Penin Manuel, Trigo Cristina, López Yolanda, Barragáns María
Servicio de Endocrinología y Nutrición, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
Servicio de Endocrinología y Nutrición, Complexo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
Endocrinol Nutr. 2014 Aug-Sep;61(7):347-50. doi: 10.1016/j.endonu.2014.01.011. Epub 2014 Mar 26.
Treatment of hypothyroid pregnant women is usually calculated based on weight (1 μg/kg/day) and TSH levels. This study assessed the usefulness of treating these women with a fixed dose of 75 μg/day.
All women with pregnancy diagnosed from January to August 2012 in the Vigo Health Area (Spain) without previous diagnosis of thyroid disease or thyroxine treatment and with TSH levels over 4,5 mUI/ml were enrolled by consecutive sampling. All 116 women in the sample were treated with a fixed daily dose of thyroxine 75 μg-thyroxine levels were measured at two, four, and six months, and thyroxine dose was modified if TSH level was lower than 0.3 or higher than 4.5 mUI/ml.
A woman had a TSH level less than 0.3 mUI/ml in a test; reduction of thyroxine dose to 50 μg/day allowed for maintaining TSH level within the desired range until delivery. Six women had TSH levels over 4.5 mUI/ml in one test; in all of them, increase in thyroxine dose to 100 μg/day allowed for maintaining the level within the desired range until delivery.
Fixed daily doses of thyroxine 75 μg allowed for achieving goal TSH levels in most of our pregnant women with subclinical hypothyroidism, irrespective of their weight and baseline TSH level.
甲状腺功能减退孕妇的治疗通常根据体重（1微克/千克/天）和促甲状腺激素（TSH）水平来计算。本研究评估了每日固定剂量75微克治疗这些孕妇的有效性。
通过连续抽样纳入2012年1月至8月在西班牙维戈健康区确诊妊娠、既往无甲状腺疾病诊断或甲状腺素治疗史且TSH水平超过4.5毫国际单位/毫升的所有女性。样本中的116名女性均接受每日固定剂量75微克甲状腺素治疗，在2个月、4个月和6个月时测量甲状腺素水平，若TSH水平低于0.3或高于4.5毫国际单位/毫升，则调整甲状腺素剂量。
一名女性在一次检测中TSH水平低于0.3毫国际单位/毫升；将甲状腺素剂量减至50微克/天可使TSH水平在分娩前维持在理想范围内。6名女性在一次检测中TSH水平超过4.5毫国际单位/毫升；对她们所有人而言，将甲状腺素剂量增至100微克/天可使该水平在分娩前维持在理想范围内。
每日固定剂量75微克甲状腺素可使大多数亚临床甲状腺功能减退孕妇达到目标TSH水平，无论其体重和基线TSH水平如何。
