不同剂量左旋甲状腺素用于妊娠合并甲减治疗的临床疗效分析  

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

作　　者：陈小凤 吴素玉 郑莉莉 CHEN Xiaofeng;WU Suyu;ZHENG Lili(Department of Gynecology and Obstetrics,Ningde Maternal and Child Health Hospital,Ningde,Fujian Province,352100 China)

机构地区：[1]宁德市妇幼保健院妇产科,福建宁德352100

出　　处：《中外医疗》2024年第3期111-114,共4页China & Foreign Medical Treatment

摘　　要：目的观察分析不同剂量左旋甲状腺素(Levothyroxine,L-T_(4))用于妊娠合并甲状腺功能减退(简称甲减)治疗中的临床疗效。方法方便选取2021年3月—2023年2月期间于宁德市妇幼保健院接受左旋甲状腺素治疗的74例妊娠合并甲减患者作为研究对象,根据患者就诊先后顺序分成低剂量组与高剂量组(各37例),低剂量组应用低剂量L-T_(4)(起始剂量25μg/次),高剂量组应用高剂量L-T_(4)(起始剂量50μg/次)。比较两组患者血清促甲状腺激素(Thyroid Stimulating Hormone,TSH)、三碘甲状腺原氨酸(Triiodothyronine,T_(3))、四碘甲状腺氨酸(Tetraiodothyronine,T_(4))、游离三碘甲状腺原氨酸(Free Triiodothyronine,FT_(3))、游离甲状腺氨酸(Free Tetraiodothyronine,FT_(4))以及妊娠结局。结果在L-T_(4)治疗后,相较于低剂量组,高剂量组TSH水平显著下降,FT_(3)、FT_(4)、T_(3)、T_(4)上升,差异有统计学意义(P均<0.05)。高剂量组早产率为5.41%,低于低剂量组的27.03%,差异有统计学意义(χ^(2)=4.874,P<0.05)。组间的产后出血、新生儿窒息发生率对比,差异无统计学意义(P均>0.05)。结论相对于低剂量L-T_(4)治疗的妊娠合并甲减患者而言,较高剂量更有助于调节孕妇甲状腺激素的水平,并改善其妊娠结局,有利于母婴健康。Objective To observe and analyze the clinical effect of different doses of levothyroxine(L-T_(4))in the treat-ment of pregnancy complicated with hypothyroidism.Methods A total of seventy-four pregnant patients with hypothy-roidism who received levothyroxine treatment in Ningde Maternal and Child Health Hospital from March 2021 to February 2023 were conveniently selected as the study objects.Patients were divided into low-dose group and high-dose group(37 cases each)according to the order of treatment.The low-dose group was treated with low-dose L-T_(4)(initial dose 25μg/time),and the high-dose group was treated with high-dose L-T_(4)(initial dose 50μg/time).Thyroid Stimu-lating Hormone(TSH),Triiodothyronine(T_(3)),Tetraiodothyronin(T_(4)),Free Triiodothyronine(FT_(3)),Free Tetraiodothyro-nin(FT_(4))and pregnancy outcomes were compared between the two groups.Results After L-T4 treatment,compared with the low-dose group,the TSH level in the high-dose group was significantly decreased,and FT_(3),FT_(4),T_(3) and T_(4) were increased,and the differences were statistically significant(all P<0.05).The preterm birth rate of the high-dose group was 5.41%,which was lower than that of the low-dose group(27.03%),and the differences were statistically significant(χ^(2)=4.874,P<0.05).The incidence rates of postpartum hemorrhage and neonatal asphyxia were compared between groups,and the differences were not statistically significant(both P>0.05).Conclusion Compared with pregnant patients with hypothyroidism treated with low-dose L-T_(4),higher dose is more helpful to regulate the level of thyroid hormone in pregnant women and improve the pregnancy outcome,which is conducive to maternal and infant health.

关 键 词：妊娠合并加减 左旋甲状腺素 高剂量 临床疗效 

分 类 号：R714[医药卫生—妇产科学]