Objective:To investigate the clinical effect of thyroid hormone replacement therapy in gravida with gestational diabetes mellitus(GDM)with hypothyroidism.Method:A total of 92 gravidas with GDM with hypothyroidism admitted to Zibo Hospital of Shandong Yiyang Health Group from January 2022 to January 2023 were selected and divided into high-dose group(n=46)and low-dose group(n=46)according to different replacement doses.The low-dose group was given low-dose thyroid hormone replacement therapy,and the high-dose group was given high-dose thyroid hormone replacement therapy.Thyroid function,glycolipid metabolism indexes and pregnancy outcome were compared between the two groups.Result:After treatment,the levels of thyroid stimulating hormone(TSH)were decreased in both groups,the levels of free triiodothyronine(FT3)and free thyroxine(FT4)were increased in both groups,and the TSH level in high-dose group was lower,and FT3 and FT4 levels in high-dose group were higher,the differences were statistically significant(P<0.05).After treatment,the levels of triglyceride(TG),total cholesterol(TC),fasting insulin(FINS)and fasting plasma glucose(FPG)in both groups were decreased,and those in the high-dose group were lower than those in the low-dose group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse pregnancy outcome between the high dose group(10.87%)and the low dose group(17.39%)(P>0.05).Conclusion:Compared with low-dose thyroid hormone replacement therapy,the application of high-dose thyroid hormone replacement therapy in gravida with GDM with hypothyroidism can better improve thyroid function and glycolipid metabolism indexes,and has higher safety.
维普
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