抗甲状腺药物治疗甲亢孕妇的疗效及对胎儿的影响

Therapeutic effect of antithyroid drugs on pregnant women with hyperthyroidism and their effects on the fetus

目的探讨抗甲状腺药物治疗甲状腺功能亢进孕妇的疗效,并对比产妇妊娠的不良结局。方法将2015年1月~2016年12月就诊的300名甲状腺功能亢进孕妇按是否接受治疗分为治疗组和对照组,各150例。治疗组孕妇给予抗甲状腺药物治疗,对照组孕妇未接受抗甲状腺药物治疗;观察并对比两组孕妇与甲状腺相关的各项指标检测及孕妇妊娠的不良结局。结果治疗组孕妇足月顺产137例,早产3例,胎儿窘迫5例,妊娠期高血压3例,新生儿畸形2例;对照组孕妇足月顺产123例,早产9例,胎儿窘迫10例,妊娠期高血压5例;两组新生儿在性别、胎龄、出生体重等方面比较,差异均无统计学意义(P>0.05);两组新生儿游离T3(FT3)、游离T4(FT4)、血清总T4(TT4)水平差异均无统计学意义(P>0.05)。结论抗甲状腺药物治疗孕妇甲状腺功能亢进可显著促进孕妇的健康,且对胎儿无明显不良反应。

Objective To investigate the efficacy of anti-thyroid drugs in the treatment of hyperthyroidism in pregnant women, and to compare the adverse outcomes of maternal pregnancy. Methods 300 hyperthyroid pregnant women who were treated from Janualy 2015 to December 2016 were divided into treatment group and control group according to whether they were treated or not, and 150 cases each. The treatment group received anti-thyroid drug treatment for pregnant women, while the control group did not receive anti-thyroid drug treatment. The indexes of pregnancy-related and thyroid-related diseases in both groups were observed and compared with those of pregnant women. Results In the treatment group, there were 137 cases of full-term preg- nancy, 3 cases of premature delivery, 5 cases of fetal distress, 3 cases of gestational hypertension and 2 cases of neonatal malforma- tion; The control group had 123 cases of full-term pregnancy, 9 cases of premature delivery, 10 cases of fetal distress, 5 cases of high blood pressure; There was no significant difference in gender, gestational age, birth weight and other aspects between the two groups of newborns（ P 〉0.05） ; There was no significant difference in the levels of free T3（FT3）, free T4（FT4）, and total T4（TT4） levels between the two groups （ P 〉0.05）. Conclusion Anti-thyroid drugs for pregnant women with hyperthyroidism can signif- icantly promote the health of pregnant women, and no significant adverse reactions to the fetus.