甲状腺素替代疗法治疗妊娠期合并亚临床甲状腺功能减退患者的临床疗效

Clinical efficacy of thyroxine replacement therapy in pregnancy patients with subclinical hypothyroidism

目的 探讨甲状腺素替代疗法治疗妊娠期合并亚临床甲状腺功能减退患者的临床疗效。方法 选取2011年5月~2016年5月海宁市妇幼保健院和海宁市第四人民医院收治的妊娠期合并亚临床甲状腺功能减退患者80例,依据治疗方法将这些患者分为甲状腺素替代疗法治疗组（替代治疗组）和常规治疗组2组,每组各40例。对2组患者的血清促甲状腺激素（TSH）、甲状腺素T4（FT4）、三酰甘油（TG）、总胆固醇（CHO）水平、分娩情况、妊娠结局及并发症发生情况、新生儿情况进行统计分析。结果 替代治疗组患者的血清TSH、TG、CHO水平均显著低于常规治疗组,FT4水平显著高于常规治疗组,差异有统计学意义（P〈0.05）,经阴道顺产率显著高于70.0%（28/40）显著高于常规治疗组35.0%（14/40）,剖宫产率30.0%（12/40）显著低于常规治疗组65.0%（26/40）,差异有统计学意义（P〈0.05）,早产、产后出血、子痫前期、低蛋白血症、胎儿发育受限发生率2.5%（1/40）、2.5%（1/40）、5.0%（2/40）、7.5%（3/40）、0均显著低于常规治疗组17.5%（7/40）、15.0%（6/40）、20.0%（8/40）、17.5%（7/40）、15.0%（6/40）,差异有统计学意义（P〈0.05）,新生儿体质量显著高于常规治疗组,差异有统计学意义（P〈0.05）,低体重儿、巨大儿、早产儿、窒息、死亡比例0、2.5%（1/40）、5.0%（2/40）、7.5%（3/40）、0均显著低于常规治疗组15.0%（6/40）、20.0%（8/40）、22.5%（9/40）、27.5%（11/40）、20.0%（8/40）,差异有统计学意义（P〈0.05）。结论 甲状腺素替代疗法治疗妊娠期合并亚临床甲状腺功能减退患者的临床疗效较常规治疗显著。

Objective To evaluate the clinical efficacy of thyroxine replacement therapy in the treatment of pregnancy patients with subclinical hypothyroidism.Methods 80 cases of patients with subclinical hypothyroidism who were admitted to our hospital from May 2011 to May 2016 were selected, they were divided into thyroxine replacement therapy treatment group （ replacement treatment group ） and conventional treatment group two groups according to the treatment methods, 40 cases in each group.The serum TSH, FT4, TG, CHO levels, childbirth, pregnancy outcomes and complications, neonatal status of the two groups were statistically analyzed.Results The serum TSH, TG, CHO levels of the replacement treatment group were significantly lower, the FT4 level was significantly higher, the difference was statistically significant （P〈0.05）, the trans vaginal yield rate 70.0%（28/40） was significantly higher than the conventional treatment group 35.0%（14/40）, the cesarean section rate 30.0%（12/40） was significantly lower than the conventional treatment group 65.0%（ 26/40 ） , the difference was statistically significant （ P〈0.05 ） , the incidences of preterm delivery, postpartum hemorrhage, preeclampsia, hypoproteinemia, fetal development restriction 2.5%（1/40）, 2.5%（1/40）, 5.0%（2/40）, 7.5%（2/40）, 0 were significantly lower than the conventional treatment group 17.5%（7/40）, 15.0%（6/40）, 20.0%（8/40）, 17.5%（7/40）, 15.0%（6/40）, the difference was statistically significant （P〈0.05）, the neonates body weight was significantly higher than the conventional treatment group, the difference was statistically significant （P〈0.05）, the proportions of low birth weight infants, giant infants, premature infants, asphyxia, death 0, 2.5%（1/40）, 5.0%（2/40）, 7.5%（2/40）, 0 were significantly lower than the conventional treatment group 15.0%（6/40）, 20%（8/40）, 22.5%（9/40）, 27.5%（11/25）, 20.0%（8/40）, the difference was statistically significant （P〈0.05）.Conclusion The clinical efficacy of thyroxine replacement therapy in the treatment of pregnancy patients with subclinical hypothyroidism is more significant than conventional treatment .