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International Journal of Internal Medicine. 2018; 1: (1) 2; DOI:10.20900/j.ijim.20180002.

Observe the effect of L-thyroxine treatment of subclinical hypothyroidism during pregnancy
左旋甲状腺素治疗妊娠期亚临床甲状腺功能减退症的疗效观察

作者: 张璐,王芳*

宝鸡市中医医院

陕西省宝鸡市中心医院

*通讯作者:王芳,单位:陕西省宝鸡市中心医院;邮箱:zhllutog@163.com

引用本文: 张璐,王芳. 左旋甲状腺素治疗妊娠期亚临床甲状腺功能减退症的疗效观察. 国际内科前沿杂志, 2018, 1(1)
Published: 2018-03-09

摘要

目的:探讨左旋甲状腺素治疗妊娠期亚临床甲状腺功能减退症的临床疗效。
方法:选取本院收治的96例妊娠期亚临床甲状腺功能减退症患者作为研究对象,根据治疗
方法的不同分为两组(n=48),对照组不进行药物干预,观察组应用左旋甲状腺素片,对比两组治疗前后的甲状腺功能、血脂指标变化及妊娠结局。
结果:观察组治疗后的TSH、TC、TG、LDL-C水平显著低于对照组(P<0.05)。两组治疗前后的FT3、FT4、HDL-C水平均无明显变化(P>0.05)。观察组的妊娠并发症总发生率明显低于对照组(P<0.05)。观察组患者的自然分娩率显著高于对照组,剖宫产率及先兆子痫、自发性流产发生率均显著低于对照组(P<0.05)。观察组新生儿的精神运动发育、智能发育评分均显著高于对照组(P<0.05)。
结论:左旋甲状腺素片治疗妊娠期亚临床甲状腺功能减退症能够有效改善母体的甲状腺功能及血脂代谢,减少妊娠并发症的发生,改善妊娠结局。

关键词: 亚临床甲状腺功能减退症;左旋甲状腺素;妊娠期;妊娠结局

Abstract

Objective: To investigate the clinical efficacy of L-thyroxine treatment of subclinical hypothyroidism during pregnancy.
Methods: 96 patients with subclinical hypothyroidism during pregnancy were divided into two groups according to the different treatment methods(n=48). The control group received no drug intervention, and the observation group used L-thyroxine tablets. Then compared the thyroid function, blood lipid changes and pregnancy outcome of two groups before and after treatment.
Results: The levels of TSH, TC, TG and LDL-C in the observation group after treatment were significantly lower than control group (P<0.05). FT3, FT4, HDL-C levels before and after treatment in both groups had no significant changes (P>0.05). The total incidence of pregnancy complications in the observation group was significantly lower than control group (P<0.05). The rate of natural childbirth in the observation group was significantly higher than that in the control group. The incidence of cesarean section, preeclampsia and spontaneous abortion were significantly lower than those in the control group (P<0.05). The neonatal psychomotor development, mental development scores in the observation group were significantly higher than control group (P<0.05).
Conclusion  : L-thyroxin treatment of subclinical hypothyroidism in pregnancy can effectively increase serum folic acid levels, improve thyroid function, reduce the incidence of pregnancy complications and improve pregnancy outcomes.

Key words: Subclinical hypothyroidism; L-thyroxine; Gestation period; Pregnancy outcome

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