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中华产科急救电子杂志 ›› 2024, Vol. 13 ›› Issue (01) : 18 -23. doi: 10.3877/cma.j.issn.2095-3259.2024.01.004

妊娠合并内分泌疾病

妊娠合并甲状腺功能亢进的诊治进展
徐真1, 白桂芹1,()   
  1. 1. 710061 西安交通大学第一附属医院妇产科 基因联合实验室
  • 收稿日期:2023-10-30 出版日期:2024-02-18
  • 通信作者: 白桂芹

Current status of the diagnosis and treatment on hyperthyroidism in pregnancy

Zhen Xu, Guiqin Bai()   

  • Received:2023-10-30 Published:2024-02-18
  • Corresponding author: Guiqin Bai
引用本文:

徐真, 白桂芹. 妊娠合并甲状腺功能亢进的诊治进展[J]. 中华产科急救电子杂志, 2024, 13(01): 18-23.

Zhen Xu, Guiqin Bai. Current status of the diagnosis and treatment on hyperthyroidism in pregnancy[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2024, 13(01): 18-23.

妊娠合并甲状腺功能亢进是指在妊娠期间甲状腺分泌过多的甲状腺激素,导致机体代谢率加快,并出现一系列症状,对母婴健康产生一定影响。妊娠期甲状腺功能亢进诊断的主要指标是促甲状腺激素抑制、高水平游离甲状腺素和(或)高水平游离三碘甲腺原氨酸。主要治疗方式是抗甲状腺药物,目标是用最小有效剂量的抗甲状腺药物使血清游离甲状腺素/总甲状腺素接近或轻度高于参考范围上限。定期监测,正确诊断与评估,以及合理管理是确保母儿良好结局的关键。

Pregnancy complicated by hyperthyroidism refers to the condition where the thyroid gland produces an excessive amount of thyroid hormone during pregnancy. This leads to an increased metabolic rate in the body and the occurrence of various symptoms, which can have an impact on the health of both the mother and the baby. The main diagnostic indicators of hyperthyroidism in pregnancy are thyroid stimulating hormone (TSH) suppression and high levels of free tetraiodothyronine (FT4) and free triiodothyronine (FT3). The primary treatment for hyperthyroidism during pregnancy involves the use of antithyroid drugs. The aim is to administer the lowest effective dose of these drugs to achieve FT4/TT4 levels that are close to or slightly above the upper limit of the reference range. Regular monitoring, accurate assessment, and appropriate management are essential to ensure favorable outcomes for both the mother and the fetus.

表1 妊娠期甲状腺功能亢进的原因[1]
表2 Graves病与GTT的鉴别诊断[11]
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