左甲状腺素钠片治疗妊娠合并甲状腺功能减退临床效果观察

Clinical effect observation of levothyroxine sodium tablets in the treatment of pregnancy complicated with hypothyroidism

目的探讨左甲状腺素钠片治疗妊娠合并甲状腺功能减退的临床效果。方法选择58例妊娠合并甲状腺功能减退产妇作为研究对象,入院后均口服左甲状腺素钠片进行治疗,分析产妇的甲状腺激素水平、血脂水平、治疗前后的负面情绪以及不良反应、不良妊娠结局。结果治疗后患者的促甲状腺激素(TSH)水平为(6.19±2.31)mU/L,游离甲状腺素(FT_(4))水平为(13.71±3.27)pmol/L,游离三碘甲状原氨酸(FT_(3))水平为(4.41±0.51)pmol/L,与治疗前比较差异有统计学意义(P<0.05);治疗后患者的总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平低于治疗前,高密度脂蛋白胆固醇(HDL-C)水平高于治疗前,焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于治疗前,差异有统计学意义(P<0.05);所有患者的不良用药反应发生率为6.90%,6例(10.34%)患者出现妊娠期合并症,12例(20.69%)分娩方式为剖宫产。结论采用左甲状腺素钠片治疗妊娠合并甲状腺功能减退可有效改善患者的相关激素水平,降低产妇分娩风险与不良妊娠发生率,对提高分娩安全性有积极影响。

Objective To explore the clinical effect of levothyroxine sodium tablets in the treatment of pregnancy with hypothyroidism.Methods A toal of 58 pregnant women with hypothyroidism were selected as the study subjects.After admission,they were treated with levothyroxine sodium tablets orally.The thyroid hormone level,blood lipid level,negative emotions before and after treatment,adverse reactions and adverse pregnancy outcomes were analyzed.Results After treatment,the level of thyroid stimulating hormone(TSH)was(6.19±2.31)mU/L,the level of free thyroxine(FT_(4))was(13.71±3.27)pmol/L,and the level of free triiodothyronine(FT_(3))was(4.41±0.51)pmol/L,which was significantly different from that before treatment(P<0.05).After treatment,the levels of total cholesterol(TC),triacylglycerol(TG)and low density lipoprotein cholesterol(LDL-C)were lower than those before treatment,and the levels of high density lipoprotein cholesterol(HDL-C)were higher than those before treatment,and the scores of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were lower than those before treatment,the difierences were statistically significant(P<0.05).The incidence of adverse drug reactions in all patients was 6.90%,6 patients(10.34%)had complications during pregnancy,and 12 patients(20.69%)had cesarean section.Conclusion The use of levothyroxine sodium tablets in the treatment of pregnancy with hypothyroidism can efiectively improve the relevant hormone levels of patients,reduce the risk of delivery and the incidence of adverse pregnancy,and have a positive impact on improving the safety of delivery.