左甲状腺素钠片治疗妊娠期亚临床甲状腺功能减退的效果观察

Clinical effect observation of levothyroxine sodium tablets in the treatment of gestational subclinical hypothyroidism

目的筛查妊娠期呈现亚临床的甲状腺功能减退(甲减)的孕妇,给予适当的左甲状腺素钠片(优甲乐)的治疗,分析判断药物治疗对甲状腺功能减退孕妇妊娠结局的疗效。方法根据116例体检孕妇的甲状腺功能五项[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、血清总三碘甲状腺原氨酸(TT3)和总四碘甲状腺原氨酸(TT4)]以及抗体两项[甲状腺过氧化酶抗体(TPO-Ab)和促甲状腺素受体抗体(TR-Ab)]检测结果 ,将60例甲状腺功能正常的孕妇作为正常组,56例亚临床甲减的孕妇作为治疗组,且治疗组给予优甲乐治疗,分析治疗组的疗效,比较两组的妊娠结局。结果治疗前治疗组的TSH水平(4.68±0.52)μIU/ml明显高于正常组的(1.68±0.33)μIU/ml(P<0.05);治疗组治疗后TSH(3.43±0.41)μIU/ml较治疗前降低(P<0.05);两组孕妇生产时血压都在正常范围内,产后出血量也正常,组间差异无统计学意义(P>0.05)。两组新生儿体重及阿氏评分(Apgar评分)比较差异均无统计学意义(P>0.05),发育状况良好。结论优甲乐应用于临床上检测到的妊娠期亚临床甲减孕妇的药物治疗有助于维持孕妇和胎儿的甲状腺激素水平正常,配合其他常规检查,确保孕妇正常,胎儿健康,对优生优育有着积极的意义。

Objective To screen pregnant women with subclinical hypothyroidism in gestation period,along with adequate levothyroxine sodium tablets (Euthyrox) for treatment, and to analyze and judge curativeeffect by drug therapy for pregnancy outcome in pregnant women with hypothyroidism. Methods On the basisof detection outcomes from thyroid function five index[ free triiodothyronine (FT3), free thyroxine (FT4), thyroidstimulating hormone (TSH), serum total triiodothyronine (TT3) and total tetraiodothyronine (TT4)] and antibody twoindex[ thyroperoxidase antibody (TPO-Ab) and thyrotrophin receptor antibody (TR-Ab)] in 116 pregnant women,all pregnant women were divided into normal group with 60 normal thyroid function cases and treatment group with 56 subclinical hypothyroidism cases. The treatment group received Euthyrox for treatment. Curative effectof the treatment group was analyzed for comparison of pregnancy outcome between the two groups. Results The treatment group had obviously higher TSH as (4.68±0.52) μIU/ml than (1.68±0.33) μIU/ml in the normal group before treatment (P<0.05). The treatment group also had lower TSH level after treatment as (3.43±0.41) μIU/ml than that before treatment (P<0.05). Both groups showed normal blood pressure during delivery and normal postpartum bleeding volume, and there was no statistically significant difference between the two groups (P>0.05).The differences of neonatal weight and Apgar score all had no statistical significance between the two groups(P>0.05), with good developmental situation. Conclusion Implement of Euthyrox in drug therapy for patients with detected subclinical hypothyroidism in gestation period is helpful to maintain normal thyroid hormones levels in pregnant women and fetus. Combining with other conventional examination, this method can guarantee normal puerperal condition and health in fetus. It contains positive significance for sound child rearing.