左旋甲狀腺素鈉片治療妊娠期亞臨床甲狀腺功能減退癥的療效及對患者血脂水平的影響

李瓊 杜玲 呂蕓 蘆金飛 張霞 陳艷潔

[摘要] 目的 探討左旋甲狀腺素鈉片治療妊娠期亞臨床甲狀腺功能減退癥的療效及對患者血脂水平的影響。方法 選取2017年1月～2019年1月于我院診治的妊娠期亞臨床甲狀腺功能減退癥患者60例，采用隨機數字表法隨機分為觀察組和對照組，每組30例，觀察組給予左旋甲狀腺素鈉片治療，初始劑量為50 μg/次，1次/d，早餐前半小時口服;對照組不給予藥物進行治療。比較兩組治療前后TSH、FT4、FT3水平及血脂各項指標變化情況及用藥安全性情況。 結果 兩組治療前TSH、FT4、FT3水平比較，無顯著性差異（P>0.05），治療后，兩組TSH及FT3水平明顯降低，FT4水平明顯升高，且觀察組治療后TSH及FT3水平顯著低于對照組，FT4水平顯著高于對照組，兩組比較，差異有統計學意義（P<0.05）;兩組治療前TC、TG、HDL-C、LDL-C水平比較，均未見明顯差異（P>0.05），治療后，兩組TC、TG及LDL-C水平顯著降低，HDL-C水平顯著升高，且觀察組治療后TC、TG及LDL-C水平顯著低于對照組，HDL-C水平顯著高于對照組，兩組比較，差異有統計學意義（P<0.05）。兩組治療期間未見明顯不良反應，安全性較好。 結論 左旋甲狀腺素鈉片治療妊娠期亞臨床甲狀腺功能減退癥療效確切，能顯著改善患者甲狀腺功能，同時可糾正脂質代謝紊亂。

[關鍵詞] 妊娠期亞臨床甲狀腺功能減退癥;左旋甲狀腺素鈉片;甲狀腺功能;血脂

[中圖分類號] R581.2? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2019）33-0057-03

[Abstract] Objective To explore the effect of levothyroxine sodium tablets on subclinical hypothyroidism during pregnancy and their effect on blood lipid level. Methods Sixty patients with subclinical hypothyroidism during pregnancy who were treated in our hospital from January 2017 to January 2019 were enrolled and divided into the observation group and the control group according to random number table method， with 30 patients in each group. The observation group was treated with levothyroxine sodium tablets orally half an hour before breakfast once a day， with the initial dose of 50 μg each time. The control group was not given medication. The levels of TSH， FT4 and FT3 and the changes of blood lipid indexes before and after treatment and the drug safty were compared between the two groups. Results Before treatment， there were no significant differences in the levels of TSH， FT4 and FT3 between the two groups（P>0.05）. After treatment， the levels of TSH and FT3 patients in the two groups were significantly reduced compared with those before treatment， and the levels of FT4 were significantly increased. The levels of TSH and FT3 in the observation group after treatment were significantly lower than those in the control group， and the FT4 level was significantly higher than that in the control group， with significant differences between the two groups（P<0.05）. Before treatment， there were no significant differences in TC， TG， HDL-C and LDL-C levels between the two groups（P>0.05）. After treatment， the levels of TC， TG and LDL-C in the two groups were significantly reduced compared with those before treatment， and the HDL-C levels were significantly increased. The levels of TC， TG and LDL-C in the observation group after treatment were significantly lower than those in the control group， and the HDL-C level was also significantly higher than that in the control group， with significant differences between the two groups（P<0.05）. There was no obvious adverse reaction during the treatment in the two groups， and the safety was good. Conclusion Levothyroxine sodium tablets are effective in the treatment of subclinical hypothyroidism during pregnancy， which can significantly improve the thyroid function of patients and correct the lipid metabolism disorder.