摘要
目的:探讨左甲状腺素钠片治疗妊娠期合并甲状腺功能减退症的临床疗效。方法:研究对象为2018年6月至2019年6月于遵化市人民医院住院治疗的妊娠期合并甲状腺功能减退症患者83例,采用随机数字表法分为研究组43例和对照组40例。对照组患者予以甲状腺片治疗,研究组患者予以左甲状腺素钠片治疗,疗程均为3个月。观察两组患者治疗前后甲状腺功能、脂代谢和糖代谢情况,叶酸(FA)、维生素B12(VitB12)和同型半胱氨酸(Hcy)水平,妊娠结局和不良反应发生情况。结果:治疗后,研究组患者血清游离三碘甲状腺素和游离四碘甲状腺素水平明显高于对照组,促甲状腺激素水平明显低于对照组;治疗后,研究组患者总胆固醇、甘油三酯和低密度脂蛋白胆固醇水平明显低于对照组,高密度脂蛋白胆固醇水平明显高于对照组;治疗后,研究组患者空腹血糖、空腹胰岛素水平和胰岛素抵抗指数明显低于对照组;治疗后,研究组患者血清FA和VitB12水平明显高于对照组,Hcy水平明显低于对照组,上述差异均有统计学意义(P<0.05)。研究组患者剖宫产、早产及流产发生率,胎儿宫内窘迫、低体重儿发生率明显低于对照组,差异均有统计学意义(P<0.05)。两组患者研究期间均未出现明显不良反应。结论:左甲状腺素钠片治疗妊娠期合并甲状腺功能减退症可有效改善患者甲状腺功能,调节糖脂代谢,减少不良妊娠结局的发生,安全性较高。
OBJECTIVE:To investigate the clinical efficacy of Levothyroxine sodium tablets in the treatment of pregnancy with hypothyroidism.METHODS:Totally 83 cases of pregnancy with hypothyroidism admitted into People’s Hospital of Zunhua from Jun.2018 to Jun.2019 were extracted to be divided into the study group(n=43)and the control group(n=40)via the random number table.The control group was treated with Thyroid tablets,while the study group received Levothyroxine sodium tablets for 3 months.Thyroid function,lipid metabolism and glucose metabolism,folic acid(FA),vitamin B12(VitB12)and homocysteine(Hcy)levels,pregnancy outcomes and adverse reactions of two groups were observed.RESULTS:After treatment,the levels of free triiodothyronine and free tetraiodothyroxine in the study group were significantly higher than those in the control group,and the levels of thyroid stimulating hormone were significantly lower than the control group;after treatment,the levels of total cholesterol,triglycerides and low-density lipoprotein cholesterol in the study group were significantly lower than those in the control group,and the levels of high-density lipoprotein cholesterol were significantly higher than the control group;after treatment,the fasting blood glucose,fasting insulin and insulin resistance index of the study group were significantly lower than those of the control group;after treatment,the serum FA and VitB12 levels in the study group were significantly higher than those in the control group,and the Hcy levels were significantly lower than the control group,the differences were statistically significant(P<0.05).The incidence of cesarean section,premature delivery and abortion,fetal distress and low birth weight were significantly lower in the study group than in the control group,and the differences were statistically significant(P<0.05).No significant adverse drug reactions were observed in both groups.CONCLUSIONS:Levothyroxine sodium tablets in the treatment of pregnancy with hypothyroidism can effectively improve the thyroid function of patients,regulate glucose and lipid metabolism,decrease the incidence of adverse pregnancy outcomes,and have higher safety.
作者
孙亚玲
辛春
郭明
刘志红
袁志英
SUN Yaling;XIN Chun;GUO Ming;LIU Zhihong;YUAN Zhiying(Dept. of Gynaecology, People’s Hospital of Zunhua, Hebei Zunhua 064200, China;Dept. of Gynecology, Tangshan Central Hospital, Hebei Tangshan 063000, China)
出处
《中国医院用药评价与分析》
2020年第7期788-791,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
河北省卫生健康委员会科研基金项目(No.20181417)。
关键词
妊娠期甲状腺功能减退症
左甲状腺素钠片
甲状腺功能
糖脂代谢
妊娠结局
Pregnancy with hypothyroidism
Levothyroxine sodium tablets
Thyroid function
Glycolipid metabolism
Pregnancy outcomes
