左甲状腺素治疗早期妊娠合并亚临床甲状腺功能减退症的疗效探讨

The Effect of Levothyroxine in the Treatment of Early Pregnancy with Subclinical Hypothyroidism

目的评价左甲状腺素早期治疗妊娠合并亚临床甲状腺功能减退症的疗效。方法对该院2018年1月—2019年2月收治的早期妊娠合并亚临床甲状腺功能减退症患者进行筛选,从中选择65例作为该次研究的对象,数字法随机分为研究组与对照组,研究组33例,对照组32例。对照组患者接受常规治疗,研究组患者接受小剂量左甲状腺素治疗。比较两组患者甲状腺功能指标、并发症发生率以及妊娠不良事件发生率。结果用药后,研究组FT3(3.87±0.52)pmol/L、FT4(15.47±1.31)pmol/L以及TSH水平(1.34±0.26)mIU/L均优于对照组(2.59±0.49)pmol/L、(12.01±1.35)pmol/L、(2.69±0.31)mIU/L,差异有统计学意义(t=3.728、3.824、3.863,P<0.05)。研究组患者并发症发生率(6.06%)低于对照组25.00%,差异有统计学意义(χ2=5.382,P<0.05);研究组患者不良妊娠事件发生率6.06%低于对照组21.88%,差异有统计学意义(χ2=5.193,P<0.05)。结论对早期妊娠合并亚临床甲状腺功能减退症患者采用小剂量左甲状腺素治疗可以改善患者甲状腺功能,可以减少并发症以及妊娠不良事件发生率,值得应用。

Objective To evaluate the efficacy of levothyroxine in the early treatment of pregnancy with subclinical hypothyroidism.Methods The early pregnancy patients with subclinical hypothyroidism who were admitted to the hospital from January 2018 to February 2019 were screened.65 cases were selected as the objects of this study,and they were randomly divided into study group and control group by numerical method.There were 33 cases in the study group and 32 cases in the control group.Patients in the control group received conventional treatment,and patients in the study group received low-dose levothyroxine treatment.The thyroid function indexes,complication rate and incidence of adverse pregnancy event were compared between the two groups.Results After medication,the study group's FT3(3.87±0.52)pmol/L,FT4(15.47±1.31)pmol/L and TSH levels(1.34±0.26)mIU/L were better than those of the control group by(2.59±0.49)pmol/L,(12.01±1.35)pmol/L,(2.69±0.31)mIU/L,the difference was statistically significant(t=3.728,3.824,3.863,P<0.05).The incidence of complications in the study group(6.06%)was lower than 25.00%in the control group,the difference was statistically significant(χ2=5.382,P<0.05);the incidence of adverse pregnancy events in the study group was 6.06%lower than 21.88%in the control group,the difference was statistically significant(χ2=5.193,P<0.05).Conclusion The use of low-dose levothyroxine therapy for early pregnancy patients with subclinical hypothyroidism can improve the thyroid function of patients and reduce the occurrence of complications and incidence of adverse pregnancy event.It is worthy of application.