左甲状腺素用于不同孕周妊娠合并SCH患者对新生儿脑损伤的影响

Effect of levothyroxine on neonatal brain injury in pregnancy patients with SCH during different gestational weeks

目的探讨左甲状腺素用于不同孕周妊娠合并亚临床甲状腺功能减退(SCH)患者对新生儿脑损伤的影响。方法选取2017年7月至2018年12月在本院接受左甲状腺素治疗的146例妊娠合并SCH患者,其中孕周<28周时开始用药的76例为早期组,孕周≥28周时开始用药的70例为晚期组。比较两组新生儿的颅脑超声情况及出生第1、3天的血清S100B、NSE水平。比较两组患者用药过程中不良反应发生情况。结果晚期组新生儿颅脑异常总发生率明显高于早期组(P<0.05)。晚期组新生儿出生第1、3天的血清S100B、NSE水平均明显高于早期组(P<0.05)。两组患者的不良反应总发生率比较,差异不显著(P>0.05)。所有不良反应均在及时调整左甲状腺素片剂量后消失。结论对于妊娠合并SCH患者,及早给予左甲状腺片干预能够减少新生儿颅脑异常发生率,安全性较高。

Objective To investigate the effect of levothyroxine on neonatal brain injury in pregnancy patients with SCH during different gestational weeks. Methods From July 2017 to December 2018, 146 pregnant women with SCH treated with levothyroxine were enrolled in our hospital. Among them, 76 patients who started taking medication <28 weeks gestation were enrolled in early group, 70 patients who started taking medication ≥28 weeks gestation were enrolled in late group. The neonatal craniocerebral ultrasonography and the levels of serum S100B and NSE at the 1 st and 3rd day of birth were compared between the two groups. The adverse reactions during medication were compared between the two groups.Results The total incidence of neonatal brain abnormalities in the late group was significantly higher than that in the early group(P<0.05). The levels of neonatal serum S100B and NSE in the late group were significantly higher than those in the early group at the 1st and 3rd day of birth(P<0.05). There was no significant difference in the total incidences of adverse reactions of patients between the two groups(P>0.05), and all adverse reactions disappeared after adjusting the dosage of levothyroxine tablets in time. Conclusion For pregnant patients with SCH, early intervention with levothyroxine tablets can reduce the incidence of neonatal craniocerebral abnormalities, and with high safety.