左旋甲状腺素对妊娠合并甲状腺功能减退患者妊娠结局的影响

Influence of euthyrox on the pregnancy outcomes for patients with hypothyroidism during pregnancy

目的探讨左旋甲状腺素对妊娠合并甲状腺功能减退(甲减)患者的临床疗效及对妊娠结局的影响。方法将108例妊娠合并甲减患者按随机数字表法随机分为治疗A组(54例)、治疗B组(54例),另选择同期分娩的健康孕妇作为对照(C组,54例)。A组给予甲状腺素片,B组给予左旋甲状腺素片,根据促甲状腺激素(TSH)水平调整剂量,直至分娩。比较不同组甲状腺功能改善情况与妊娠结局。结果治疗后,两组游离T3(FT3)、游离T4(FT4)明显升高,TSH明显降低,且治疗B组的改善幅度较A组更为显著(P<0.05);与C组、B组比较,A组贫血、早产、胎儿生长迟缓的发生率明显升高,产后出血量明显增加,新生儿出生体质量及Apgar评分明显降低(P<0.05);B组与C组的妊娠结局相关指标比较,差异无统计学意义(P>0.05)。结论左旋甲状腺素片治疗妊娠期合并甲减者可促进甲状腺功能的恢复,改善妊娠结局。

Objective To explore the influence and clinical effect of euthyrox on pregnancy outcomes for patients with hypothyroidism during pregnancy. Methods O ne hundred and eight patients with hypothyroidism during pregnancy were assigned into group A and group B,and 54 cases of healthy pregnant woman at the same time were included as group C. Group A and group B were treated thyroi- din tablet and levothyroxine sodium tablets （euthyrox） until the delivery,and the dosage was adjusted according to the TSH level. The changes of thyroid function and pregnancy outcomes were compared. Results The levels of FT3 , FT 4 were remarkably increased, and TSH reduced after treatment in group A and group B,and the indicators in group B were significantly better than those in group A （P 〈 0.05）. Compared with group B and group C,the incidences of anemia,preterm labor,fetal growth retardation,postpartum haemorrhage in group A were remarkably increased, while neonate birth weight and Apgar score were reduced （P 〈 0. 05 ）. There were no significant differences in the related indicators of pregnancy outcomes between group B and group C （P 〉0. 05）. Conclusions Euthyrox can ef-fectively promote the recovery of thyroid function and improve the pregnancy outcomes for patients with hypothyroidism during pregnancy.