原发性甲状腺功能减退症孕妇甲状腺素替代治疗对甲状腺功能及母婴结局的影响

The Effect of Thyroxine Replacement Therapy on Thyroid Function and Maternal and Neonatal Outcomes in Pregnant Women with Primary Hypothyroidism

目的探讨原发性甲状腺功能减退症孕妇甲状腺素替代治疗对甲状腺功能及母婴结局的影响。方法选取2017年5月至2018年5月我院妇产科治疗的原发性甲减孕妇120例,随机分为观察组和对照组各60例,选择同期60例健康孕妇纳入健康组。观察组采用甲状腺素替代疗法,对照组采用安慰剂,观察3组孕妇甲状腺功能各项指标及母婴结局。结果治疗后,观察组血清促甲状腺素(TSH)水平低于治疗前和对照组(P<0.05),游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)水平高于治疗前和对照组(P<0.05),且观察组与健康组比较差异无统计学意义(P>0.05)。对照组妊娠期高血压、妊娠糖尿病、胎膜早破的发生率均高于观察组和健康组(P<0.05)。对照组早产、小于胎龄儿的发生率均高于观察组和健康组(P<0.05)。结论采用甲状腺素替代疗法治疗孕妇甲减,可有效调节甲状腺素水平,母婴预后良好。

Objective To investigate the effect of thyroxine replacement therapy on thyroid function and maternal and neonatal outcomes in pregnant women with primary hypothyroidism.Methods 120 pregnant women with primary hypothyroidism who were treated in department of obstetrics and gynecology of the hospital from May,2017 to May,2018 were selected for the study.They were randomly divided into the observation group and the control group,60 cases each.60 healthy pregnant women during the same period were selected as the healthy group.The observation group was given thyroxine replacement therapy,and the control group was given placebo.The thyroid function indexes and maternal and neonatal outcomes among the three groups were observed.Results After the treatment,the serum thyroid stimulating hormone(TSH)level in the observation group was lower than that before the treatment and the control group( P <0.05),while the levels of free triiodothyronine(FT3)and free thyroxine(FT4)were higher than those before the treatment and the control group( P <0.05).There was no significant difference between the observation group and the healthy group( P >0.05).The incidences of gestational hypertension,gestational diabetes and premature rupture of membranes in the control group were higher than that in the observation group and the healthy group( P <0.05).The incidences of premature delivery and small for gestational age in the control group were higher than that in the observation group and the healthy group( P <0.05).Conclusion The use of thyroxine replacement therapy for the treatment of hypothyroidism in pregnant women can effectively regulate thyroid hormone levels and ensure good maternal and neonatal outcomes.