左甲状腺素钠片治疗对妊娠亚甲减患者VB12、Hcy及甲状腺功能的影响

Effect of levothyroxine sodium tablets on VB12,Hcy and thyroid function in patients with subclinical hypothyroidism during pregnancy

目的分析左甲状腺素钠片治疗对妊娠亚临床甲状腺功能减退(亚甲减)患者维生素B12(VB12)、同型半胱氨酸(Hcy)及甲状腺功能的影响。方法58例妊娠亚甲减患者,采用随机数字表法分为观察组与对照组,各29例。对照组患者给予常规治疗,观察组患者在对照组基础上给予左甲状腺素钠片治疗。对比两组临床疗效,治疗前后血清VB12、Hcy及甲状腺功能,妊娠结局。结果观察组治疗总有效率96.55%高于对照组的79.31%,差异有统计学意义(P<0.05)。治疗后,两组游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)组内及组间对比差异无统计学意义(P>0.05);两组VB12较本组治疗前增高,且观察组高于对照组;Hcy及TSH较本组治疗前降低,且观察组低于对照组,差异均有统计学意义(P<0.05)。观察组的自然分娩率72.41%高于对照组的34.48%,剖宫产率27.59%、早产率3.45%、新生儿窒息率3.45%和产后出血率0均低于对照组的65.52%、20.69%、20.69%、13.79%,差异有统计学意义(P<0.05)。结论左甲状腺素钠片能够有效治疗妊娠亚甲减,降低患者的Hcy、TSH水平,提高VB12水平,有效改善患者的妊娠结局,可在临床上推广使用。

Objective To analyzed the effect of levothyroxine sodium tablets on vitamin B12(VB12),homocysteine(Hcy)and thyroid function in patients with subclinical hypothyroidism during pregnancy.Methods A total of 58 patients with subclinical hypothyroidism during pregnancy were divided into observation group and control group according to random numerical table,with 29 cases in each group.The control group received conventional therapy,and the observation group received levothyroxine sodium tablets.The clinical efficacy,serum VB12 and Hcy before and after treatment,thyroid function,and pregnancy outcome were compared between the two groups.Results The total effective rate of treatment 96.55%of the observation group was higher than 79.31%of the control group,and the difference was statistically significant(P<0.05).After treatment,there was no statistically significant difference in free triiodothyronine(FT3)and free thyroxine(FT4)between the two groups(P>0.05).VB12 of the two groups were higher than those before treatment,and the observation group was higher than the control group.Hcy and TSH of the two groups were lower than those before treatment,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05).The vaginal delivery rate 72.41%of the observation group was higher than 34.48%of the control group,and the difference was statistically significant(P<0.05).The cesarean section rate 27.59%,preterm birth rate 3.45%,neonatal asphyxia rate 3.45%,and postpartum hemorrhage rate 0 of the observation group were lower than 65.52%,20.69%,20.69%and 13.79%of the control group,and the difference was statistically significant(P<0.05).Conclusion Levothyroxine sodium tablets is effectively in the treatment of subclinical hypothyroidism during pregnancy,reduce the Hcy and TSH levels of patients,improve the level of VB12,and effectively improve the pregnancy outcome of patients,which can be widely used in clinical practice.