左旋甲状腺素治疗对亚临床甲状腺功能减退症孕妇血清叶酸和甲状腺功能的影响

发布时间：2018-11-24 17:28

【摘要】：目的探讨左旋甲状腺素治疗对亚临床甲状腺功能减退症(SCH)孕妇血清叶酸和甲状腺功能的影响。方法选取妊娠中晚期孕妇及体检中心常规体检的育龄妇女95例,分为妊娠期SCH组(A组,30例)、妊娠期甲状腺功能正常组(B组,35例)及育龄期甲状腺功能正常组(C组,30例),妊娠期SCH组患者接受左旋甲状腺素治疗,妊娠期SCH患者在治疗前及治疗8周后,其他受试者在治疗前空腹采静脉血,检测叶酸、促甲状腺激素、游离甲状腺激素(FT4)、游离三碘甲状腺原氨酸(FT3)、空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)。结果 A组血清叶酸水平显著低于B、C组(P0.01)。A组总胆固醇,水平亦显著高于B、C组(P0.01)。孕妇血清促甲状腺激素与叶酸水平存在弱的负相关(r=-0.20,P0.05),与总胆固醇、LDL-C水平呈正相关(均P0.05)。治疗后,A组患者叶酸显著升高,血清促甲状腺激素显著降低(均P0.05),而FT3,FT4水平无明显变化(均P0.05)。结论叶酸水平降低和高总胆固醇、LDL-C水平可能是SCH孕妇发生不良妊娠结局的危险因素。左旋甲状腺素治疗能升高SCH孕妇的血清叶酸水平,降低血清促甲状腺激素水平,对改善妊娠结局可能有积极意义。
[Abstract]:Objective to investigate the effect of levothyroxine therapy on serum folic acid and thyroid function in (SCH) pregnant women with subclinical hypothyroidism. Methods Ninety-five pregnant women of childbearing age who underwent routine physical examination in middle and late pregnancy and physical examination center were divided into SCH group (group A, n = 30), normal thyroid function group (group B, n = 35) and normal thyroid function group (group C, n = 35). 30 cases were treated with levothyroxine in gestational SCH group. Before and after 8 weeks of treatment, other subjects collected venous blood before and after treatment, and detected folic acid and thyrotropin. Free thyroid hormone (FT4), free triiodothyronine (FT3), fasting blood glucose, total cholesterol, triacylglycerol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C). Results the level of serum folic acid in group A was significantly lower than that in group C (P0.01). A group), and the level of serum folic acid in group A was significantly higher than that in group B (P0.01). There was a weak negative correlation between serum thyrotropin and folic acid level in pregnant women (r = 0.20 P 0.05), and a positive correlation between serum thyrotropin and total cholesterol and LDL-C level (all P 0.05). After treatment, the level of folic acid and serum thyrotropin decreased significantly in group A (P0.05), but the level of FT3,FT4 did not change (P0.05). Conclusion the decrease of folic acid level, high total cholesterol and LDL-C level may be the risk factors of adverse pregnancy outcome in SCH pregnant women. Levothyroxine can increase serum folic acid level and decrease serum thyroid stimulating hormone level in pregnant women with SCH, which may have positive significance in improving pregnancy outcome.
【作者单位】：福建医科大学附属第二医院内分泌科;福建医科大学附属第二医院妇产科;
【基金】：泉州市科技局社会发展计划重点基金资助项目(2011Z40)
【分类号】：R714.256

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