不同初始剂量左甲状腺素钠片治疗妊娠期SCH的有效性及安全性比较  

Comparison of efficacy and safety of different initial doses of levothyroxine sodium tablets in the treatment of SCH during pregnancy

作　　者：胡小莹 牛颖佳 刘静 HU Xiaoying;NIU Yingjia;LIU Jing(Obstetrics Department,Genertec Universal Xi'an Aero-engine Hospital,Xi'an 710021;Obstetrics Department,Northwest Women's and Children's Hospital,Xi'an 710061,China)

机构地区：[1]通用环球西安西航医院产科,陕西西安710021 [2]西北妇女儿童医院产科,陕西西安710061

出　　处：《临床医学研究与实践》2025年第1期107-110,共4页Clinical Research and Practice

摘　　要：目的 分析不同初始剂量左甲状腺素钠片治疗妊娠期亚临床甲状腺功能减退症(SCH)的有效性及安全性。方法 选取2020年6月至2022年6月收治的80例妊娠期SCH患者为研究对象,按照左甲状腺素钠片初始剂量差异将其分为低初始剂量组(40例,50μg)和高初始剂量组(40例,75μg)。比较两组的治疗效果。结果 高初始剂量组的治疗总有效率高于低初始剂量组(P<0.05)。治疗后,高初始剂量组的促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)水平低于低初始剂量组,游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平高于低初始剂量组(P<0.05)。治疗后,高初始剂量组的鸢尾素、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平低于低初始剂量组,高密度脂蛋白胆固醇(HDL-C)水平高于低初始剂量组(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)。高初始剂量组的不良妊娠结局总发生率低于低初始剂量组(P<0.05)。结论 高初始剂量左甲状腺素钠片用于妊娠期SCH患者中能够取得更好的治疗效果,可有效改善甲状腺功能,调节机体代谢,满足胎儿发育需求,降低不良妊娠结局发生风险,且不增加药物不良反应,值得临床应用。Objective To analyze the efficacy and safety of different initial doses of levothyroxine sodium tablets in the treatment of subclinical hypothyroidism(SCH)during pregnancy.Methods A total of 80 patients with SCH during pregnancy admitted from June 2020 to June 2022 were selected as the research objects.According to the initial dose difference of levothyroxine sodium tablets,the patients were divided into low initial dose group(40 cases,50μg)and high initial dose group(40 cases,75μg).The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the high initial dose group was higher than that in the low initial dose group(P<0.05).After treatment,the levels of thyroid stimulating hormone(TSH)and thyroid peroxidase antibody(TPOAb)in the high initial dose group were lower than those in the low initial dose group,the levels of free triiodothyronine(FT3)and free thyroxine(FT4)were higher than those in the low initial dose group(P<0.05).After treatment,the levels of irisin,total cholesterol(TC),triglyceride(TG)and low density lipoprotein-cholesterol(LDL-C)in the high initial dose group were lower than those in the low initial dose group,and the level of high density lipoprotein-cholesterol(HDL-C)was higher than that in the low initial dose group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).The total incidence of adverse pregnancy outcomes in the high initial dose group was lower than that in the low initial dose group(P<0.05).Conclusion High initial dose of levothyroxine sodium tablets can achieve better therapeutic effect in patients with SCH during pregnancy.It can effectively improve thyroid function,regulate body metabolism,meet fetal development needs,reduce the risk of adverse pregnancy outcomes,and do not increase adverse drug reactions.It is worthy of clinical application.

关 键 词：妊娠期 亚临床甲状腺功能减退症 左甲状腺素钠片 初始剂量 

分 类 号：R714.256[医药卫生—妇产科学]