优甲乐替代疗法对妊娠合并甲状腺功能减退症患者母婴妊娠结局的影响

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目的探讨妊娠合并甲状腺功能减退症(甲减)患者应用优甲乐对母婴妊娠结局的影响。方法选取2014年1-12月收治的甲减患者150例为研究对象,依据甲状腺功能控制情况分为控制组(78例)和未控制组(72例),同时选择150例同期分娩且甲状腺功能正常的孕产妇为正常组,比较3组孕产妇的甲状腺激素水平、妊娠并发症及围产儿结局等。结果未控制组孕中期、孕晚期血清促甲状腺激素(TSH)水平均显著高于正常组(P<0.01)和控制组(P<0.05);未控制组血清游离三碘甲状腺原氨酸(FT3)及游离甲状腺素(FT4)水平显著低于正常组(P<0.01)和控制组(P<0.05);未控制组妊娠期高血压疾病、妊娠期糖尿病、胎膜早破等并发症发生率显著高于正常组(P<0.01)和控制组(P<0.05);控制组妊娠合并症及并发症发生率与正常组比较差异均无统计学意义(P>0.05);未控制组早产及新生儿低体重发生率均显著高于正常组(P<0.01),控制组早产及新生儿低体重发生率与正常组比较差异均无统计学意义(P>0.05)。结论妊娠合并甲减的孕产妇应用优甲乐控制甲状腺功能可调整甲状腺激素水平,降低妊娠并发症发生率,改善母婴妊娠结局。 Objective To investigate the effect of Euthyrox on pregnancy outcome in pregnant women with hypothyroidism (hypothyroidism). Methods A total of 150 hypothyroidism patients admitted from January to December 2014 were enrolled in this study. Thyroid function was divided into control group (n = 78) and uncontrolled group (n = 72). Simultaneous 150 cases of childbirth with thyroid function Normal maternal normal group, comparing the three groups of thyroid hormone levels of pregnant women, pregnancy complications and perinatal outcomes. Results The level of TSH in the second trimester and the third trimester in the control group was significantly higher than that in the control group (P <0.01) and control group (P <0.05). In the uncontrolled group, serum free triiodothyronine (FT3 (P <0.01) and control group (P <0.05). The incidence of complications such as hypertensive disorder complicating pregnancy, gestational diabetes and premature rupture of membranes in uncontrolled group were significantly lower than those in control group (P <0.01) and control group (P <0.05). There was no significant difference in the incidence of complications of pregnancy and complication between control group and control group (P> 0.05) The incidence of low birth weight in infants was significantly higher than that in normal controls (P <0.01). There was no significant difference in the incidence of preterm birth and neonatal low birth weight between control group and normal controls (P> 0.05). Conclusion Pregnancy with hypothyroidism in pregnant women with euthyrox thyrotropin control thyroid hormone levels can be adjusted to reduce the incidence of pregnancy complications and improve maternal and child pregnancy outcomes.
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