妊娠期亚临床甲状腺功能减退症左甲状腺素治疗剂量探讨

目的：探讨影响妊娠期亚临床甲状腺机能减退（SCH）患者左甲状腺素（L-T4）治疗剂量的因素。方法：42例妊娠期SCH患者,每4周监测甲状腺功能,根据促甲状腺激素（TSH）水平调整L-T4剂量,使每次TSH值均达标。记录首诊时患者体质量、TSH值、甲状腺过氧化物酶抗体（TPO-Ab）水平、产前体质量和新生儿体质量等。使用SPSS17.0对产前L-T4剂量进行多元线性回归分析。结果：产前L-T4剂量与患者体质量及体质量增加值、首诊时TSH值、TPO-Ab水平、新生儿体质量等无明显关系（P〉0.05）。结论：患者首诊时TSH值、体质量、孕期体质量增加值、TPO-Ab水平、新生儿体质量等不能预测产前L-T4剂量,TSH全程控制达标有赖于规律的监测和随访。

The levothyroxine dose in the treatment of patients with subclinical hypothyroidism during pregnancy

Objective： To investigate the levothyroxine（ L-T4） dose in the treatment of patients with subclinical hypothyroidism（ SCH）during pregnancy. Methods： The thyroid functions of 42 patients with SCH during pregnancy were detected every 4 weeks,the L-T4 dose was adjusted according to the level of thyroid stimulating hormone（ TSH） to make the TSH arrive at the standard scope. The patients weight,TSH value and the level of thyroid peroxidase antibodies（ TPO-Ab） at initial diagnosis,and neonatal weight and prenatal patients weight were recorded. The prenatal L-T4 dose was analyzed by multiple linear regression with SPSS17. 0. Results： There were not significant relationships between the prenatal L-T4 dose and patients weight,pregnant woman increasing weight,TSH value and the level of TPO-Ab at initial diagnosis,and neonatal weight（ P〈0.05）. Conclusions： The patient weight and TSH value,pregnant woman increasing weight,the level of TPO-Ab at initial diagnosis,and neonatal weight can not predict the prenatal L-T4 dose. Controlling the TSH value depends on the regular monitoring and following-up.