摘要
目的:探讨左甲状腺素钠治疗妊娠糖尿病伴亚临床甲状腺功能减退症(SCH)的临床效果。方法:将2022年1月—2024年1月北京市昌平区中医医院收治的80例妊娠糖尿病伴SCH患者随机分为两组,各40例。对照组使用常规疗法治疗,观察组在对照组基础上使用左甲状腺素钠治疗。对比两组甲状腺功能指标、血糖、胰岛功能指标、不良妊娠结局。结果:治疗后,两组游离三碘甲状腺原氨酸、游离甲状腺素水平无明显变化(P>0.05);两组甲状腺激素水平降低,且观察组低于对照组(P<0.001)。治疗前,两组空腹血糖(FBG)、餐后2h血糖(2hPBG)、空腹胰岛素(FINS)、空腹C肽水平比较,差异无统计学意义(P>0.05);治疗后,两组FBG、2hPBG均呈下降趋势,FINS、空腹C肽水平上升,相较于对照组,观察组改善幅度更明显(P<0.001)。观察组不良妊娠结局总发生率低于对照组(P<0.05)。结论:左甲状腺素钠联合常规疗法治疗妊娠糖尿病伴SCH的临床效果显著,能改善患者甲状腺功能、血糖水平、胰岛功能,减少不良妊娠结局发生风险。
Objective:To investigate the clinical effect of levothyroxine sodium in the treatment of gestational diabetes mellitus with subclinical hypothyroidism(SCH).Methods:Eighty patients with gestational diabetes mellitus with SCH admitted to Beijing Changping District Hospital of Traditional Chinese Medicine from January 2022 to January 2024 were randomly divided into two groups of 40 patients each.The control group was treated with conventional therapy,and the observation group was treated with levothyroxine sodium on the basis of the control group.Thyroid function indexes,blood glucose,pancreatic islet function indexes and adverse pregnancy outcomes were compared between the two groups.Results:After treatment,there was no significant change in the levels of free triiodothyronine and free thyroxine in the two groups(P>0.05);the levels of thyroid hormones in the two groups were reduced,and the observation group was lower than the control group(P<0.001).Before treatment,there was no statistically significant difference in the levels of fasting blood glucose(FBG),2-h postprandial blood glucose(2 hPBG),fasting insulin(FINS),and fasting C peptide between the two groups(P>0.05);after treatment,the levels of FBG and 2 hPBG in the two groups showed a decreasing trend,and the levels of FINS and fasting C peptide increased,and the magnitude of the improvement in the observation group was more obvious than that in the control group(P<0.001).Compared with the control group,the observation group showed more significant improvement(P<0.001).The total incidence of adverse pregnancy outcomes in the observation group was lower than that in the control group(P<0.05).Conclusion:The clinical effect of levothyroxine sodium combined with conventional therapy in the treatment of gestational diabetes mellitus with SCH is remarkable,and it can improve the patients'thyroid function,blood glucose level,pancreatic islet function,and reduce the risk of adverse pregnancy outcomes.
作者
吴立华
伊丽努尔·伊力亚斯
赵丽妍
Wu Lihua;Elinor Elias;Zhao Liyan(Department of Obstetrics and Gynecology,Beijing Changping Hospital of Traditional Chinese Medicine,Beijing 102200,China)
出处
《中国社区医师》
2025年第15期19-21,共3页
Chinese Community Doctors
关键词
妊娠糖尿病
亚临床甲状腺功能减退症
左甲状腺素钠片
妊娠结局
Gestational diabetes mellitus
Subclinical hypothyroidism
Levothyroxine sodium tablets
Pregnancy outcome
