甲巯咪唑对甲亢孕妇控制程度及主要并发症的影响

Díaz Arizmendi Diana Elizabeth, Mendieta Zerón Hugo
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摘要

甲状腺功能亢进是妊娠期主要的内分泌疾病之一。该项目的目的是根据美国甲状腺协会(ATA)的建议,在没有丙硫脲嘧啶可用的实际情况下确定甲状腺功能亢进孕妇的控制程度。这是一项描述性、回顾性和纵向研究,包括18至35岁甲状腺功能亢进孕妇的医疗档案。如果他们的甲状腺特征在ATA的建议范围内并且没有肾上腺素能症状,他们被归类为“充分”控制;如果单药治疗不能稳定,或者需要大剂量的抗甲状腺药物或受体阻滞剂,或者出现严重的并发症,包括需要母亲或新生儿的重症监护病房(ICU),则被归类为“控制不足”。在妊娠晚期治疗组与孕妇或新生儿并发症之间进行卡方检验。173例甲状腺功能亢进孕妇,平均年龄21±4.7岁。33例甲亢患者在妊娠结束前接受甲巯咪唑单药治疗,其中23例(69.69%)被归为“充分”控制。在现实生活中,妊娠期间甲状腺功能亢进症的诊断有延迟,但即使没有丙基硫脲嘧啶,在甲巯咪唑单药治疗的病例中,也可以达到20.53%的“充分”控制。
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Degree of Control and Main Complications of Hyperthyroid Pregnant Women in a Real Life Experience with Methimazol
Hyperthyroidism is one of the main endocrinopathies during pregnancy. The aim of this project was to identify the degree of control of hyperthyroid pregnant women based on the recommendations of the American Thyroid Association (ATA) in a real situation without the availability of propylthiouracil. This was a descriptive, retrospective and longitudinal study, including medical files of pregnant women with hyperthyroidism between 18 and 35 years. They were classified as having "Adequate" control if their thyroid profiles were within the recommendations of the ATA and had no adrenergic symptoms; and were categorized as having "Inadequate" control if they were not stabilized with monotherapy, or if they required high doses of antithyroid drugs or beta-blockers or showed serious complications including the need of an Intensive Care Unit (ICU) for mothers or neonates. The Chi square test was performed between treatment groups during the third trimester and the complications of pregnant women or neonates. A total of 173 hyperthyroid pregnant women were studied with an average age of 21 ± 4.7 years. Of the 33 patients with hyperthyroidism who received monotherapy with methimazole until the end of pregnancy, 23 (69.69%) were classified as having "Adequate" control. In a real life situation there is delay in the diagnosis of hyperthyroidism during pregnancy but even without propylthiuracil, an “Adequate” control can be reached in up to 20.53% of cases based on a methimazole monotherapy.
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