优甲乐替代疗法对妊娠合并甲减患者血糖指标、甲状腺功能及妊娠结局的影响

Effect of Euthyrox Replacement Therapy on Blood glucose index,Thyroid function and Pregnancy Outcome in Pregnant Women with Hypothyroidism

目的:研究优甲乐替代疗法对妊娠合并甲减患者血糖指标、甲状腺功能及妊娠结局的影响。方法:回顾性收集2018年6月~2020年6月于某院就诊的196例妊娠期甲减患者的临床资料,根据是否给予优甲乐替代疗法分为对照组和实验组各98例,对照组采用常规治疗方法,实验组在常规方法基础上予以优甲乐替代疗法,比较两组治疗前、治疗后(分娩结束)空腹血糖、餐后2h血糖、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺激素(FT4)值、总胆固醇(TG)、低密度脂蛋白胆固醇(LDL-C)以及高密度脂蛋白胆固醇(HDL-C)水平变化,并比较两组不良妊娠结局发生率。结果:分娩结束后,实验组TSH、TG以及LDL-C值下降幅度、FT3、FT4以及HDL-C值上升幅度明显大于对照组,实验组不良妊娠结局发生率明显低于对照组,差异具有统计学意义(P<0.05);而实验组治疗前、治疗后(分娩结束)空腹血糖值、餐后2h血糖值与对照组相近,差异无统计学意义(P>0.05)。结论:优甲乐替代疗法治疗妊娠期甲减能明显改善患者甲状腺功能,调节患者血脂水平并降低患者不良妊娠结局发生率,但对患者血糖指标影响较小。

Objective:To study the effect of euthyrox replacement therapy on blood glucose,thyroid function and pregnancy outcome in pregnant women with hypothyroidism.Methods:The clinical data of 196 patients with hypothyroidism during pregnancy who were treated in a hospital from June 2018 to June 2020 were retrospectively collected.They were divided into control group(n=98,conventional treatment)and experimental group(n=98,euthyrox replacement therapy based on the conventional treatment).The levels of fasting blood glucose,2-hour postprandial blood glucose,thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free tetraiodothyronine(FT4),total cholesterol(TG),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)before and after treatment(after delivery)were compared between the two groups;The incidence of adverse pregnancy outcomes was compared between the two groups.Results:After delivery,the decrease range of TSH,TG and LDL-C value,the increase range of FT3,FT4 and HDL-C value in the experimental group were significantly higher than those in the control group,and the incidence of adverse pregnancy outcomes in the experimental group was significantly lower than that in the control group,the difference was statistically significant(P<0.05);The fasting blood glucose and 2-hour postprandial blood glucose of the experimental group before and after treatment(after delivery)were similar to those of the control group,and the difference was not statistically significant(P>0.05).Conclusion:Euthyrox replacement therapy in the treatment of hypothyroidism during pregnancy can significantly improve thyroid function,regulate blood lipid levels and reduce the incidence of adverse pregnancy outcomes,but has little effect on blood glucose.