714.256[医药卫生—妇产科学]