左旋甲状腺素对妊娠期糖尿病伴亚临床甲减孕妇的疗效分析

Clinical Analysis of Levothyrocine in Gestational Diabetes Mellitus Women with Subclinical Hypothyroidism

目的 分析左旋甲状腺素对妊娠期糖尿病伴亚临床甲减孕妇的疗效。方法 围绕南阳市中心医院2021年2月至2022年2月收治的86例妊娠期糖尿病伴亚临床甲减孕妇展开研究,以随机抽样法为分组依据,将研究样本分为试验组和对照组,各43例。对照组仅使用胰岛素治疗,试验组在对照组用药基础上增加左旋甲状腺素治疗。对比两组妊娠期治疗前后血糖、甲状腺素、胰岛素波动情况、并发症发生率。结果 治疗前组间血糖控制情况对比,差异无统计学意义(P>0.05),治疗14 d后试验组空腹血糖、餐后2 h血糖、糖化血红蛋白控制情况均优于对照组,差异有统计学意义(P<0.05);治疗前两组甲状腺腺素指标对比,差异无统计学意义(P>0.05),治疗14 d后试验组甲状腺激素水平低于对照组,差异有统计学意义(P<0.05);治疗前两组各项胰岛功能指标对比,差异无统计学意义(P>0.05),治疗14 d后试验组空腹胰岛素水平、空腹C肽水平均高于对照组,差异有统计学意义(P<0.05);试验组孕妇妊娠并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论 左旋甲状腺素是妊娠期糖尿病伴亚临床甲减孕妇优质用药,在控制甲状腺激素与血糖方面均有体现,同时具备预防妊娠并发症的作用,值得临床借鉴。

Objective To analyze the effect of levothyroxine on pregnant women with gestational diabetes mellitus with subclinical hypothyroidism.Methods This study focused on 86 pregnant women with gestational diabetes mellitus with subclinical hypothyroidism admitted to Nanyang Central Hospital from February 2021 to February 2022.Based on random sampling method,the study samples were divided into experimental group and control group,with 43 cases in each group.The control group was treated with insulin only,and the experimental group was treated with levothyroxine in addition to the control group.The fluctuation of blood glucose,thyroxine and insulin and the incidence of complications were compared between the two groups before and after treatment.Results Before treatment,there was no statistically significant difference in blood glucose control among the groups(P>0.05).After 14 days of treatment,fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin in the experimental group were better than those in the control group,the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in thyroid gland index between the two groups(P>0.05).After 14 days of treatment,the level of thyrotropin in test group was lower than that in control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistical significance in islet function indexes between the two groups(P>0.05).After 14 days of treatment,fasting insulin level and fasting C-peptide level of experimental group were higher than those of control group,with statistical significance(P<0.05).The incidence of pregnancy complications in experimental group was lower than that in control group,and the difference was statistically significant(P<0.05).Conclusion Levothyroxine is a high-quality drug for pregnant women with gestational diabetes mellitus with subclinical hypothyroidism.It can control thyroid hormone and blood sugar,and can prevent pregnancy complications at the same time,which is worth clinical reference.