McDougall I R, Maclin N
Division of Nuclear Medicine, Stanford University Medical Center, California 94305-5281, USA.
J Fam Pract. 1995 Sep;41(3):238-40.
There have been several published reports that hypothyroid women do not need to increase the dose of levothyroxine when they become pregnant.
For this study, 20 pregnant women who were hypothyroid as a result of surgical thyroidectomy, radio-iodine therapy, or combination therapy were followed for the duration of their pregnancies. These patients were seen regularly, and evaluated clinically and by measurement of free thyroxine (FT4) and thyrotropin (thyroid-stimulating hormone [TSH]).
The amount of levothyroxine that was adequate in the nonpregnant state was found to be inadequate during pregnancy. The dosage of levothyroxine given to these patients was increased by an average of 36 micrograms and returned to earlier levels after delivery. There was considerable individual variation in the requirement for additional levothyroxine during pregnancy.
For hypothyroid pregnant patients, thyroid function tests, especially TSH, are recommended during each trimester to determine the need for additional levothyroxine.
已有多篇发表的报告指出，甲状腺功能减退的女性在怀孕时无需增加左甲状腺素的剂量。
在本研究中，对20名因手术甲状腺切除术、放射性碘治疗或联合治疗导致甲状腺功能减退的孕妇进行了孕期全程随访。定期对这些患者进行检查，并通过临床评估以及测量游离甲状腺素（FT4）和促甲状腺素（甲状腺刺激激素[TSH]）进行评估。
发现在非孕期足够的左甲状腺素量在孕期并不足够。给予这些患者的左甲状腺素剂量平均增加了36微克，并在分娩后恢复到先前水平。孕期额外左甲状腺素的需求量存在相当大的个体差异。
对于甲状腺功能减退的孕妇，建议在每个孕期进行甲状腺功能检查，尤其是TSH检查，以确定是否需要额外的左甲状腺素。
