目的：观察左甲状腺素钠片（优甲乐）治疗妊娠期甲状腺功能减退症对甲状腺功能及妊娠结局的影响。方法选择2014年2月—2015年3月在武汉市武昌医院妇产科确诊为妊娠期甲状腺功能减退症的患者共100例。采用随机数字表法分为2组，观察组50例，以优甲乐治疗，对照组则予以常规处理。比较2组患者妊娠结局以及TSH、FT3、FT4、TPOAb的水平变化。结果与治疗前比较，治疗后2组TSH、FT3、FT4、TPOAb均有明显的改善[观察组：（3{．1±0．9）μU／ml vs．（7．2±1．4）μU ／ml，（13．5±1．7） pmol／L vs．（10．0±1．9） pmol／L，（3．2±0．5） pmol／L vs．（2．3±0．9）pmol／L，（52．8±12．5）U／ml vs．（182．0±71．2）U／ml；对照组：（5．1±0．8）μU／ml vs．（7．4±1．5）μU ／ml，（11．3±1．6）pmol／L vs．（9．9±1．9）pmol／L，（3．0±0．4）pmol／L vs．（2．2±0．9）pmol／L，（96．5±10．4）U／ml vs．（182．3±73．5）U／ml]，差异均有统计学意义（ P ＜0．05），且观察组妊娠并发症总发生率为28．0％，低于对照组的78．0％，观察组围产儿不良结局的总发生率为8．0％，低于对照组的28．0％，2组比较差异均有统计学意义（ P ＜0．05）。结论妊娠期甲状腺功能减退症妇女应用优甲乐治疗，能够有效改善TSH、FT3、FT4水平，降低不良妊娠结局的发生，治疗效果显著。%Objective To observe the left thyroxin sodium piece ( Euthyrox) in the treatment of hypothyroidism dur-ing pregnancy ( hypothyrea) on thyroid function and the outcome of the pregnancy.Methods 100 patients with hypothyroid-ism during pregnancy were selected in Department of Obstetrics and Gynecology, Wuchang Hospital of Wuhan City from Feb-ruary 2014 to March 2015.They were randomly divided into observation group and control group, 50 cases for each group . The observation group was treated with Euthyrox, while the control group received conventional treatment.Pregnancy outcomes and the level changes of TSH, FT3 , FT4 , TPOAb in both groups were compared.Results After treatment, the TSH, FT3 , FT4 , TPOAb were significantly improved as compared with those before treatment in both groups.[ The observation group :(3.1 ±0.9) μU/ml vs.(7.2 ±1.4) μU/ml, (13.5 ±1.7) pmol/L vs.(10.0 ±1.9) pmol/L, (3.2 ±0.5) pmol/L vs. (2.3 ±0.9) pmol/L, (52.8 ±12.5) U/ml vs.(182.0 ±71.2) U/ml.The control group:(5.1 ±0.8)μU/ml vs.(7.4 ± 1.5)μU /ml,(11.3 ±1.6)pmol/L vs.(9.9 ±1.9)pmol/L,(3.0 ±0.4)pmol/L vs.(2.2 ±0.9)pmol/L,(96.5 ±10.4)U/ml vs.(182.3 ±73.5)U/ml], that’s a statistically significant difference compared with before treatment ( P <0.05).And the total incidence of the pregnancy complications in the observation group was 28.0%less than 78.0%in the control group. The total incidence of adverse perinatal outcomes was 8.0%, significantly lower than 28.0%in the control group, the differ-ences above between the two groups were significant ( P <0.05).Conclusion Pregnancy women with hypothyroidism trea-ted with Euthyrox can effectively improve the level of TSH, FT3 , FT4 content, reduce the occurrence of adverse pregnancy out-comes, and achieve significant therapeutic effect.
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