PTU免疫疗法在治疗妊娠合并甲亢中对母婴的影响研究

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目的本研究旨在发现妊娠合并甲亢孕妇在使用PTU治疗过程中对母婴的影响,包括母体及幼体TSH、TT3、TT4指标的变化以及对围孕妇产期的影响,以便更合理的指导PTU药物治疗妊娠合并甲亢。方法 31名妊娠合并甲亢患者为自2008年至2014年来本院治疗的孕妇,其中实验组16名孕妇采用PTU治疗方案,对照组15名孕妇采用停药保守观察治疗法,在治疗过程中对孕产期患者进行TSH、TT3、TT4、FT3、FT4指标的测定以及围产期的检测。结果统计学分析结果证实使用PTU疗法能够有效治疗妊娠合并甲亢孕妇的病情,治疗组孕妇TSH水平升高至正常水平,TT3、TT4指标下降至正常水平,且婴儿体内TSH、TT3、TT4指标正常,对照组孕妇体内TSH指标持续低下,其中一名患者病情严重,终止妊娠,对照组中3名婴儿受到母体影响,TSH水平降低,有患甲亢的风险。结论丙基硫氧嘧啶(PTU)通过胎盘的量非常少,对孕妇及婴儿的副作用较少,因而作为临床上普遍使用的治疗妊娠合并甲亢的指导药物。 Objectives The aim of this study was to find out the effects of PTU on the mothers and infants during the treatment of pregnant women complicated with hyperthyroidism, including the change of TSH, TT3 and TT4 in maternal and juvenile larynx, and the influence on pregnant and lying-in women during their pregnancy so as to guide PTU drug more rationally Treatment of pregnancy complicated with hyperthyroidism. Methods Thirty-one pregnant women with hyperthyroidism during pregnancy were pregnant women treated in our hospital from 2008 to 2014. Among them, 16 pregnant women in the experimental group were treated with PTU, and 15 pregnant women in the control group were treated with conservative treatment of withdrawal. During the treatment, Patients during the delivery period for the determination of TSH, TT3, TT4, FT3, FT4 indicators and perinatal testing. Results The results of statistical analysis confirmed that PTU treatment could effectively treat pregnant women with hyperthyroidism in pregnancy. TSH levels in pregnant women in the treatment group increased to normal levels, TT3 and TT4 indexes decreased to normal levels, and the indexes of TSH, TT3 and TT4 in infants were normal, TSH index in pregnant women in the control group continued to be low, one of the patients was in severe condition and terminated the pregnancy. Three infants in the control group were affected by the mother and the TSH level was reduced and the risk of hyperthyroidism was increased. Conclusions Propylthiouracil (PTU) is very low in the placenta and has few side effects on pregnant women and infants. Therefore, PTU is widely used as a guide in the treatment of hyperthyroidism during pregnancy.
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