基于个体差异应用不同剂量左旋甲状腺素钠对妊娠合并甲减患者的疗效观察  

Effect observation of different doses of levothyroxine sodium on pregnant patients with hypothyroidism based on individual differences

作　　者：朱雅琴 黄娟 钟美玲 ZHU Ya-qin;HUANG Juan;ZHONG Mei-ling(Obstetrics and Gynecology Department,Fenyi County Maternal and Child Health Hospital,Xinyu 336600,China)

机构地区：[1]江西省新余市分宜县妇幼保健院妇产科,336600

出　　处：《中国现代药物应用》2024年第7期113-116,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨妊娠合并甲状腺功能减退(甲减)患者采用不同剂量左旋甲状腺素钠治疗的临床疗效。方法选取60例妊娠合并甲减患者作为本次研究对象,按平衡序贯法分为实验组与对照组,各30例。对照组孕妇服用左旋甲状腺素钠片50μg/d,实验组孕妇根据机体内促甲状腺素(TSH)水平予以适量的左旋甲状腺素钠治疗。对比两组孕妇临床疗效、甲状腺功能分娩方式、不良妊娠结局、并发症发生率及新生儿发育水平。结果实验组孕妇临床总有效率93.33%显著高于对照组的73.33%(P<0.05)。治疗前,两组孕妇游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)、TSH水平对比无差异(P>0.05)。治疗后,两组孕妇FT3、FT4、TSH水平较治疗前均有所好转,且实验组孕妇FT3(4.34±0.41)pmol/L、FT4(12.39±2.95)pmol/L均高于对照组的(3.21±0.19)、(9.54±2.15)pmol/L,TSH(6.28±0.43)mIU/L低于对照组的(7.78±0.55)mIU/L(P<0.05)。实验组孕妇剖宫产率16.67%、不良妊娠发生率10.00%显著低于对照组的40.00%、40.00%(P<0.05);实验组孕妇并发症总发生率为3.33%,显著低于对照组的23.33%(P<0.05)。6个月后,实验组新生儿智能发育指数(MDI)评分(88.19±2.59)分、运动发育指数(PDI)评分(86.42±2.57)分均显著高于对照组的(79.19±3.54)、(78.16±2.37)分(P<0.05)。结论基于甲减孕妇个体差异给予不同剂量左旋甲状腺素钠取得了显著的临床疗效,不仅能改善孕妇甲减情况,还能促进胎儿发育,减少并发症的发生几率,值得推广。Objective To explore the clinical efficacy of different doses of levothyroxine sodium on pregnant patients with hypothyroidism based on individual differences.Methods 60 pregnant patients with hypothyroidism were selected as the study subjects,and were divided into an experimental group and a control group according to balanced sequential method,each with 30 cases.The pregnant women in the control group were given levothyroxine sodium tablets 50μg/d,and the pregnant women in the experimental group were given appropriate levothyroxine sodium treatment according to the level of thyroid stimulating hormone(TSH)in the body.The clinical efficacy,thyroid function,mode of delivery,adverse pregnancy outcome and complication rate,mental development level were compared between the two groups.Results The total clinical effective rate of 93.33%in the experimental group was significantly higher than 73.33%in the control group(P<0.05).Before treatment,there were no differences in the levels of free triiodothyronine(FT3),free thyroxine(FT4)and TSH between the two groups(P>0.05).After treatment,the levels of FT3,FT4 and TSH in both groups improved compared with those before treatment;the experimental group had FT3 of(4.34±0.41)pmol/L and FT4 of(12.39±2.95)pmol/L,which were higher than(3.21±0.19)and(9.54±2.15)pmol/L in the control group;the observation group had lower TSH of(6.28±0.43)mIU/L than(7.78±0.55)mIU/L in the control group(P<0.05).The cesarean section rate and incidence of adverse pregnancy of the experimental group were 16.67%and 10.00%,which were significantly lower than 40.00%and 40.00%of the control group(P<0.05).The total complication rate of the experimental group was 3.33%,which was significantly lower than 23.33%of the control group(P<0.05).After 6 months of treatment,the mental development index(MDI)score and psychomotor development index(PDI)in the experimental group were significantly higher than(79.19±3.54)and(78.16±2.37)points in the control group(P<0.05).Conclusion According to the individual diffe

关 键 词：左旋甲状腺素钠 妊娠 甲状腺功能减退 基于个体差异 不同剂量 

分 类 号：R714.256[医药卫生—妇产科学]