激素替代治疗对妊娠伴甲减的疗效及对脂代谢、凝血功能指标、妊娠结局的影响分析

Analysis of the Efficacy of Hormone Replacement Therapy in Pregnancy with Hypothyroidism and its Effects on Lipid Metabolism,Coagulation Index and Pregnancy Outcome

目的:探析妊娠伴甲减患者采用激素替代治疗所取得的效果以及对脂代谢、凝血功能指标、妊娠结局的影响。方法:选取2019年10月—2021年5月焦作市妇幼保健院收治的136例妊娠伴甲减患者作为研究对象,根据治疗方案的不同将患者分为对照组与观察组,每组各68例。对照组接受常规治疗;观察组在常规治疗的基础上采用激素替代治疗。比较两组患者临床疗效、治疗前后脂代谢情况[低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)]、凝血功能指标水平[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)]、甲状腺功能水平[游离甲状腺素(FT4)、促甲状腺激素(TSH)]以及妊娠结局情况。结果:与对照组比较,观察组治疗效果更佳,差异有统计学意义(χ^(2)=5.492,P<0.05);治疗后,观察组LDL-C、TG、APTT、PT、TSH等指标水平更低,FT4水平更高,差异有统计学意义(t=15.692、8.605、15.964、5.068、4.790、4.586,P<0.05);观察组不良妊娠结局发生率低于对照组,差异有统计学意义(χ^(2)=12.331,P<0.05)。结论:对妊娠伴甲减患者采取激素替代治疗可获得较好的效果,能够有效改善其脂代谢情况,提升凝血功能及甲状腺功能,预防不良妊娠结局的出现。

Objective:To explore the results achieved with hormone replacement therapy in patients with pregnancy with hypothyroidism and the effects on lipid metabolism,coagulation indicators,and pregnancy outcomes.Methods:136 patients with pregnancy with hypothyroidism admitted to the hospital from October 2019 to May 2021 were selected for the study,and the patients were divided into control and observation groups according to the treatment regimen,with 68 cases in each group.The control group received conventional treatment,and the observation group used hormone replacement therapy on top of conventional treatment.The clinical outcomes,lipid metabolism(low-density lipoprotein cholesterol[LDL-C],triglycerides[TG]),coagulation index levels(activated partial thromboplastin time[APTT],prothrombin time[PT]),thyroid function levels(free thyroxine[FT4],thyroid stimulating hormone[TSH])and pregnancy outcomes were compared between the two groups.Results:Compared with the control group,the treatment effect was better in the observation group,and the difference was statistically significant(χ^(2)=5.492,P<0.05).After treatment,the observation group had lower levels of LDL-C,TG,APTT,PT,and TSH and higher levels of FT4,with statistically significant differences(t=15.692,8.605,15.964,5.068,4.790,4.586,P<0.05).The incidence of adverse pregnancy outcomes was lower in the observation group than in the control group,and the difference was statistically significant(χ^(2)=12.331,P<0.05).Conclusion:Hormone replacement therapy in patients with hypothyroidism in pregnancy can achieve better results,which can effectively improve their lipid metabolism,enhance coagulation and thyroid function,and prevent adverse pregnancy outcomes.