切换至 "中华医学电子期刊资源库"

中华产科急救电子杂志 ›› 2024, Vol. 13 ›› Issue (01) : 13 -17. doi: 10.3877/cma.j.issn.2095-3259.2024.01.003

妊娠合并内分泌疾病

妊娠合并甲状旁腺功能减退症的诊治
胡惠英1, 高劲松1,()   
  1. 1. 100730 中国医学科学院 北京协和医学院 北京协和医院妇产科 国家妇产疾病临床医学研究中心
  • 收稿日期:2023-12-08 出版日期:2024-02-18
  • 通信作者: 高劲松
  • 基金资助:
    中央高水平医院临床科研业务费资助(2022-PUMCH-B-075)

Diagnosis and treatment of hypoparathyroidism in pregnancy

Huiying Hu, Jinsong Gao()   

  • Received:2023-12-08 Published:2024-02-18
  • Corresponding author: Jinsong Gao
引用本文:

胡惠英, 高劲松. 妊娠合并甲状旁腺功能减退症的诊治[J/OL]. 中华产科急救电子杂志, 2024, 13(01): 13-17.

Huiying Hu, Jinsong Gao. Diagnosis and treatment of hypoparathyroidism in pregnancy[J/OL]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2024, 13(01): 13-17.

甲状旁腺功能减退症是妊娠期罕见的合并症,是由于甲状旁腺素产生过少或作用缺陷而导致的一组以低钙、高磷血症和神经肌肉兴奋性增加为临床特点的疾病,临床表现多样,实验室检查为低钙血症、高磷血症、血甲状旁腺素降低或反常的正常。妊娠合并甲状旁腺功能减退症的治疗目标是维持血钙在正常值的低限,治疗药物选择活性维生素D和钙剂。重视患者教育、妊娠期和哺乳期精细化监测和管理、以及及时调整用药方案,是改善母儿预后的保证。

Hypoparathyroidism is a rare complication of pregnancy, which is a group of diseases characterized by hypocalcemia, hyperphosphatemia, and increased neuromuscular excitability due to insufficient production or defective action of parathyroid hormone (PTH). In some aspects, it is similar to the physiological response of pregnancy and is difficult to distinguish. The clinical manifestations are diverse, and the laboratory examination shows hypocalcemia, hyperphosphatemia, decreased blood PTH, or abnormal normal. The therapeutic target for pregnancy complicated with hypothyroidism is to maintain blood calcium at a normal low limit, and active vitamin D and calcium supplements are suggested. Valuing patient education, fine monitoring and management during pregnancy and lactation, and timely adjusting medication plans are the guarantees for improving the prognosis of mothers and infants.

[1]
Shoback D. Hypoparathyroidism[J]. Ne Engl J Med2008359(4):391-403.
[2]
Lopes MP, Kliemann BS, Bini IB, et al. Hypoparathyroidism and pseudohypoparathyroidism: etiology, laboratory features and complications[J]. Arch Endocrinol Metab201660(6):532-536.
[3]
赵江红,严东琴,黄美婷,等. 早期妊娠合并甲状旁腺功能亢进一例并文献复习[J/OL]. 中华产科急救电子杂志202110(4):230-235.
[4]
杨洁,杨剑秋,边旭明,等. 妊娠合并甲状旁腺功能减退症四例临床分析[J]. 中华妇产科杂志201449(3):218-219.
[5]
Kovacs CS. Vitamin D in pregnancy and lactation: maternal, fetal, and neonatal outcomes from human and animal studies[J]. Am J Clin Nutr200888(2):520S-528S.
[6]
Tambyah PA, Ong BKC, Lee KO. Reversible parkinsonism and asymptomatic hypocalcemia with basal ganglia calcification from hypoparathyroidism 26 years after thyroid surgery[J]. Am J Med199394(4):444-445.
[7]
Rajendram R, Deane JA, Barnes M, et al. Rapid onset childhood cataracts leading to the diagnosis of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy[J]. Am J Ophthalmol2003136(5):951-952.
[8]
童南伟,邢小平. 内科学:内分泌科分册[M]. 北京:人民卫生出版社,2015: 99-100.
[9]
Betterle C, Garelli S, Presotto F. Diagnosis and classification of autoimmune parathyroid disease[J]. Autoimmun Rev201413(4-5):417-422.
[10]
Kohlmeier L, Marcus R. Calcium disorder of pregnancy[J]. Endocrinol Metab Clin North Am199524(1):15-39.
[11]
Kovacs CS. Maternal mineral and bone metabolism during pregnancy, lactation, and post-weaning recovery[J]. Physiol Rev201696(2):449-547.
[12]
Kovacs CS. Calcium and bone metabolism disorders during pregnancy and lactation[J]. Endocrinol Metab Clin North Am201140(4):795-826.
[13]
Almaghamsi A, Almalki MH, Buhary BM. Hypocalcemia in pregnancy: a clinical review update[J]. Oman Med J201833(6):453-462.
[14]
Hofmeyr GJ, Duley L, Atallah A. Dietary calcium supplementation for prevention of pre-eclampsia and related problems: a systematic review and commentary[J]. BJOG2007114(8):933-943.
[15]
Mitchell DM, Jüppner H. Regulation of calcium homeostasis and bone metabolism in the fetus and neonate[J]. Curr Opin Endocrinol Diabetes Obes201017(1):25-30.
[16]
陈艳红,陈敦金. 早产的治疗[J/CD]. 中华产科急救电子杂志20187(4):221-224.
[17]
Krysiak R, Kobielusz-Gembala I, Okopien B. Hypoparathyroidism in pregnancy[J]. Gynecol Endocrinol201127(8):529-532.
[18]
Landing BH, Kamoshita S. Congenital hyperparathyroidism secondary to maternal hypoparathyroidism[J]. J Pediatr197077(5):842-847.
[19]
Sigridur B, Bart C, Outi M, et al. Women with chronic hypoparathyroidism have low risk of adverse pregnancy outcomes[J]. J Clin Endocrinol Metab2021106(11):3312-3319.
[20]
蔡宜彤,关海霞. 甲状旁腺功能减退症合并妊娠的临诊应对[J]. 中华内分泌代谢杂志201935(2):153-156.
[21]
Cundy T, Haining SA, Guilland-Cumming DF, et al. Remission of hypoparathyroidism during lactation: evidence for a physiological role for prolactin in the regulation of vitamin D metabolism[J]. Clin Endocrinol201026(6):667-674.
[22]
Kovacs CS, Kronenberg HM. Maternal-fetal calcium and bone metabolism during pregnancy, puerperium, and lactation[J]. Endocr Rev199818(6):832-872.
[23]
Fran SM. Elevated parathyroid hormone-related peptide associated with lactation and bone density loss[J]. JAMA1996276(7):549-554.
[24]
Shah KH, Bhat S, Shetty S, et al. Hypoparathyroidism in pregnancy[J]. BMJ Case Rep20152015:1-4.
[25]
Winer KK, Wen KC, Reynolds JC, et al. Long-term treatment of hypoparathyroidism: a randomized controlled study comparing parathyroid hormone-(1-34) versus calcitriol and calcium[J]. J Clin Endocrinol Metab200388(9):4214-4220.
[26]
Hatswell BL, Allan CA, Teng J, et al. Management of hypoparathyroidism in pregnancy and lactation—a report of 10 cases[J]. Bone Rep20153:15-19.
[27]
Hartogsohn EAR, Khan AA, Kjaersulf LU, et al. Changes in treatment needs of hypoparathyroidism during pregnancy and lactation: a case series[J]. Clin Endocrinol202093(3):261-268.
[28]
Khan AA, Clarke B, Rejnmark L, et al. Hypoparathyroidism in pregnancy management of endocrine disease hypoparathyroidism in pregnancy: review and evidence-based recommendations for management[J]. Eur J Endocrinol2019180(2):R37-44.
[29]
Khan AA, Koch CA, Van Uum S, et al. Standards of care for hypoparathyroidism in adults: a Canadian and International Consensus[J]. Eur J Endocrinol2019180(3):P1-22.
[30]
Blickstein I, Kessler I, Lancet M. Idiopathic hypoparathyroidism with gestational diabetes[J]. Am J Obstet Gynecol1985153(6):649-650.
[31]
Sweeney L, Malabanan A, Rosen H. Decreased calcitriol requirement during pregnancy and lactation with a window of increased requirement immediately post partum[J]. Endocr Pract201016(3):459-462.
[1] 王亚红, 蔡胜, 葛志通, 杨筱, 李建初. 颅骨骨膜窦的超声表现一例[J/OL]. 中华医学超声杂志(电子版), 2024, 21(11): 1089-1091.
[2] 李钱梅, 何冠南, 赵婧, 陈曦, 唐玉英, 马丽琼, 梁蓉, 袁桃, 李明星. 早孕期低危妊娠和高危妊娠胎盘微血流成像特征及预后分析[J/OL]. 中华医学超声杂志(电子版), 2024, 21(07): 726-732.
[3] 唐金侨, 叶宇佳, 王港, 赵彬, 马艳宁. 医学影像学检查方法在颞下颌关节紊乱病中临床应用研究进展[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(06): 406-411.
[4] 屈翔宇, 张懿刚, 李浩令, 邱天, 谈燚. USP24及其共表达肿瘤代谢基因在肝细胞癌中的诊断和预后预测作用[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 659-662.
[5] 赵林娟, 吕婕, 王文胜, 马德茂, 侯涛. 超声引导下染色剂标记切缘的梭柱型和圆柱型保乳区段切除术的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 634-637.
[6] 熊鹰, 林敬莱, 白奇, 郭剑明, 王烁. 肾癌自动化病理诊断:AI离临床还有多远?[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 535-540.
[7] 袁雨涵, 杨盛力. 体液和组织蛋白质组学分析在肝癌早期分子诊断中的研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 883-888.
[8] 中华医学会器官移植学分会. 肝移植术后缺血性胆道病变诊断与治疗中国实践指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 739-748.
[9] 郑大雯, 王健东. 胆囊癌辅助诊断研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 769-773.
[10] 王秋生. 胆道良性疾病诊疗策略[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 779-782.
[11] 李浩, 陈棋帅, 费发珠, 张宁伟, 李元东, 王硕晨, 任宾. 慢性肝病肝纤维化无创诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 863-867.
[12] 谭瑞义. 小细胞骨肉瘤诊断及治疗研究现状与进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 781-784.
[13] 王子阳, 王宏宾, 刘晓旌. 血清标志物对甲胎蛋白阴性肝细胞癌诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 677-681.
[14] 陈慧, 邹祖鹏, 周田田, 张艺丹, 张海萍. 皮肤镜对头皮红斑性皮肤病辅助鉴别诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 692-698.
[15] 胡云鹤, 周玉焯, 付瑞瑛, 于凡, 李爱东. CHS-DRG付费制度下GB1分组住院费用影响因素分析与管理策略探讨[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 568-574.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?