摘要
妊娠期亚临床甲状腺功能减退(SCH)是指妊娠期间血清促甲状腺激素(TSH)高于妊娠特异性参考值上限,而血清游离甲状腺素(FT4)在妊娠特异性参考值范围内。妊娠SCH特别是合并甲状腺自身抗体阳性者可以增加妊娠不良结局和围产期并发症的风险,并可能影响后代的智力和运动发育。建议对妊娠早期妇女开展SCH的筛查,筛查最佳时间是妊娠8周之内,筛查内容包括FT4、TSH和甲状腺过氧化物酶抗体(TPOAb)。建议孕前或妊娠期出现的SCH患者使用左旋甲状腺素(L-T4)治疗,治疗目标是将TSH恢复到妊娠特异参考值范围内。妊娠期间需碘量增加约50%,需适量补碘,建议每天额外补碘150μg,以碘化钾最佳。
Subclinical hypothyroidism（SCH）is defined as elevated serum thyrotropin（TSH）level with a normal serum-free thyroxine（FT4）level.Gestational age-specific criteria should be used for the diagnosis of SCH.Pregnant women with SCH,especialy those with higher thyroid autoantibody levels,have increased risks of adverse maternal outcomes,perinatal complications and their offsprings have increased risks of mental and physical disorders.Routine maternal thyroid function tests including FT4,TSH and TPOAb are necessary to improve maternal and perinatal outcomes.The best time for the screening is within eight weeks of pregnancy.Women with SCH whether before or during pregnancy should be treated with oral levothyroxine.TSH levels should be maintained within pregnancy specific reference range.Adequate iodine supplementation during pregnancy is critical and if feasible it should be initiated before the woman attempts to conceive.The extra 150μg daily supplement is recommended and potassium iodide is the best choice.
出处
《临床荟萃》
CAS
2016年第3期268-271,共4页
Clinical Focus
关键词
甲状腺功能减退
妊娠
筛查
治疗
hypothyroidism
pregnancy
screening
treatment
