摘要
妊娠期间由于血清甲状腺素结合球蛋白、人绒毛膜促性腺激素水平增加以及肾脏对碘的清除率增加等，致使妊娠期甲状腺激素的产生、循环、代谢和调节会随妊娠的不同阶段而改变。这为妊娠期间甲状腺疾病的诊断和治疗带来困难。因此，建立妊娠特异性血清甲状腺激素的正常参考范围非常必要，这将降低妊娠期甲状腺疾病的漏诊率和误诊率。妊娠期母体甲状腺功能不足包括临床甲状腺功能减退症（甲减）、亚临床甲减和低甲状腺素血症，可以对后代的神经智力发育造成损伤。妊娠期甲减妇女应该接受左甲状腺素（L—T4）替代治疗，治疗目标为血清促甲状腺激素（TSH）水平在妊娠早期不超过2．5mIU／L；妊娠中期和妊娠晚期不超过3．0mIU／L或者不超过妊娠期特异性血清TSH的正常参考范嗣。
Because of an increase in thyroxine-binding globulin, human chorionic gonadotropin and increased maternal renal clearance of iodide during pregnancy, the production, circulation, metabolism and regulation of thyroid hormones change with gestational age. These lead to the difficuhy in the diagnosis and management of thyroid disorders during pregnancy. It is important to establish pregnancy specific reference intervals for thyrotropin and thyroid hormones, which will reduce the rate of misdiagnosis and missed diagnosis of thyroid disorders during pregnancy. Thyroid insufficiency during pregnancy including overt hypothyroidism, subclinical hypothyroidism and hypothyroxinemia will damage fetal brain development. Pregnant women with hypothyroidism should accept levotbyroxinc therapy. The aim of lcvothyroxine treatment is to keep the serum thyrotropin levels of pregnant women under control 0.3 to 2.5 mIU/L for the first trimester,0.3 to 3.0 mIU/L or trimester-specific reference intervals for the second and the third trimester.
出处
《国际内分泌代谢杂志》
2008年第5期289-293,共5页
International Journal of Endocrinology and Metabolism
