妊娠期甲状腺疾病规培讲课.pptxVIP

妊娠期甲状腺疾病规培讲课第1页/共22页 妊娠期甲状腺功能减退症第2页/共22页 甲状腺激素的生理作用对于全身器官有广泛的影响The ThyroidIncreased LDL cholesterol2Elevatedtriglycerides2The LiverThe IntestinesConstipation4Decreased GI motility4Decreased fertility6Menstrual abnormalities6The Reproductive SystemDepression1Decreased concentration1General lack of interest1Impaired fetal intellectual development7The BrainDecreased function5Fluid retention and edema5The KidneysDecreased heart rate3Increased blood pressure3Decreased cardiac output3Diastolic dysfunction3The Heart1. Nemeroff CB. Clinical significance of psychoneuroendocrinology in psychiatry: focus on the thyroid and adrenal. J Clin Psychiatry. 1989;50(suppl):13-20.2. Klausen IC, Nielsen FE, Hegedüs L, Gerdes LU, Charles P, Faergeman O.Treatment of hypothyroidism reduces low-density lipoproteins but not lipoprotein (a) Metabolism. 1992;41:911-914.3. Polikar R, Burger AG, Scherrer U, Nicod P. The thyroid and the heart. Circulation. 1993;87:1435-1441.4. Vassilopoulou-Sellin R, Sellin JH. The gastrointestinal tract and liver in hypothyroidism. In:Braverman LE, Utiger RD, eds. Werner and Ingbar’s The Thyroid. 7th ed. Philadelphia, Pa: Lippincott-Raven Publishers; 1996:816-820.5. Moses AM, Scheinman SJ. The kidneys and electrolyte metabolism. In:Braverman LE, Utiger RD, eds. Werner and Ingbar’s The Thyroid. 7th ed. Philadelphia, Pa: Lippincott-Raven Publishers; 1996:812-815. 6. Emerson CH.Thyroid function and disease in the female. In: Gold JJ, Josimovich JB, eds. Gynecologic Endocrinology. 4th ed. New York, NY:Plenum Publishing Corp; 1987:109-133.7. Haddow JE, Palomaki GE, Allan WC, et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med. 1999;341:549-555. 第3页/共22页 甲状腺激素的生物学作用一、对代谢的影响 1.产热效应：使组织耗氧量和产热量增加； 2.对蛋白质、糖、脂肪代谢影响：加速蛋白质和各种酶的生成、促进糖的吸收，增强糖原分解；促进脂肪氧化；二、对生长与发育的影响：促进组织分化、生长与发育成熟三、对神经系统的影响：影响神经系统的发育，兴奋交感神经系统；四、其他:心血管系统、水和电解质第4页/共22页 甲状腺功能的调节肝脏下丘脑垂体甲状腺TRHT4 /T3TBG雌激素卵巢TSH碘化物结合FT4负反馈FT4 /FT30.04%0.5%