左旋甲状腺素钠片治疗妊娠期亚临床甲状腺功能减退症的疗效及对患者血脂水平的影响

李琼 杜玲 吕芸 芦金飞 张霞 陈艳洁

[摘要] 目的 探讨左旋甲状腺素钠片治疗妊娠期亚临床甲状腺功能减退症的疗效及对患者血脂水平的影响。方法 选取2017年1月～2019年1月于我院诊治的妊娠期亚临床甲状腺功能减退症患者60例，采用随机数字表法随机分为观察组和对照组，每组30例，观察组给予左旋甲状腺素钠片治疗，初始剂量为50 μg/次，1次/d，早餐前半小时口服;对照组不给予药物进行治疗。比较两组治疗前后TSH、FT4、FT3水平及血脂各项指标变化情况及用药安全性情况。 结果 两组治疗前TSH、FT4、FT3水平比较，无显著性差异（P>0.05），治疗后，两组TSH及FT3水平明显降低，FT4水平明显升高，且观察组治疗后TSH及FT3水平显著低于对照组，FT4水平显著高于对照组，两组比较，差异有统计学意义（P<0.05）;两组治疗前TC、TG、HDL-C、LDL-C水平比较，均未见明显差异（P>0.05），治疗后，两组TC、TG及LDL-C水平显著降低，HDL-C水平显著升高，且觀察组治疗后TC、TG及LDL-C水平显著低于对照组，HDL-C水平显著高于对照组，两组比较，差异有统计学意义（P<0.05）。两组治疗期间未见明显不良反应，安全性较好。 结论 左旋甲状腺素钠片治疗妊娠期亚临床甲状腺功能减退症疗效确切，能显著改善患者甲状腺功能，同时可纠正脂质代谢紊乱。

[关键词] 妊娠期亚临床甲状腺功能减退症;左旋甲状腺素钠片;甲状腺功能;血脂

[中图分类号] R581.2          [文献标识码] B          [文章编号] 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.