| 孙春萍,刘皆,张伟,等.左甲状腺素钠早期治疗对妊娠合并亚临床甲状腺功能减退症妊娠结局和胎儿的影响[J].安徽医药,2022,26(12):2520-2524. |
| 左甲状腺素钠早期治疗对妊娠合并亚临床甲状腺功能减退症妊娠结局和胎儿的影响 |
| Effect of early treatment with levothyroxine sodium on pregnancy outcomes and fetus of pregnancy with subclinical hypothyroidism |
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| DOI：10.3969/j.issn.1009-6469.2022.12.041 |
| 中文关键词: 妊娠并发症 甲状腺功能减退症 左甲状腺素钠 分娩方式 产后出血 妊娠结局 |
| 英文关键词: Pregnancy complications Hypothyroidism Levothyroxine sodium Delivery mode Postpartum hemorrhage Pregnancy outcome |
| 基金项目:2020年度合肥市卫生健康委应用医学研究项目( Hwk2020yb0012) |
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| 中文摘要: |
| 目的观察左甲状腺素钠早期治疗对妊娠合并亚临床甲状腺功能减退症(甲减)妊娠结局和胎儿的影响。方法回顾性选取 2020年 1月至 2021年 7月安徽医科大学第三附属医院孕期进行产前检查门诊随访治疗的妊娠合并亚临床甲减(即妊娠前或妊娠期甲状腺功能诊断为亚临床甲减) 64例作为观察组，同时收集同期分娩且甲状腺功能正常的 40例孕产妇为作为对照组。比较两组之间分娩方式、产后出血发生率、妊娠结局及新生儿结局的差异。结果观察组替代治疗前促甲状腺激素(TSH)、游离三碘甲状腺原氨酸( FT3)、血清游离甲状腺激素( FT4)、抗甲状腺球蛋白抗体( TGAb)、抗甲状腺过氧化物酶抗体(TPOAb)水平分别为( 6.62±0.66)mU/L、(2.63±0.15)pmol/L、(8.46±0.94)pmol/L、(126.25±10.16)IU/mL、(85.46±6.33)IU/mL，与对照组( 2.15±0.25)mU/L、(3.38±0.25)pmol/L、(14.55±1.25)pmol/L、(86.50±6.54)IU/mL、(10.35±2.59)IU/mL相比均差异有统计学意义( P<0.05)，与对照组相比，观察组替代治疗前 TSH、FT3、FT4、TGAb、TPOAb(均 P<0.05)；治疗后观察组 TGAb及 TPOAb阳性率均明显降低，与替代治疗前相比( P<0.05)；观察组剖宫产率及产后出血发生率与对照组相比差异无统计学意义( P> 0.05)；两组妊娠高血压综合征、低出生体质量儿、早产、羊水过少等发生率比较差异无统计学意义( P>0.05)；两组新生儿窒息率及住院率比较差异无统计学意义( P>0.05)。结论左甲替代早期治疗后可改善妊娠合并亚临床甲减病人的妊娠结局，改善胎儿情况。 |
| 英文摘要: |
| Objective To observe the effects of early treatment with levothyroxine sodium on the pregnancy outcomes and fetuses inpregnancy combined with subclinical hypothyroidism.Methods A total of 64 pregnant women with subclinical hypothyroidism (i.e.,thyroid function diagnosed as subclinical hypothyroidism before or during pregnancy) who underwent antenatal checkups during preg.nancy at the Third Affiliated Hospital of Anhui Medical University from January 2020 to July 2021 were retrospectively selected as theobservation group, while 40 pregnant women who delivered at the same time period and had normal thyroid function were recruited asthe control group. The differences in mode of delivery, incidence of postpartum hemorrhage, pregnancy outcomes and neonatal out.comes between the two groups were compared.Results The levels of thyrotropin (TSH), free triiodothyronine (FT3), serum free thyroid hormone (FT4), anti-thyroglobulin antibody (TGAb), and anti-thyroid peroxidase antibody (TPOAb) in the observation group before re.placement therapy were significantly different from those in the control group [(6.62±0.66) mU/L, (2.63±0.15) pmol/L, (8.46±0.94)pmol/L, (126.25±10.16) IU/mL and (85.46±6.33) IU/mL vs. (2.15±0.25) mU/L, (8.46±0.94) pmol/L, (14.55±1.25) pmol/L, (86.50±6.54) IU/mL and (10.35±2.59) IU/mL] (P<0.05). After treatment, the positive rates of TGAb and TPOAb in the observation group were signifi.cantly lower than those before replacement therapy (P<0.05). There was no statistically significant difference in the incidence of cesare.an section and postpartum hemorrhage in the observation group compared with the control group (P>0.05); there was no statistically sig.nificant difference in the incidence of gestational hypertension syndrome, low birth mass, preterm delivery, and low amniotic fluid be.tween the two groups (P>0.05); and there was no statistically significant difference in the rate of neonatal asphyxia and hospitalizationbetween the two groups (P>0.05).Conclusion Early treatment with levothyroxine sodium replacement can improve pregnancy and im. prove the fetal condition in patients with subclinical hypothyroidism in combination with pregnancy. |
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