左旋甲状腺素对妊娠期糖尿病合并甲减患者血糖水平及并发症的影响

Effect of levothyroxine on blood glucose levels and complications in patients with gestational diabetes mellitus and hypothyroidism

目的分析左旋甲状腺素对妊娠期糖尿病合并甲减患者血糖水平及并发症的影响。方法经医院伦理学会批准随机选取我院2015年1月-2018年12月收治的妊娠期糖尿病合并甲减患者120例,骰子分组法将其所有患者分成对照组与研究组,每组60例,分别接受常规治疗及在常规治疗基础上接受左旋甲状腺素治疗。比较两组患者妊娠结局、血糖达标情况、甲状腺功能水平、并发症。结果研究组患者不良分娩率低于对照组(P<0.05)。研究组患血糖控制达标率高于对照组(P<0.05)。治疗前两组患者TSH、FT4水平差异比较无统计学意义(P>0.05),治疗后降低;其中研究组患者TSH水平低于对照组(P<0.05),FT4水平低于对照组(P>0.05)。研究组患者并发症率低于对照组(P<0.05)。结论左旋甲状腺素能协同胰岛素降低妊娠期糖尿病合并甲减血糖水平,并能明显改善甲状腺功能,减少并发症,提升妊娠结局。

Objective To analyze the effect of levothyroxine on blood glucose levels and complications in patients with gestational diabetes mellitus and hypothyroidism.Methods 120 patients with gestational diabetes mellitus and hypothyroidism treated in our hospital from January 2015 to December 2018 were randomly selected with the approval of the hospital ethics society.All patients were divided into a control group and a research group by the dice grouping method,with 60 patients in each group.Received conventional treatment and received levothyroxine treatment on the basis of conventional treatment.The pregnancy outcomes,blood glucose attainment rate,thyroid function levels,and complications were compared between the two groups.Results The adverse delivery rate of patients in the study group was lower than that in the control group(P<0.05).The blood glucose attainment rate of patients in the study group was higher than that in the control group(P<0.05).There was no significant difference in the levels of TSH and FT4 between the two groups of patients before treatment(P>0.05)and decreased after treatment;the TSH level of patients in the study group was lower than that in the control group(P<0.05),and the level of FT4 was lower than in the control group(P>0.05).The complication rate was lower in the study group than in the control group(P<0.05).Conclusion Levothyroxine can cooperate with insulin to reduce gestational diabetes mellitus with hypoglycemia,and it can significantly improve thyroid function,reduce complications and improve pregnancy outcomes.