甲状腺素替代疗法对妊娠期亚临床甲状腺功能减退孕妇妊娠结局的影响

Effect of thyroxine replacement therapy on pregnancy outcome in pregnant women with gestational subclinical hypothyroidism

目的探讨甲状腺素替代疗法对妊娠期亚临床甲状腺功能减退(甲减)孕妇妊娠结局的影响。方法回顾性分析114例妊娠期亚临床甲减孕妇的临床资料,根据治疗情况分为A组51例及B组63例。A组孕妇给予常规生活指导,B组孕妇在此基础上给予左甲状腺素钠治疗。比较两组早产、低出生体重、先天性甲减发生率及新生儿出生后5 min Apgar评分,比较两组孕妇甲状腺功能相关指标、维生素B12及同型半胱氨酸(Hcy)水平。结果两组早产、低出生体重、先天性甲减发生率及新生儿出生后5 min Apgar评分差异均无统计学意义(均P> 0. 05);干预后B组血清促甲状腺激素及Hcy水平均低于A组及干预前,维生素B12水平均高于A组及干预前(均P <0. 05)。结论甲状腺素替代疗法治疗妊娠期亚临床甲减孕妇可有效改善甲状腺功能,并调节维生素B12和Hcy水平。

Objective To investigate the effect of thyroxine replacement therapy on pregnancy outcome in pregnant women with gestational subclinical hypothyroidism. Methods The clinical data of 114 pregnant women with gestational subclinical hypothyroidism were analyzed retrospectively,and all subjects were divided into group A(51 cases) and group B(63 cases) according to their treatment.Pregnant women in group A were given daily life guidance,while pregnant women in group B were given levothyroxine sodium therapy on the basis of daily life guidance.The two groups were compared with respect to incidence rates of premature delivery,low-weight birth and congenital hypothyroidism,as well as neonatal 5-minute Apgar score after delivery,moreover,thyroid function-associated indices and vitamin B 12 and homocysteine(Hcy) levels of pregnant women were compared between the two groups. Results No statistically significant difference was found between the two groups in incidence rate of premature delivery,low-weight birth or congenital hypothyroidism,or neonatal 5-minute Apgar score after delivery(all P >0.05);after intervention,the serum thyroid-stimulating hormone and Hcy levels in group B were lower,along with higher B 12 level,compared with the indices in group A or before intervention(all P <0.05). Conclusion Thyroxine replacement therapy can improve thyroid function effectively,regulate vitamin B 12 and Hcy levels in the treatment of pregnant women with gestational subclinical hypothyroidism.