丙基硫氧嘧啶影响妊娠合并甲状腺功能亢进孕妇甲状腺功能及妊娠结局的研究

目的:探讨丙基硫氧嘧啶(PTU)影响妊娠合并甲状腺功能亢进(甲亢)孕妇甲状腺功能及妊娠结局的影响。方法:选择我院妇产科2010年3月至2013年1月收治的110例妊娠合并甲亢的患者作为观察对象,随机分为观察组58例,对照组52例。观察组予PTU每天300 mg口服,对照组确诊后未能定期检测甲状腺功能而自行停药,或拒绝PTU药物治疗。结果:观察组TT3、TT4、FT3、FT4、TSH水平均显著低于对照组,差异均具有统计学意义(均P0.05);观察组早产或流产、剖宫产、妊娠高血压、心力衰竭、重度子痫明显低于对照组,而足月产明显高于对照组,差异均具有统计学意义(均P0.05);观察组的围生儿发生胎儿窘迫、低体重儿、新生儿甲亢、转入NICU发生率均显著低于对照组,两组比较差异均具有统计学意义(均P0.05)。结论:规范的PTU治疗能很好地改善妊娠合并甲亢患者的孕期甲状腺功能,减低甲亢对孕妇及新生儿的危害,改善妊娠结局,且对新生儿畸形率无显著的影响,是一种相对安全和有效的治疗方法。

Study on the Influence of Thyroid Function and Pregnancy Outcome of Propylthiouracil in the Treatment of Pregnancy Combined with Hyperthyroidism Women

Objective:To investigate the influence of thyroid function and pregnancy outcome of propylthiouracil in the treatment of pregnancy combined with hyperthyroidismwomen.Methods:110 cases of pregnancy combined with hyperthyroidismin department of gynecology and obstetrics of our hospital from March 2010 to January 2013 were selected as observation objects, and were randomly divided into observation group of 58 cases, 52 cases in control group. Observation group were given PTU 300 mg per day orally, control group after the diagnosis of thyroid function failed to regularly test their withdrawal, or refused to PTU therapy.Results:In the observation group, TT3, TT4, FT3, FT4, TSH levels were significantly lower than those in the control group, the differences were statistically significant (P<0.05); premature delivery or abortion, cesarean section, pregnancy induced hypertension, heart failure, and severe preeclampsia of the observation group was significantly lower than that of the control group, while the term birth was significantly higher than that of the control group, the differences were statistically significant (P<0.05); the occurrence of fetal distress, perinatal infants, low birth weight, neonatal hyperthyroidism, transferred to the incidence of NICU in observation group was significantly lower than control group, the difference between the two groups were statistically significant (P<0.05).Conclusion:PTU treatment specification can improve thyroid functionhyperthyroidismduring pregnancy in patients with pregnancy, reduce the harm to the maternal and neonatal hyperthyroidism,improve the pregnancy outcome, and had no significant effect on neonatal malformation rate. It is a relatively safe and effective method in the therapy.