小剂量左甲状腺素钠片治疗妊娠早中期亚临床甲状腺功能减退症的疗效分析

Analysis Efficacy of Low-dose Levothyroxine Sodium Tablets in the Treatment of Subclinical Hypothyroidism in Early and Second Trimester of Pregnancy

目的 分析予以妊娠早、中期亚临床甲状腺功能减退症患者小剂量左甲状腺素钠片治疗的临床效果。方法 随机选择2020年1月—2021年12月徐州市铜山区中医院门诊接收的50例妊娠早、中期亚临床甲状腺功能减退症患者为研究对象进行回顾性分析,予以标准剂量左甲状腺素钠片治疗的25例患者纳入对照组,予以小剂量左甲状腺素钠片治疗的25例纳入观察组;对比不同用药剂量下两组甲状腺功能指标、妊娠结局及新生儿发育情况。结果 观察组TSH、TPOAb水平为(2.01±0.45)mIU/L、(20.38±3.87)IU/mL,低于对照组的(2.49±0.81)mIU/L、(25.46±4.10)IU/mL;FT4水平为(16.35±2.71)pmol/L,高于对照组的(13.22±2.10)pmol/L,差异有统计学意义(t=2.590、4.505、4.565,P<0.05)。观察组不良妊娠结局发生率(4.00%)与对照组(12.00%)对比,差异无统计学意义(χ^(2)=0.272,P>0.05)。两组新生儿PKU、CH、CAH、G-6-PD发生率对比(0.00%vs4.00%),差异无统计学意义(P>0.05)。结论 针对妊娠早、中期亚临床甲状腺功能减退症,且TSH水平大于妊娠早中期上限,但<5 mIU/L的患者,予以小剂量左甲状腺素钠片治疗效果显著,且不会影响新生儿的发育,用药安全性较高。

Objective To analyze the clinical effect of low-dose levothyroxine sodium tablets in the treatment of patients with subclinical hypothyroidism in the first and second trimesters of pregnancy.Methods Fifty patients with subclinical hypothyroidism in the first and second trimesters of pregnancy who were admitted to the outpatient department of the Xuzhou Tongshan Traditional Chinese Medicine Hospital from January 2020 to December 2021 were randomly selected as the research objects for retrospective analysis. Twenty-five patients treated with standard-dose levothyroxine sodium tablets were included in the control group, and 25 patients treated with low-dose levothyroxine sodium tablets were included in the observation group. The thyroid function indexes, pregnancy outcomes and neonatal development were compared between the two groups under different drug doses.Results The levels of TSH and TPOAb in the observation group were(2.01±0.45) mIU/L and(20.38±3.87) IU/mL, which were lower than those in the control group(2.49±0.81) mIU/L and(25.46±4.10) IU/mL;the level of FT4 was(16.35±2.71) pmol/L, which was higher than that of the control group(13.22±2.10) pmol/L, and the difference was statistically significant(t=2.590, 4.505, 4.565, P<0.05).There was no statistically significant difference in the incidence of adverse pregnancy outcomes between the observa-tion group(4.00%) and the control group(12.00%)(χ^(2)=0.272, P>0.05). The incidence rates of PKU, CH, CAH and G-6-PD in the two groups were compared(0.00%) vs(4.00%), and there was no statistically significant difference(P>0.05).Conclusion For patients with subclinical hypothyroidism in the first and second trimesters, and the TSH level is greater than the upper limit of the first and second trimesters, but less than 5 mIU/L, the treatment effect of low-dose levothyroxine sodium tablets is significant, and it will not affect the development of neonates, and the drug safety is high.