期刊文献+

妊娠期甲状腺功能减退症患者左甲状腺素钠治疗剂量的影响因素分析 被引量:1

Analysis of the Influencing Factors of the Therapeutic Dose of Levothyroxine Sodium in Patients with Hypothyroidism during Pregnancy
下载PDF
导出
摘要 目的:探讨妊娠期甲状腺功能减退症(甲减)患者左甲状腺素(L-T_(4))钠治疗剂量的影响因素。方法:回顾性分析2019年5月-2021年5月防城港市中医医院收治的106例妊娠期甲减患者的临床资料。对所有患者进行促甲状腺激素(thyrotropin,TSH)、甲状腺过氧化物酶自身抗体(thyroid peroxidase autoantibody,TPOAb)检测,并进行分组。所有患者均给予L-T_(4)钠片治疗并收集所有患者的一般资料。比较三组一般资料,治疗达标时L-T_(4)钠片剂量(日剂量及体重日剂量)。比较三组TPOAb滴度阴性、阳性患者治疗达标时L-T_(4)钠片剂量(日剂量及体重日剂量)。分析影响L-T_(4)钠片剂量的因素。结果:三组年龄、体重、治疗起始孕周、治疗前TPOAb滴度、达到治疗目标时孕周、达到治疗目标时TSH水平比较差异均无统计学意义(P>0.05)。A组治疗前TSH水平为(3.05±0.84)mIU/L,B组治疗前TSH水平为(7.12±2.11)mIU/L,C组治疗前TSH水平为(12.07±1.33)mIU/L,三组治疗起始TSH水平逐渐升高(F=263.278,P<0.001)。三组治疗达标时L-T_(4)钠片日剂量及体重日剂量随着TSH水平升高而升高(P<0.05)。A组TPOAb滴度阴性、阳性患者治疗达标时L-T_(4)钠片日剂量、体重日剂量比较差异均无统计学意义(P>0.05);B组及C组TPOAb滴度阳性患者治疗达标时L-T_(4)钠片日剂量、体重日剂量均高于TPOAb滴度阴性患者(P<0.05)。血清TSH水平4.0~10 mIU/L、TSH水平>10 mIU/L、TPOAb阳性是影响L-T_(4)钠片剂量的独立危险因素(P<0.05)。结论:妊娠期甲减患者L-T_(4)治疗剂量受血清TSH水平及TPOAb表达影响,血清TSH水平、TPOAb阳性是影响L-T_(4)钠片剂量的独立危险因素。临床应用中应结合血清TSH水平及TPOAb滴度调整L-T_(4)剂量。 Objective:To investigate the influencing factors of the therapeutic dose of Levothyroxine(L-T_(4))Sodium in patients with hypothyroidism during pregnancy.Method:The clinical data of 106 patients with hypothyroidism during pregnancy admitted to Fangchenggang Hospital of Traditional Chinese Medicine from May 2019 to May 2021 were analyzed retrospectively.All patients were tested for thyrotropin(TSH)and thyroid peroxidase autoantibody(TPOAb)and divided into groups.All patients were treated with L-T_(4) Sodium Tablets and general data of all patients were collected.The general data of the three groups were compared,and the dose of L-T_(4) Sodium Tablets(daily dose and body weight daily dose)when the treatment reached the standard of the three groups were compared.The dose of L-T_(4) Sodium Tablets(daily dose and body weight daily dose)when the treatment reached the standard was compared in the patients with negative and positive TPOAb titers among the three groups.The factors influencing the dose of L-T_(4) Sodium Tablets were analyzed.Result:There were no significant differences in age,weight,gestational week at the beginning of treatment,TPOAb titer before treatment,gestational week at the time of reaching the treatment goal,and TSH level at the time of reaching the treatment goal among the three groups(P>0.05).The TSH level before treatment in group A was(3.05±0.84)mIU/L,that in group B was(7.12±2.11)mIU/L,and that in group C was(12.07±1.33)mIU/L,the TSH level in the three groups gradually increased at the beginning of treatment(F=263.278,P<0.001).The daily dose and body weight daily dose of L-T_(4) Sodium Tablets when the treatment reached the standard increased with the increase of TSH level among the three groups(P<0.05).There were no significant differences in daily dose and body weight daily dose of L-T_(4) Sodium Tablets when the treatment reached the standard between patients with negative and positive TPOAb titers in group A(P>0.05);the daily dose and body weight daily dose of L-T_(4) Sodium Tablets when the treatment reached the standard of patients with positive TPOAb titer in group B and C were higher than those of patients with negative TPOAb titer(P<0.05).Serum TSH level 4.0-10 mIU/L,TSH level>10 mIU/L,positive TPOAb were independent risk factors affecting the dose of L-T_(4) Sodium Tablets(P<0.05).Conclusion:The therapeutic dose of L-T_(4) in patients with hypothyroidism during pregnancy is affected by serum TSH level and TPOAb expression,the serum TSH level,and positive TPOAb were independent risk factors affecting the dose of L-T_(4) Sodium Tablets.The dosage of L-T_(4) should be adjusted according to the serum TSH level and TPOAb titer in clinical application.
作者 蒋粹萃 夏卫红 吴星萍 黄嫱 JIANG Cuicui;XIA Weihong;WU Xingping;HUANG Qiang(Fangchenggang Hospital of Traditional Chinese Medicine,Fangchenggang 538021,China;本)
出处 《中外医学研究》 2022年第35期158-162,共5页 CHINESE AND FOREIGN MEDICAL RESEARCH
关键词 妊娠期甲状腺功能减退症 甲状腺过氧化物酶自身抗体 促甲状腺激素 左甲状腺素钠 Hypothyroidism during pregnancy Thyroid peroxidase autoantibody Thyrotropin Levothyroxine Sodium
  • 相关文献

参考文献14

二级参考文献83

共引文献357

同被引文献9

二级引证文献1

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部