孕期甲状腺功能减退患者应用左甲状腺素钠片的治疗效果观察

Observation on therapeutic effect of levothyroxine sodium tablets in patients with hypothyroidism during pregnancy

目的探讨孕期甲状腺功能减退患者应用左甲状腺素钠片的治疗效果。方法80例孕期甲状腺功能减退患者作为研究对象,采用单双号抽签的方式分为对照组(单号)及观察组(双号),每组40例。对照组采用常规治疗,观察组采用常规治疗联合左甲状腺素钠片治疗。对比两组患者治疗前、分娩前的甲状腺功能指标[三碘甲状腺原氨酸(T_(3))、甲状腺素(T_(4))、血清促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))],母体并发症发生情况,围生儿不良结局发生情况。结果治疗前,两组患者的TSH、FT_(3)、FT_(4)对比,差异无统计学意义(P>0.05);分娩前,两组患者的TSH低于本组治疗前,FT_(3)、FT_(4)高于本组治疗前,且观察组患者的TSH(2.10±0.62)mU/L低于对照组的(3.68±0.78)mU/L,FT_(3)(5.45±0.71)pmol/L、FT_(4)(17.78±2.12)pmol/L高于对照组的(3.37±0.45)、(10.10±1.44)pmol/L,差异具有统计学意义(P<0.05)。两组患者治疗前及分娩前的T_(3)、T_(4)组间组内对比,差异无统计学意义(P>0.05)。观察组母体并发症发生率7.50%低于对照组的32.50%,差异具有统计学意义(P<0.05)。观察组围生儿不良结局发生率10.00%低于对照组的30.00%,差异具有统计学意义(P<0.05)。结论孕期甲状腺功能减退患者的妊娠结局会受到不良影响,需要检查其甲状腺功能指标,尽早采取治疗措施,左甲状腺素钠片对患者甲状腺功能指标可起到良好的调节效果,为维护母婴安全,患者整个孕期应坚持服用此药。

Objective To discuss the therapeutic effect of levothyroxine sodium tablets in patients with hypothyroidism during pregnancy.Methods A total of 80 patients with hypothyroidism during pregnancy were studied and were divided into control group(odd number)and observation group(even number)by single and double number lottery,with 40 cases in each group.The control group was treated with conventional treatment,while the observation group was treated with conventional treatment and levothyroxine sodium tablets.Both groups were compared in terms of thyroid function indexes[triiodothyronine(T_(3)),thyroxine(T_(4)),thyroid stimulating hormone(TSH),free triiodothyronine(FT_(3)),free thyroxine(FT_(4))]before treatment and before delivery,maternal complications,and adverse perinatal outcomes.Results Before treatment,the TSH,FT_(3) and FT_(4) in both groups were compared,and the differences were not statistically significant(P>0.05).Before delivery,the TSH in both groups was lower than that before treatment in this group,and FT_(3) and FT_(4) were higher than that before treatment in this group;the TSH(2.10±0.62)mU/L in the observation group was lower than(3.68±0.78)mU/L in the control group;FT_(3)(5.45±0.71)pmol/L and FT_(4)(17.78±2.12)pmol/L in the observation group were higher than(3.37±0.45)and(10.10±1.44)pmol/L in the control group;the differences were statistically significant(P<0.05).There was no statistically significant difference in the T_(3) and T_(4) between and within the two groups before treatment and before delivery(P>0.05).The incidence of maternal complications in the observation group was 7.50%,which was lower than 32.50%in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse perinatal outcomes in the observation group was 10.00%,which was lower than 30.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion For patients with hypothyroidism during pregnancy,their pregnancy outcome will be adversely affected.It is necessary to check their thyroid function indexes and take treatment measures as soon as possible.Levothyroxine sodium tablets can play a good regulatory effect on the thyroid function indexes of patients.In order to maintain the safety of mother and baby,patients should take this medicine throughout pregnancy.