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目的探讨甲状腺机能减退症(简称甲减)并妊娠的诊断、临床特点及甲状腺激素替代治疗的效果。方法观察16例甲减患者并妊娠的临床特点、左旋甲状腺素(简称优甲乐)替代治疗的剂量与疗效。结果甲减患者并发舒张压为主的高血压、高脂血症、心肌酶增高、心绞痛、心包积液、蛋白尿增高,月经紊乱(不孕、晚孕)等。给予优甲乐2μg/kg/d时,血清TSH2.5～0.3mU/L,血清TT4、FT4正常的上限,上诉症状消失,月经来潮并妊娠。结论不孕患者早期检查甲状腺功能,合理甲状腺激素替代治疗能有效改善症状,受孕率增高,获得优生优育。
Objective To investigate the diagnosis, clinical characteristics and the effect of thyroid hormone replacement therapy in patients with hypothyroidism (Hypothyroidism) and pregnancy. Methods The clinical features of 16 patients with hypothyroidism and pregnancy were observed. The dose and efficacy of L-thyroxine (referred to as Euthyrox) replacement therapy were observed. Results Hypothyroidism patients with concurrent diastolic hypertension, hyperlipidemia, increased myocardial enzymes, angina pectoris, pericardial effusion, increased proteinuria, menstrual disorders (infertility, late pregnancy) and so on. When given Euthyrox 2μg / kg / d, serum TSH2.5 ~ 0.3mU / L, serum TT4, FT4 upper limit of normal, the symptoms disappear, menstrual cramps and pregnancy. Conclusion Infertility patients with early detection of thyroid function, reasonable thyroid hormone replacement therapy can effectively improve the symptoms, pregnancy rate increased, access to prenatal and postnatal care.