不同剂量丙基硫氧嘧啶治疗妊娠合并甲亢及对妊娠结局和凝血功能影响

目的:探索不同剂量丙基硫氧嘧啶治疗妊娠合并甲亢患者妊娠结局及对凝血功能影响。方法:选取2015年1月—2017年12月本院收治的150例妊娠合并甲亢患者,随机分为低剂量组75例(每天给予150mg丙基硫氧嘧啶)和高剂量组75例(每天给予300mg丙基硫氧嘧啶),比较两组妊娠结局、肝功能、甲状腺功能、凝血功能和甲亢治疗效果。结果:治疗后,与低剂量组比较,高剂量组ALP、GGT、TBIL、ALT和AST水平增高,TSH、FT4、FT3、TT4、PT、TT、FIB和DD水平降低,治疗总有效率(92.0%)高于低剂量组(77.3%),剖宫产、早产、妊娠期高血压、心力衰竭、重度子痫及胎儿窘迫、新生儿甲亢、低体重儿等发生率均低于低剂量组(均P<0.05)。结论:高剂量丙基硫氧密啶治疗妊娠合并甲亢,不仅可有效控制甲亢,减轻高凝状态,而且可以改善产妇及新生儿妊娠结局,但药物对患者的肝功能存在一定影响,需密切关注肝功能指标。

Effect of different doses of propylthiouracil for treating pregnant women with hyperthyroidism on their pregnancy outcomes and coagulation function

Objective:To analyze the effect of different doses of propylthiouracil for treating pregnant women with hyperthyroidism on their pregnancy outcomes and coagulation function.Methods:150 pregnant women with hyperthyroidism were randomly divided into control group(75 women treated by 150 mg propylthiouracil daily)and study group(75 women trested by 300 mg propylthiouracil daily)from January 2015 and December 2017.The pregnancy outcomes,liver function,thyroid function,coagulation function,and therapeutic effect of women were compared between the two groups.Results:After treatment,the levels of ALP,GGT,TBIL(TBIL),ALT and AST of women in the study group were significant higher than those of women in the control group,but the levels of TSH,FT4,FT3,TT4,PT,TT,FIB,and DD of women in the study group were significant lower(P<0.05).The total effective rate of women in the study group was 92.0%,which was significant higher than that(77.3%)of women in the control group(P<0.05).The incidences of cesarean section,premature delivery,pregnancy-induced hypertension,heart failure,and severe eclampsia of women,and rates of neonatal fetal distress,hyperthyroidism,and low birth weight infants in the study group were significantly lower than those of women in the control group(P<0.05).Conclusion:High-dose propylthiomidine for treating pregnant women with hyperthyroidism can not only control hyperthyroidism during pregnancy,alleviate hypercoagulability of women,but also improve the outcomes of the mothers and infants,but it has a certain impact on the liver function of women,so it is need to pay close attention to the liver function of women.