丙硫氧嘧啶与甲巯咪唑对妊娠合并甲状腺功能亢进症患者肝功能、妊娠结局及新生儿甲状腺功能的影响

Effects of propylthiouracil and methylimidazole on liver function,pregnancy outcome and neonatal thyroid function in patients with hyperthyroidism during pregnancy

目的探讨甲巯咪唑与丙硫氧嘧啶对妊娠合并甲状腺功能亢进症(甲亢)患者肝功能、妊娠结局及新生儿甲状腺功能的影响。方法选取2014年1月~2017年1月我院收治的80例妊娠合并甲亢患者作为研究对象,以随机数字表法分为propylthiouracilum组(PTU组)和methimazole组(MMI组),每组40例。PTU组给予丙硫氧嘧啶(PTU)治疗,MMI组给予甲巯咪唑(MMI)治疗。观察两组药物性肝损伤发生情况、妊娠结局、新生儿甲状腺功能异常情况。结果基线期,两组药物性肝损伤发生率基本相同,差异无统计学意义(P>0.05);治疗后,PTU组药物性肝损伤发生率显著高于MMI组,差异有统计学意义(P<0.05)。两组早产的发生率和阿氏评分基本相同,差异无统计学意义(P>0.05);PTU组胎儿丢失的发生率显著低于MMI组,差异有统计学意义(P<0.05)。两组新生儿甲状腺功能异常发生率基本相同,差异无统计学意义(P>0.05)。结论两种药物均不能兼顾到孕产妇和胎儿的现实情况。妊娠合并甲亢要科学利用抗甲状腺药物,以期改善母婴预后。

Objective To investigate the effects of methimazole and propylthiouracil on liver function,pregnancy outcome and neonatal thyroid function in patients with hyperthyroidism during pregnancy.Methods From January 2014 to January 2017,80 cases of pregnancy complicated with hyperthyroidism in our hospital were selected as the research subjects.They were randomly divided into propylthiouracilum group(group PTU)and methimazole group(group MMI),40 cases in each group.PTU group was treated with propylthiouracil(PTU)treatment,MMI group was treated with methimazole(MMI)treatment.The incidence of drug-induced liver injury,pregnancy outcome and neonatal thyroid dysfunction were observed in the two groups.Results In the baseline period,the incidence of drug-induced liver injury in the two groups was basically the same,and the difference was not statistically significant(P>0.05).After treatment,the incidence of drug-induced liver injury in group PTU was significantly higher than that in group MMI,and the difference was statistically significant(P<0.05).The incidence of premature delivery and the Apgar score were basically the same in the two groups,the difference was not statistically significant(P>0.05).The incidence of fetal loss in group PTU was significantly lower than that in group MMI,and the difference was statistically significant(P<0.05).The incidence of thyroid dysfunction in the two groups was basically the same,and the difference was not statistically significant(P>0.05).Conclusion Neither of the two drugs can take into account the reality of pregnant women and fetuses.We should make scientific use of antithyroid drugs in pregnancy with hyperthyroidism,in order to improve the prognosis of mother and child.