大剂量左甲状腺素钠片治疗妊娠合并甲状腺功能减退症的效果  

Effect of high-dose levothyroxine sodium tablets in the treatment of pregnancy with hypothyroidism

作　　者：蔡蕾[1] 崇庆国 CAI Lei;CHONG Qingguo(Sheyang County People's Hospital,Yancheng 224300;Yancheng Third People's Hospital,Yancheng224000,China)

机构地区：[1]射阳县人民医院,江苏盐城224300 [2]盐城市第三人民医院,江苏盐城224000

出　　处：《临床医学研究与实践》2024年第4期143-146,共4页Clinical Research and Practice

摘　　要：目的探讨大剂量左甲状腺素钠片治疗妊娠合并甲状腺功能减退症的效果。方法选取2016年11月至2021年11月收治的200例妊娠合并甲状腺功能减退症患者为研究对象,将其随机分为A组和B组,各100例。A组予以小剂量左甲状腺素钠片治疗,B组予以大剂量左甲状腺素钠片治疗。比较两组的治疗效果。结果治疗后,B组的甲状腺长径短于A组,甲状腺过氧化物酶抗体(TPOAb)、促甲状腺激素(TSH)水平低于A组,游离甲状腺素(FT4)水平高于A组(P<0.05)。两组的妊娠结局总发生率比较,差异无统计学意义(P>0.05)。治疗后,B组的高密度脂蛋白胆固醇(HDL-C)水平高于A组,甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平低于A组(P<0.05)。治疗后,B组的叶酸水平高于A组(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论大剂量左甲状腺素钠片治疗妊娠合并甲状腺功能减退症患者的效果更佳,能够明显改善甲状腺功能及血脂代谢异常,有利于改善妊娠结局,整体安全性良好。Objective To investigate the effect of high-dose levothyroxine sodium tablets in the treatment of pregnancy with hypothyroidism.Methods A total of 200 patients with pregnancy with hypothyroidism admitted from November 2016 to November 2021 were selected as the research objects and randomly divided into group A and group B,with 100 cases in each group.The group A was treated with low-dose levothyroxine sodium tablets,and the group B was treated with high-dose levothyroxine sodium tablets.The therapeutic effects of the two groups were compared.Results After treatment,the thyroid length in the group B was shorter than that in the group A,thyroid peroxidase antibody(TPOAb)and thyroid stimulating hormone(TSH)levels in the group B were lower than those in the group A,and the free thyroxine(FT4)level was higher than that in the group A(P<0.05).There was no significant difference in the total incidence of pregnancy outcomes between the two groups(P>0.05).After treatment,the level of high-density lipoprotein cholesterol(HDL-C)in the group B was higher than that in the group A,and the levels of triglyceride(TG),total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)were lower than those in the group A(P<0.05).After treatment,the folic acid level in the group B was higher than that in the group A(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion High-dose levothyroxine sodium tablets in the treatment of patients with pregnancy with hypothyroidism has a better effect.It can significantly improve thyroid function and abnormal lipid metabolism,which is conducive to improving pregnancy outcomes,and the overall safety is good.

关 键 词：左甲状腺素钠片 大剂量 妊娠合并甲状腺功能减退症 血脂代谢 妊娠结局 甲状腺功能 

分 类 号：R714.256[医药卫生—妇产科学]