左甲状腺素钠片对妊娠期甲状腺功能减退孕妇甲状腺功能及糖、脂代谢水平的影响  

Effect of Levothyroxine Sodium Tablets on Thyroid Function and Preg⁃nancy Outcome in Pregnant Women with Hypothyroidism During Preg⁃nancy

作　　者：赵青 李招霞 王柯 ZHAO Qing;LI Zhaoxia;WANG Ke(Department of Endocrinology,Cao County People's Hospital,Heze 274000,Shandong,China)

机构地区：[1]曹县人民医院内分泌科,山东菏泽274000

出　　处：《系统医学》2025年第7期22-26,共5页Systems Medicine

摘　　要：目的 探究左甲状腺素钠片对妊娠期甲状腺功能衰退患者的糖、脂代谢水平及甲状腺功能的影响。方法方便选取2019年1月—2023年12月曹县人民医院62例妊娠期甲状腺功能减退的孕妇为研究对象,依据治疗方法分成对照组(n=31,常规疗法)和观察组(n=31,常规疗法+左甲状腺素钠片)。对比两组孕妇甲状腺功能指标[甲状腺激素(thyroid stimulating hormone, TSH)、甲状腺过氧化物酶抗体(anti-thyroid peroxidase antibody, TPOAb)、血清游离三碘甲状腺素(serum free triiodothyronine, FT3)、血清游离甲状腺素(serum free thyroxine, FT4)]、糖代谢水平[空腹血糖(fasting blood glucose, FBG)、空腹胰岛素(fasting insulin, FINS)]、脂代谢水平[血清总胆固醇(total cholesterol, TC)、甘油三酯(triglyceride, TG)、血清低密度脂蛋白胆固醇(low-density lipoprotein cholesterol, LDL-C)及高密度脂蛋白胆固醇(high-density lipoprotein cholesterol, HDL-C)]。结果 治疗前,两组甲状腺功能指标、糖代谢水平、脂代谢水平相比,差异均无统计学意义(P均>0.05)。治疗后,观察组TSH、TPOAb、FT3、FT4水平均优于对照组,差异均有统计学意义(P均<0.05)。观察组FBG、FINS、HOMA-IR分别为(5.22±0.43)mmol/L、(11.62±3.23)mlU/L、2.42±1.26,均低于对照组的(5.74±0.78)mmol/L、(14.52±3.57)mlU/L、3.45±1.22,差异均有统计学意义(t=3.251,3.354,3.270;P均<0.05)。观察组患者TC、TG、LDL-C各项指标均低于对照组,HDL-C指标高于对照组,差异均有统计学意义(P均<0.05)。结论 左甲状腺素钠片治疗妊娠期孕妇能够有效调节甲状腺功能,改善血糖、血脂代谢水平。Objective To explore the effect of levothyroxine sodium tablets on glucose and lipid metabolism and thy⁃roid function in patients with hypothyroidism during pregnancy.Methods Sixty-two pregnant women with hypothyroid⁃ism during pregnancy in Cao County People's Hospital from January 2019 to December 2023 were conveniently se⁃lected as the research objects.According to the treatment methods,they were divided into control group(n=31,conven⁃tional therapy)and observation group(n=31,conventional therapy+levothyroxine sodium tablets).The thyroid function indexes[thyroid stimulating hormone(TSH),anti-thyroid peroxidase antibody(TPOAb),serum free triiodothyronine(FT3),serum free thyroxine(FT4)]and glucose metabolism levels[fasting blood glucose(FBG),fasting insulin(FINS)]were compared between the two groups,Lipid metabolism levels[serum total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)].Results Before treatment,there was no statistically significant differences in thyroid function index,glucose metabolism level and lipid metabo⁃lism level between the two groups(all P>0.05).After treatment,the levels of TSH,TPOAb,FT3 and FT4 in the obser⁃vation group were better than those in the control group,and the differences were statistically significant(all P<0.05).The FBG,FINS and HOMA-IR in the observation group were(5.22±0.43)mmol/L,(11.62±3.23)mlU/L and 2.42±1.26,which were lower than(5.74±0.78)mmol/L,(14.52±3.57)mlU/L and 3.45±1.22 in the control group,and the differ⁃ences were statistically significant(t=3.251,3.354,3.270;all P<0.05).The indexes of TC,TG and LDL-C in the obser⁃vation group were lower than those in the control group,and the indexes of HDL-C were higher than those in the con⁃trol group,and the differences were statistically significant(all P<0.05).Conclusion Levothyroxine sodium tablets can effectively regulate thyroid function and improve blood glucose and lipid metabolism in pregnant women.

关 键 词：左甲状腺素钠片 妊娠期 甲状腺功能 糖代谢 

分 类 号：R4[医药卫生—临床医学]