左甲状腺素钠治疗妊娠合并TPO Ab阴性亚临床甲减临床效果

Clinical efficacy of levothyroxine sodium for treating pregnant women with TPoAb negative of subclinical hypothyroidism

目的:探讨左甲状腺素钠(L T4)治疗妊娠合并甲状腺过氧化物酶抗体(TPOAb)阴性亚临床甲减患者的临床效果。方法:随机分组方法将本院确诊为妊娠合并TPOAb阴性的亚临床甲减患者分为L T4组(70例)和对照组(70例),对照组常规治疗,L T4组在对照组常规治疗基础上给予L T4治疗。观察两组妊娠结局及妊娠并发症情况。结果:L T4组流产率(8.6%)及早产率(4.3%)均低于对照组(14.6%、10.0%),血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇低于对照组,高密度脂蛋白胆固醇高于对照组,甲状腺功能指标改善优于对照组(均P<0.05);妊娠期高血压疾病(5.1%)、贫血(21.6%)、妊娠期糖尿病(2.9%)及肝内胆汁淤积发生比例(2.9%)低于对照组(P<0.05);结论:L T4可更好改善妊娠伴TPOAb抗体阴性的亚临床甲状腺功能减退患者的甲状腺功能及围产结局,降低并发症。

Objective:To investigate the clinical efficacy of levothyroxine sodium(L T4)for treating pregnant women with thyroid peroxidase antibody(TPOAb)negative of subclinical hypothyroidism.Methods:140 pregnant women with TPO Ab negative of subclinical hypothyroidism were randomly divided into two groups(70 cases in each groups).The women in experimental group were treated with L T4 combined with routine treatment,and the women in experimental group were treated with routine treatment.The rates of pregnancy outcomes and pregnant complications of women in both groups were observed.Results:The abortion rate(8.6%)and preterm birth rate(4.3%)of women in experimental group were significant lower than those(14.6%and 10.0%)of women in the control group.The levels of serum total cholesterol,triacylglycerol and low density lipoprotein of women in experimental group were significant higher than those of women in the control group,but the high density lipoprotein level was significant lower.The improvement of thyroid function indexes of women in experimental group was significant better than that of women in the control group(all P<0.05).The incidence of gestational hypertension(5.1%),anemia(21.6%),gestational diabetes(2.9%),or intrahepatic cholestasis(2.9%)was significant lower than that of women in the control group(P<0.05).Conclusion:L T4 can improve thyroid function,perioperative outcomes,and reduce the incidence of complications of women with TPOAb negative of subclinical hypothyroidism significantly.