不同剂量丙硫氧嘧啶治疗妊娠合并甲亢的效果分析

Effect Analysis of Different Doses of Propylthiouracil in the Treatment of Pregnancy Complicated with Hyperthyroidism

目的:探究不同剂量丙硫氧嘧啶治疗妊娠合并甲状腺功能亢进(简称甲亢)的效果。方法:选取2021年9月—2023年3月瑞金市人民医院妇产科收治的妊娠合并甲亢患者70例,随机分为低剂量组(起始予以丙硫氧嘧啶50 mg/次,3次/d)和高剂量组(起始予以丙硫氧嘧啶100 mg/次,3次/d),两组均治疗2个月。评价两组治疗效果及用药安全性,对比两组治疗前后凝血功能、肝功能及甲状腺功能,并统计妊娠不良结局情况。结果:治疗后,高剂量组凝血酶原时间(PT)、凝血酶时间(TT)均较低剂量组长,纤维蛋白原(FIB)及D-二聚体(D-D)均较低剂量组低(P<0.05)。治疗后,两组γ-谷氨酰转移酶(GGT)、总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)及碱性磷酸酶(ALP)均较治疗前升高,但低剂量组上述指标水平均低于高剂量组(P<0.05)。与治疗前相比,两组治疗后的游离甲状腺素(FT_(4))、游离三碘甲腺原氨酸(FT_(3))及总甲状腺激素(TT_(4))均降低,高剂量组均低于低剂量组,促甲状腺激素(TSH)均升高,高剂量组高于低剂量组(P<0.05)。两组总有效率、妊娠结局、不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:不同剂量丙硫氧嘧啶治疗妊娠合并甲亢的临床效果相当,高剂量丙硫氧嘧啶可改善患者高凝状态,低剂量丙硫氧嘧啶则能有效减少药物对患者肝功能造成的损害。

Objective:To investigate the effect of different doses of Propylthiouracil in the treatment of pregnancy complicated with hyperthyroidism.Method:A total of 70 pregnant patients with hyperthyroidism admitted to Department of Obstetrics and Gynecology,People's Hospital of Ruijin City from September 2021 to March 2023 were randomly divided into low-dose group(was initially given Propylthiouracil 50 mg/time,3 times/day)and high-dose group(was initially given Propylthiouracil 100 mg/time,3 times/day),both groups were treated for 2 months.The therapeutic effect and drug safety of the two groups were evaluated,the coagulation function,liver function and thyroid function of the two groups before and after treatment were compared,and adverse pregnancy outcomes were counted.Result:After treatment,the prohemase time(PT)and thrombin time(TT)in the high-dose group were longer than those in the low-dose group,and the fibrinogen(FIB)and D-dimer(D-D)in the high-dose group were lower than those in the low-dose group(P<0.05).After treatment,the levels ofγ-glutamyltransferase(GGT),total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and alkaline phosphatase(ALP)in the two groups were higher than those before treatment,and the levels of the above indexes in low-dose group were lower than those in high-dose group(P<0.05).Compared with before treatment,the levels of free thyroxine(FT_(4)),free triiodothyronine(FT_(3))and total thyroid hormone(TT_(4))in both groups after treatment were decreased,those in the high-dose group were lower than those in the low-dose group,the thyroid stimulating hormone(TSH)in both groups were increased,and that in the high-dose group were higher that in the low-dose group(P<0.05).There were no significant difference in the total effective rate,pregnancy outcome and incidence of adverse reactions between the two groups(P>0.05).Conclusion:The clinical effect of different doses of Propylthiouracil in the treatment of pregnancy complicated with hyperthyroidism is similar.High-dose Propylthiouracil can improve the hypercoagulability of patients,while low-doses Propylthiouracil can effectively reduce the damage of liver function.