妊娠期亚临床甲减TPO-Ab阴性予L-T4治疗对妊娠结局的影响

Subclinical Hypothyroidism During Pregnancy to TPO-Ab Negative Effects of L-T4 Treatment on Pregnancy Outcome

目的回顾性分析妊娠期亚临床甲减TPO-Ab阴性的患者治疗后TSH的变化及对妊娠结局的影响。方法选择2014—2015年孕期诊断并分娩的妊娠期亚临床甲减TPO-Ab阴性的患者84例作为研究对象,自愿接受L-T4规范治疗的患者39例作为观察组,不愿意接受L-T4规范治疗的患者45例作为对照组。比较两组TSH的变化及妊娠不良结局的差异。结果治疗后TSH两组比较差异有统计学意义(P<0.01),妊娠期高血压病、妊娠期糖尿病、早产、胎盘早剥、胎膜早破、胎儿窘迫、胎儿生长受限及新生儿窒息发生情况比较差异均无统计学意义(P均>0.05)。结论妊娠期亚临床甲减TPO-Ab阴性经L-T4治疗后TSH维持在目标值范围,但不良妊娠结局无显著变化。

Objective To explore the effect of L -T4 treatment on pregnancy outcome and the change of TSH in TPO -Ab-negative patients associated with subclinical hypothyroidism （SCH） during pregnancy. MethodsFrom 2014 to 2015,84 TPO -Ab-negative patients associated with SCH , who were confirmed by pregnancydiagnosis and had childbirth, were enrolled as study subjects in the retrospective analysis. Patients were dividedinto treatment group （ voluntarily receiving L -T4 standard treatment, n = 39 ） and control group （ receiving no L -T4 standard treatment, n = 45 ） . The changes of TSH and the difference of adverse pregnancy outcome in the twogroups were compared. Results Comparison of the two groups after treatment, there were significant differencesin TSH （ P 〈0.01） , There were no significant differences in occurrences of hypertensive disorder complicatingpregnancy, gestational diabetes mellitus, premature delivery, placental abruption, premature rupture of membrane,fetal distress, fetal growth restriction and neonatal asphyxia between the treatment group and the controlgroup （all P 〉0. 05）. Conclusion No significant differences in adverse outcomes of pregnancy were found inT PO - Ab negative patients associated with SCH during pregnancy receiving L -T4 treatment compared with thoserefusing L -T4 treatment, but TSH were remained at the range of the target.