不同剂量左甲状腺素治疗妊娠合并甲状腺功能减退症的疗效

Effect of different doses of levothyroxine on pregnancy complicated with hypothyroidism

目的探讨不同剂量左甲状腺素治疗妊娠合并甲状腺功能减退症患者的疗效。方法选取60例妊娠合并甲状腺功能减退症患者,根据随机数字表法将患者分为两组,每组30例。对照组采用小剂量左甲状腺素治疗,观察组采用大剂量左甲状腺素治疗。比较两组治疗前后甲状腺激素水平、血脂指标及妊娠结局。结果治疗后观察组游离甲状腺素(FT4)水平高于对照组,血清促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)水平均低于对照组(P<0.05)。观察组治疗后血清甘油三酯(TG)、总胆固醇(TC)及高密度脂蛋白-胆固醇(HDL-C)指标低于对照组,低密度脂蛋白-胆固醇(LDL-C)指标高于对照组(P<0.05)。对照组不良妊娠结局发生率为13.33%,观察组不良妊娠结局发生率为16.67%,比较差异无统计学意义(P>0.05)。结论妊娠合并甲状腺功能减退症患者应用大剂量左甲状腺素可明显改善甲状腺功能及血脂指标。

Objective To investigate the effect of different doses of levothyroxine in the treatment of pregnancy with hypothyroidism,Methods 60 pregnant patients with hypothyroidism were selected and divided into two groups with 30 cases in each group according to random number table method.The control group was treated with low-dose levothyroxine,and the observation group was treated with high-dose levothyroxine.The thyroid hormone level,blood lipid index and pregnancy outcome before and after treatment were compared between the two groups.Results After treatment,the level of free thyroxine(FTa)in observation group was higher than that in control group,and the levels of serum thyroid stimulating hormone(TSH)and thyroid peroxidase antibody(TPOAb)in observation group were lower than those in control group(P<0.05).After treatment,serum triglyceride(TG),total cholesterol(TC)and high density lipoprotein cholesterol(HDL-C)indexes in observation group were lower than those in control group,and low density lipoprotein cholesterol(LDL-C)index was higher than that in control group(P<0.05).The incidence of adverse pregnancy outcome was 13.33%in the control group and 16.67%in the observation group,with no statistical significance(P>0.05).Conclusion In pregnant patients with hypothyroidism,high dose of levothyroxine can significantly improve thyroid function and blood lipid indexes.