妊娠期甲状腺功能减退症诊治进展.pdfVIP

332 Chinese Journal of Practical Internal Medicine Apr． 2014 Vol． 34 No． 4 专 · 题笔谈 甲状腺功能减退症 妊娠期甲状腺功能减退症诊治进展 李 静 文章编号:1005 － 2194 (2014)04 － 0332 － 04 中图分类号:Ｒ581． 2 文献标志码:A : ( ) ， 摘要 研究表 明妊娠期临床 甲状腺功能减退症 简称甲减 会增加妊娠 不 良结局 的风 险 亚临床 甲减也 可能有类似 影响 。其诊断应采用 TSH 和 FT4 的妊娠三期及方法特异性参考范围进行 。最新研究提 示评价妊娠 4 ～ 6 周 TSH 可 采用与非妊娠妇女相 同参考范围。妊娠期临床 甲减必须治疗。妊娠期亚临床 甲减伴 TPOAb 阳性者应接 受 L-T4 治 ， 。 疗 但 不必考虑终止妊娠 : ; ; 关键词 甲状腺功能减退症 妊娠 甲状腺素 Update of the diagnosis and treatment of hypothyroidism in pregnancy． LI Jing． Department of Endocrinology and Metabolism ，Institute of Endocrinology ，the First Affiliated Hospital of China Medical University ，Liaoning Provincial Key La- boratory of Endocrine Diseases ，Shenyang 110001 ，China Corresponding author :LI Jing ，E-mail :lijingendocrine@ 126. com Abstract :It has been found that overt hypothyroidism can increase the risk for adverse outcomes in pregnancy and subclini- cal hypothyroidism may also have similar effects． The diagnosis of hypothyroidism should be performed based on both trimes- ter- and method-specific reference ranges for serum TSH and FT4 ． A study has recently reported that the normal reference range of serum TSH in women during 4 － 6 weeks of pregnancy should be same as that of non-pregnant females． The preg- nant women with overt hypothyroidism must be given with L-thyroxine． Those with both subclinical hypothyroidism and posi- tive TPOAb in the sera should also be treated although termination of pregnancy is not necessary． Keywords :hypothyroidism ;pregnancy ;thyroxine ［