目的 分析甲状腺激素替代疗法对妊娠期亚临床甲状腺功能减退症患者妊娠结局的影响.方法 128例妊娠期亚临床甲状腺功能减退症患者,随机分为研究组和对照组,每组64例.对照组采用常规治疗方法,研究组以常规治疗为基础采用甲状腺激素替代疗法治疗.比较两组患者治疗前和分娩前1 d促甲状腺激素(TSH)水平、新生儿出生时体质量及出生1 min Apgar评分、分娩方式、不良妊娠结局发生情况.结果 治疗前,两组患者TSH水平比较,无明显差异(P>0.05).分娩前1 d,两组患者TSH水平均出现了不同程度的下降,研究组患者TSH水平(1.36±0.23)mU/L低于对照组的(4.42±0.61)mU/L,差异明显(P<0.05).研究组新生儿出生体质量(3524.63±275.73)g、出生1 min Apgar评分(9.84±0.25)分均高于对照组的(3232.63±193.88)g、(9.23±0.21)分,差异明显(P<0.05).研究组自然分娩率59.38％高于对照组的39.06％,剖宫产率18.75％低于对照组的39.06％,差异明显(P<0.05).两组产钳助产率比较,无明显差异(P>0.05).研究组不良妊娠结局发生率10.94％ 低于对照组的31.25％,差异明显(P<0.05).结论 使用甲状腺激素替代疗法对妊娠期亚临床甲状腺功能减退症患者进行治疗后,其TSH水平出现了明显的下降,改善了不良妊娠结局.
Effect of thyroid hormone replacement therapy on pregnancy outcomes in patients with subclinical hypothyroidism during pregnancy
Objective To analyze the effect of thyroid hormone replacement therapy on pregnancy outcomes in patients with subclinical hypothyroidism during pregnancy. Methods A total of 128 patients with subclinical hypothyroidism during pregnancy were randomly divided into a control group and a study group,with 64 cases in each group. Patients in the control group were treated with conventional methods,while patients in the study group were treated with thyroid hormone replacement therapy on the basis of conventional treatment. Comparison was made on thyroid stimulating hormone (TSH) levels before treatment and 1 d before delivery,neonatal body mass at birth and 1-min Apgar score,mode of delivery,and the occurrence of adverse pregnancy outcomes between the two groups. Results Before treatment,there was no significant difference in TSH levels between the two groups (P>0.05). 1 d before delivery,the TSH levels in both groups deceased to varying degrees,and the TSH level of (1.36±0.23) mU/L in the study group was lower than (4.42±0.61) mU/L in the control group,and the difference was significant (P<0.05). The neonatal body mass at birth of the study group was (3524.63±275.73) g and the 1-min Apgar score was (9.84±0.25) points,which were higher than (3232.63±193.88) g and (9.23±0.21) points in the control group,and the difference was significant (P<0.05). The rate of natural delivery was 59.38％ in the study group,which higher than 39.06％ in the control group;the rate of cesarean section was 18.75％ in the study group,which was lower than 39.06％ in the control group;the difference was significant (P<0.05). There was no significant difference in the rate of forceps delivery between the two groups (P>0.05). The incidence of adverse pregnancy outcome in the study group was 10.94％,which was lower than 31.25％ in the control group,and the difference was significant (P<0.05). Conclusion The TSH level of the patients with subclinical hypothyroidism in pregnancy decreased significantly after thyroid hormone replacement therapy,which improves the adverse pregnancy outcomes.
万方数据
维普
