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

刘晓莉

[摘要] 目的 观察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。 方法 2015年5月～2016年9月期间于我院接受治疗的患有亚临床甲状腺功能减退症的孕妇中选取40例设为SCH组，同时选取健康孕妇40例为对照组。对SCH组行左旋甲状腺素治疗，并统计SCH组孕妇治疗前后的血清叶酸以及甲状腺功能变化情况，并与对照组进行对照。 结果 经治疗，SCH组孕妇在各项指标（包括FA、TSH、FT3、FT4、TC、TG、LDL-C以及HDL-C）方面较治疗前均有一定变化，其中FA、TSH、TC、TG、LDL-C变化显著，差异有统计学意义（P<0.05）。 结论 临床中，FA水平下降以及较高的TC、LDL-C与孕妇出现SCH症状之间有较为密切的联系，结合实际情况对其行左旋甲状腺素治疗可以很好地提升患有SCH症状孕妇的血清叶酸水平，且能够显著改善其甲状腺基本功能，值得临床推广与应用。

[关键词] 亚临床甲状腺功能减退；左旋甲状腺素；血清叶酸；甲状腺功能

[中图分类号] R714.256 [文献标识码] A [文章编号] 1673-9701（2017）16-0020-03

[Abstract] Objective To analyze the possible effect of L-thyroxine on serum folic acid and thyroid function in pregnant women with subclinical hypothyroidism. Methods A total of 40 pregnant women with subclinical hypothyroidism admitted in our hospital from May 2015 to September 2016 were set as SCH group， meanwhile 40 healthy pregnant women were selected as the control group. The patients in the SCH group were treated with L-thyroxine for prevention and the changes of serum folic acid and thyroid function in the SCH group before and after treatment were summed up. The results in the SCH group were compared with those in the control group Results After treatment， the indicators （including FA， TSH， FT3， FT4， TC， TG ， LDL-C and HDL-C） of the pregnant women in SCH group had a certain changement ， of which FA， TSH， TC， TG and LDL-C were significant changed. And there was statistical difference between the SCH group and the control group（P<0.05）. Conclusion In the clinical， there is a close relationship between the decrease of FA， the high TC， LDL-C and the occurrence of SCH symptoms in pregnant women. The treatment of L-thyroxine combined with the actual situation can improve the serum folic acid levels well and significantly improve the thyroid basic function in pregnant women with SCH symptoms， which can be more extensively promoted clinically and applied in practice.

[Key words] Subclinical hypothyroidism； L-thyroxine； Serum folic acid； Thyroid function

患有亞临床甲状腺功能减退症（subclinical hypothyroidism，SCH）的孕妇可能会存在妊娠不良结局隐患，还可能会造成新生儿神经智力方面的不可逆性受损[1]。经研究证明，这可能与孕妇本身的叶酸水平逐渐下降有关[2]。多年临床实验证明，左旋甲状腺素对孕妇的甲状腺功能减退症有较为理想的调节效果，可以有效缓解SCH症状患者的血清叶酸以及甲状腺功能[3]。本文对随机抽取的患有SCH症状的孕妇40例进行研究，旨在探讨左旋甲状腺素的治疗效果，现报道如下。

1 资料与方法

1.1一般资料

结合实际情况，通过姓名抽取方式，在2015年5月～2016年9月期间于我院接受治疗的患有亚临床甲状腺功能减退症状的孕妇中选取40例，将其设为SCH组，平均年龄（28.09±4.65）岁，平均孕周（28.12±3.56）周；同时择取健康孕妇40例作为对照组，平均年龄（27.85±4.71）岁，平均孕周（28.83±3.35）周。两组孕妇在一般资料上均无显著差异，本研究经本院伦理委员会认可，孕妇家属均知情同意，并签署了同意书。……