不同起始剂量左甲状腺素钠治疗妊娠期亚临床甲状腺功能减退症患者的效果比较  

Comparison of effects of different initial doses of Levothyroxine sodium in treatment of patients with subclinical hypothyroidism during pregnancy

作　　者：王月姿 WANG Yuezi(Department of Obstetrics and Gynecology of Yucheng County People’s Hospital,Shangqiu 476300 Henan,China)

机构地区：[1]虞城县人民医院妇产科,河南商丘476300

出　　处：《中国民康医学》2025年第6期143-145,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较不同起始剂量左甲状腺素钠治疗妊娠期亚临床甲状腺功能减退症(SCH)患者的效果。方法:回顾性分析2020年11月至2023年2月该院收治的97例妊娠期SCH患者的临床资料,按照左甲状腺素钠片起始剂量不同将其分为A组(n=32)、B组(n=32)、C组(n=33)。A组起始用药剂量为12.5μg/次,B组起始用药剂量为25.0μg/次,C组起始用药剂量为50.0μg/次,比较三组治疗前后甲状腺功能指标[促甲状腺激素(TSH)、游离四碘甲状腺原氨酸(FT4)]水平、不良妊娠结局发生率和不良反应发生率。结果:治疗后,三组FT4水平比较,差异无统计学意义(P>0.05);三组TSH水平均低于治疗前,且C组低于A组、B组,差异有统计学意义(P<0.05);A组与B组不良妊娠结局发生率比较,差异无统计学意义(P>0.05);C组不良妊娠结局发生率均低于A组、B组,差异有统计学意义(P<0.05);三组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:12.5、25.0、50.0μg/次起始剂量的左甲状腺素钠治疗妊娠期SCH患者均可促进TSH下降,起始用药剂量为50.0μg/次可在不增加药物不良反应基础上,使TSH更快回归正常水平,对改善妊娠期SCH孕妇不良妊娠结局有益。Objective:To compare effects of different initial doses of Levothyroxine sodium in treatment of patients with subclinical hypothyroidism(SCH)during pregnancy.Methods:The clinical data of 97 patients with SCH during pregnancy admitted to this hospital from November 2020 to February 2023 were retrospectively analyzed.According to the initial dose of Levothyroxine sodium tablets,they were divided into group A(n=32),group B(n=32)and group C(n=33).The initial dose of group A was 12.5μg/time,the initial dose of group B was 25.0μg/time,and the initial dose of group C was 50.0μg/time.The levels of thyroid function indexes[thyroid stimulating hormone(TSH),free tetraiodothyronine(FT4)]and after the treatment,the incidence of adverse pregnancy outcomes,and the incidence of adverse reactions were compared among the three groups before.Results:After the treatment,there was no significant difference in the FT4 levels among the three groups(P>0.05).The TSH levels in the three groups were lower than those before the treatment,that in group C was lower than those in group A and group B,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse pregnancy outcomes between group A and group B(P>0.05).The incidence of adverse pregnancy outcomes in group C was lower than those in group A and group B,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusions:The initial dose of 12.5,25.0 and 50.0μg/time of Levothyroxine sodium in the treatment of the patients with SCH during pregnancy can promote the decrease of TSH.The initial dose of 50.0μg/time can make the TSH level return to normal faster without increasing the adverse drug reactions,which is beneficial to improve the adverse pregnancy outcomes of the pregnant women with SCH during pregnancy.

关 键 词：妊娠期 亚临床甲状腺功能减退症 左甲状腺素钠 不良妊娠结局 甲状腺功能 

分 类 号：R715[医药卫生—妇产科学]