妊娠期亚临床甲状腺功能减退症左甲状腺素治疗剂量探讨

    The levothyroxine dose in the treatment of patients with subclinical hypothyroidism during pregnancy

    • 摘要: 目的: 探讨影响妊娠期亚临床甲状腺机能减退(SCH)患者左甲状腺素(L-T4)治疗剂量的因素.方法: 42例妊娠期SCH患者,每4周监测甲状腺功能,根据促甲状腺激素(TSH)水平调整L-T4剂量,使每次TSH值均达标.记录首诊时患者体质量、TSH值、甲状腺过氧化物酶抗体(TPO-Ab)水平、产前体质量和新生儿体质量等.使用SPSS17.0对产前L-T4剂量进行多元线性回归分析.结果: 产前L-T4剂量与患者体质量及体质量增加值、首诊时TSH值、TPO-Ab水平、新生儿体质量等无明显关系(P>0.05).结论: 患者首诊时TSH值、体质量、孕期体质量增加值、TPO-Ab水平、新生儿体质量等不能预测产前L-T4剂量,TSH全程控制达标有赖于规律的监测和随访.

       

      Abstract: Objective: To investigate the levothyroxine(L-T4) dose in the treatment of patients with subclinical hypothyroidism(SCH) during pregnancy.Methods: The thyroid functions of 42 patients with SCH during pregnancy were detected every 4 weeks,the L-T4 dose was adjusted according to the level of thyroid stimulating hormone(TSH) to make the TSH arrive at the standard scope.The patients weight,TSH value and the level of thyroid peroxidase antibodies(TPO-Ab) at initial diagnosis,and neonatal weight and prenatal patients weight were recorded.The prenatal L-T4 dose was analyzed by multiple linear regression with SPSS17.0.Results: There were not significant relationships between the prenatal L-T4 dose and patients weight,pregnant woman increasing weight,TSH value and the level of TPO-Ab at initial diagnosis,and neonatal weight(P>0.05).Conclusions: The patient weight and TSH value,pregnant woman increasing weight,the level of TPO-Ab at initial diagnosis,and neonatal weight can not predict the prenatal L-T4 dose.Controlling the TSH value depends on the regular monitoring and following-up.

       

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