左甲状腺素对妊娠伴甲状腺功能减退症患者血脂水平及甲状腺功能的影响

Effects of Levothyroxine on Blood Lipids Level and Thyroid Function in Pregnant Women with Hypothyroidism

目的:探讨左甲状腺素对妊娠伴甲状腺功能减退症患者血脂水平及甲状腺功能的影响。方法:选取2017年9月~2019年9月本院门诊部收治的80例妊娠伴甲状腺功能减退症患者作为研究对象,根据是否采用左甲状腺素治疗分为治疗组(40例)和对照组(40例)。对照组予以常规治疗,治疗组在对照组基础上予以左甲状腺素治疗,直至分娩。比较两组孕妇甲状腺功能[促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT_(3))]、叶酸(FA)水平、血脂[三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)]水平、血管内皮功能[一氧化氮(NO)、内皮素-1(ET-1)、内皮依赖性扩张百分率(FMD%)]、妊娠并发症发生率,以及新生儿甲状腺功能。结果:治疗后,治疗组FT_(4)、FT_(3)、FA水平高于对照组,TSH水平低于对照组(P <0.05);治疗组TG、TC、LDL水平低于对照组,HDL水平高于对照组(P <0.05);治疗组ET-1水平低于对照组,NO、FMD%水平高于对照组(P <0.05);治疗组新生儿TSH水平低于对照组(P <0.05),两组新生儿FT4、FT_(3)水平无统计学差异(P>0.05);治疗组糖代谢异常发生率低于对照组(P <0.05),两组妊娠期高血压及胆汁淤积发生率无统计学差异(P> 0.05)。结论:左甲状腺素可有效改善妊娠伴甲状腺功能减退症患者的血脂水平及甲状腺功能。

Objective:To investigate the effect of levothyroxine on blood lipid level and thyroid function in pregnant women with hypothyroidism.Methods:80 pregnant women with hypothyroidism treated in the outpatient department of our hospital from September 2017 to September 2019 were selected as the study objects.According to whether levothyroxine was used,patients were divided into treatment group(n=40)and control group(n=40).Control group was given routine treatment,while treatment group with additional levothyroxine on that basis.All treatment was provided until labor.The thyroid function(TSH,FT 4,FT 3),folic acid(FA)level,blood lipid(TG,TC,HDL,LDL)level,vascular endothelial function(NO,ET-1,FMD%),incidence of pregnancy complications and neonatal thyroid function were compared between two groups.Results:After treatment,the levels of FT 4,FT 3 and FA in treatment group were higher than those in control group,while TSH in treatment group was lower than that in control group(P<0.05).The levels of TG,TC and LDL in treatment group were lower than those in control group,while the level of HDL was higher in treatment group(P<0.05).The level of ET-1 in treatment group was lower than that in control group,while the levels of NO and FMD%in treatment group were higher than those in control group(P<0.05).The level of neonatal TSH in treatment group was lower than that in control group(P<0.05),but there was no significant difference in the levels of neonatal FT 4 and FT 3 between two groups(P>0.05).The incidence of abnormal glucose metabolism in treatment group was lower than that in control group(P<0.05).There was no significant difference in the incidence of hypertensive disorder complicating pregnancy and cholestasis between two groups(P>0.05).Conclusion:Levothyroxine can effectively improve the level of blood lipids and thyroid function in pregnant women with hypothyroidism.