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目的:研究对妊娠期合并甲状腺亚临床功能减退患者采用甲状腺素替代疗法的时机和剂量规律,为临床上优生优育提供参考建议。方法:回顾性分析该院内分泌科收治的妊娠合并甲状腺亚临床功能减退的孕妇36例,分析按照不同剂量在不同时间给药前后患者甲状腺激素FT4、促甲状腺激素TSH指标变化情况。结果:甲状腺激素的替代量均明显高于入组时的使用量,FT4在治疗后每一个月与入组时比较均明显高于入组时,TSH在治疗后每一个月与入组时比较均明显低于入组时的水平,且差异均具有统计学意义(P<0.05);分别比较入组时和孕9月时的血清总胆固醇(CHO)、三酰甘油(TG)、瘦素的变化,经过替代治疗3种指标均明显下降,且差异具有统计学意义(P<0.05)。结论:妊娠早期进行甲状腺功能检查,对有甲状腺功能减退的妊娠妇女及时采取甲状腺激素替代疗法将可以有效地调节机体甲状腺素水平,达到优生优育的目的。
Objective: To study the timing and dosage patterns of thyroid hormone replacement therapy in patients with subclinical thyroid hypothyroidism during pregnancy, and to provide references for prenatal and postnatal care. Methods: A retrospective analysis of 36 cases of pregnant women with thyroid hypothyroidism and pregnancy admitted to the Department of Endocrinology in the hospital was performed. The changes of thyroid hormone FT4 and thyrotropin TSH before and after different doses were analyzed. Results: The dosage of thyroid hormones was significantly higher than that of the control group. FT4 in each month after treatment was significantly higher than that at enrollment, and TSH was higher in every month after treatment (P <0.05). The levels of serum total cholesterol (CHO), triglyceride (TG), leptin After treatment, all the three indexes were significantly decreased, and the difference was statistically significant (P <0.05). CONCLUSION: Thyroid function test can be performed in early gestation. Thyroid hormone replacement therapy in pregnant women with hypothyroidism can effectively regulate the level of thyroxine and achieve the purpose of prenatal and postnatal care.