甲状腺素替代疗法对妊娠合并亚临床型甲减症孕妇的疗效分析

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目的探讨妊娠合并亚临床型甲减症孕妇采用甲状腺素替代疗法的给药剂量规律和治疗效果。方法选取2011年3月~2014年3月该院收治的孕2个月内确诊为亚临床型甲减症的孕妇41例,均给予甲状腺素替代疗法治疗,根据孕妇外周血清促甲状腺激素水平调整左旋甲状腺素片服用剂量,检测治疗前和治疗后不同孕周时甲状腺素T4(FT4)、促甲状腺激素(TSH)水平和治疗前和孕9个月时血清总胆固醇(CHO)、三酰甘油(TG)水平,进行统计学分析。结果孕3个月~孕9个月各时间段甲状腺激素替代量、FT4水平均明显高于治疗前,差异有统计学意义(P<0.05);各时间段TSH水平均明显低于治疗前,差异有统计学意义(P<0.01)。孕9个月时血清CHO、TG水平均明显低于治疗前,差异有统计学意义(P<0.05)。结论妊娠早期检查甲状腺功能,对亚临床型甲减症孕妇尽早给予甲状腺素替代疗法可有效调节机体甲状腺素水平,达到优生优育的目的。 Objective To investigate the dosage regimen and therapeutic effect of thyroid hormone replacement therapy in pregnant women with subclinical hypothyroidism. Methods From March 2011 to March 2014, 41 pregnant women diagnosed as subclinical hypothyroidism during the first 2 months of pregnancy in our hospital were treated with thyroid hormone replacement therapy. According to the level of serum thyrotropin in pregnant women, The dose of L-thyroxine tablets was taken. The levels of thyroid hormone T4 (FT4), thyroid stimulating hormone (TSH) and serum total cholesterol (CHO), triglyceride (TG) levels, for statistical analysis. Results The levels of thyroid hormone replacement and FT4 in each time period from 3 months pregnant to 9 months pregnant were significantly higher than those before treatment (P <0.05). The levels of TSH in each time period were significantly lower than those before treatment, The difference was statistically significant (P <0.01). At 9 months of pregnancy, serum CHO and TG levels were significantly lower than before treatment, the difference was statistically significant (P <0.05). Conclusions Examination of thyroid function in early pregnancy, thyroid hormone replacement therapy as early as possible for pregnant women with subclinical hypothyroidism can effectively regulate thyroid hormone levels, and achieve the purpose of prenatal and postnatal care.
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