林亮

【摘要】 目的：探讨左甲状腺素钠片治疗妊娠期甲状腺功能减退症（SCH）患者的临床效果。方法：选取2017年8月-2019年7月笔者所在医院收治的68例妊娠期SCH患者，根據随机数字表法分为对照组和观察组，每组34例。对照组接受常规治疗，观察组在对照组基础上接受左甲状腺素钠片治疗。比较两组干预后甲状腺激素（TSH、FT4、FT3）、血清Hcy及叶酸水平，观察两组妊娠并发症（胎儿生长不良、胎盘早剥、妊娠出血）情况。结果：干预后观察组TSH水平明显低于对照组，FT4、FT3水平均明显高于对照组（P<0.05）;观察组血清Hcy及叶酸水平均高于对照组（P<0.05）;观察组妊娠并发症发生率为5.88%，低于对照组的29.41%（P<0.05）。结论：妊娠期SCH患者应用左甲状腺素钠片可改善甲状腺功能，降低妊娠并发症发生率，值得进一步研究及推广。

【关键词】 左甲状腺素钠片 妊娠期 甲状腺功能减退症 疗效

doi：10.14033/j.cnki.cfmr.2020.17.055 文献标识码 B 文章编号 1674-6805（2020）17-0-03

Clinical Effect of Levothyroxine Sodium Tablets in the Treatment of SCH during Pregnancy/LIN Liang. //Chinese and Foreign Medical Research， 2020， 18（17）： -131

[Abstract] Objective： To investigate the clinical effect of Levothyroxine Sodium Tablets in the treatment of subclinical hypothyroidism （SCH） during pregnancy. Method： A total of 68 cases with SCH during pregnancy admitted to our hospital from August 2017 to July 2019 were selected and divided into the control group and the observation group according to the method of random number table， 34 cases in each group. The control group received routine treatment， and the observation group received Levothyroxine Sodium Tablets on the basis of the control group. After intervention， thyroid hormone （TSH， FT4， FT3）， serum Hcy and folate levels of the two groups were compared， and the pregnancy complications （fetal dysplasia， placental abruption and pregnancy hemorrhage） were observed between the two groups. Result： After intervention， the level of TSH in the observation group were significantly lower than that of the control group， and the levels of FT4 and FT3 were significantly higher than those of the control group （P<0.05）. The levels of serum Hcy and folate in the observation group were higher than those of the control group （P<0.05）. And the incidence of pregnancy complications of the observation group was 5.88%， which was lower than 29.41% of the control group （P<0.05）. Conclusion： Levothyroxine Sodium Tablets can improve thyroid function in patients with SCH during pregnancy， and reduce the incidence of pregnancy complications， which is worthy of further research and promotion.

[Key words] Levothyroxine Sodium Tablets Pregnancy Subclinical hypothyroidism Curative effect

First-authors address： Wuchuan Peoples Hospital， Wuchuan 524500， China

甲状腺功能减退症（SCH）是由多种原因引起的一组内分泌疾病。常规治疗包括低脂饮食、补充蛋白质和碘盐，但治疗效果不显著，患者甲状腺激素水平不能得到有效改善[1]。妊娠期SCH患者容易合并多种并发症，严重者可能会发生流产、早产及死胎等情况[2]。甲状腺激素具有促进生长发育作用，一旦出现妊娠期SCH对妊娠结局及胎儿生长发育将造成不可估量的负面影响。左旋甲状腺素钠片与内源型甲状腺激素作用相同，能有效调节甲状腺素水平，从而有效治疗SCH[3]。目前，关于左旋甲状腺素钠片对妊娠期SCH患者母婴结局的研究较少。本文主要探讨68例妊娠期SCH患者应用左甲状腺素钠片治疗的临床效果，具体内容如下。

1 资料与方法

1.1 一般资料

选取2017年8月-2019年7月笔者所在医院收治的68例妊娠期SCH患者。纳入标准：（1）符合2015年ATA指南中關于妊娠期SCH的诊断标准;（2）均在笔者所在医院接受产前检查并建卡。……