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目的观察早期综合干预联合左甲状腺素钠治疗妊娠合并甲状腺功能减退的效果。方法将224例妊娠合并甲状腺功能减退患者随机分为研究组和对照组各112例。接受联合干预及左甲状腺素钠治疗者为研究组,以接受联合干预及常规甲状腺素片治疗者为对照组。对比2组治疗前后游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺刺激激素(TSH)及SSRS评分。结果在接受治疗前,2组FT3、FT4及TSH水平比较差异无统计学意义(P>0.05)。而在接受治疗2个月后,2组FT3、FT4水平均升高,TSH水平降低,且研究组波动幅度大于对照组,差异有统计学意义(P<0.05)。治疗前2组SSRS评分比较差异无统计学意义(P>0.05)。在接受治疗2个月后,2组SSRS评分均升高,且研究组升高幅度大于对照组,差异有统计学意义(P<0.05)。结论早期综合干预联合左甲状腺素钠可显着提高妊娠合并甲状腺功能减退的治疗效果。
Objective To observe the effect of early comprehensive intervention combined with levothyroxine on pregnancy with hypothyroidism. Methods 224 cases of pregnancy with hypothyroidism were randomly divided into study group and control group of 112 cases. The patients receiving combined intervention and levothyroxine treatment were the study group, and the control group received the combined intervention and conventional thyroxine treatment. Free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin-stimulating hormone (TSH) and SSRS scores were compared between the two groups before and after treatment. Results Before treatment, there were no significant differences in FT3, FT4 and TSH between the two groups (P> 0.05). After 2 months of treatment, the levels of FT3 and FT4 increased and the level of TSH decreased in both groups, and the fluctuation range of the study group was larger than that of the control group (P <0.05). There was no significant difference in SSRS scores between the two groups before treatment (P> 0.05). After 2 months of treatment, SSRS scores increased in both groups, and the increase in the study group was greater than that in the control group, with significant difference (P <0.05). Conclusion Early comprehensive intervention combined with levothyroxine can significantly improve the therapeutic effect of hypothyroidism during pregnancy.