长期的甲状腺功能低下症患者在怀孕期间开始接受levothyroxine
Sophie Demartin1, Stefan Matei Constantinescu1, Kris G Poppe2
1Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
European thyroid journal
|May 28, 2024
概括
有三分之一的孕妇需要莱沃甲状腺素 (LT4) 发展长期的甲状腺功能低下症. 早期的甲状腺刺激激素 (TSH) 水平和怀孕期间的LT4剂量可以预测持续产后治疗的需要.
科学领域:
- 内分泌学 在内分泌学.
- 生殖医学 生殖医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 怀孕期间的Levothyroxine (LT4) 管理需要不同的产后策略.
- 目前的指导方针为产后患者的LT4管理提供了多种建议.
研究的目的:
- 为了研究使用levothyroxine (LT4) 治疗孕妇的产后管理.
- 为了确定预测怀孕后长期甲状腺功能低下症的因素.
主要方法:
- 在2014年至2020年期间,对177名怀孕妇女进行了LT4的回顾性研究.
- 分析包括多变量逻辑回归和ROC曲线分析.
- 对106名患者进行了长期随访 (产后≥6个月).
主要成果:
- 34%的随访患者 (36/106) 患有长期的甲状腺功能低下症.
- 在长期甲状腺功能低下症患者中观察到较早的LT4启动,更高的TSH水平和更高的怀孕期间的LT4剂量.
- 怀孕期间最大的LT4剂量 (OR=1.03) 与长期的甲状腺功能低下症有显著的关联.
- 最佳切断点:LT4剂量为68.75μg/天,TSH水平≥3.8mU/L预测长期甲状腺功能低下.
结论:
- 在怀孕期间接受LT4治疗的患者中,大约三分之一的患者经历了长期的甲状腺功能低下症.
- 治疗开始时的甲状腺刺激激素 (TSH) 水平和怀孕期间的LT4剂量是决定继续产后LT4治疗的关键因素.
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