Department of Endocrinology and Metabolism, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen, Guangdong, China.
Department of Endocrinology and Metabolism, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China.
Arch Gynecol Obstet. 2023 Aug;308(2):403-411. doi: 10.1007/s00404-022-06774-z. Epub 2022 Sep 16.
The occurrence of thyrotoxicosis during pregnancy is mainly attributed to gestational transient thyrotoxicosis (GTT) and Graves' disease (GD). It is important to distinguish between GTT and Graves' disease because the two diseases are treated very differently. However, a gold standard for the differential diagnosis of the two diseases is currently lacking, and the most common method of differentiation is based on past medical history and clinical presentation combined with thyroid-related antibodies.
A literature search of the electronic databases PubMed, Embase, Medline, Google Scholar, Cochrane Library, China Knowledge Infrastructure, Wanfang Database, Chinese Scientific Journals Full Text Database and China Biomedical CD-ROM was performed. The search period ranged from journal inception until 2022. We used the following search terms in "All fields": {["thyroid" (common field) OR "thyroid" (subject line)] OR "hyperthyroidism" (common field)} AND {["pregnancy" (title) OR "pregnancy" (title)] AND "one over" (common field)} OR {["pregnancy" (common field) OR "pregnancy" (common field) OR "pregnancy" (subject line)] AND "Graves'" (common field)}.
In recent years, some clinical studies at home and abroad have proposed other meaningful differential indicators, such as thyroid stimulating hormone, chorionic gonadotropin, thyroid hormone levels and thyroid ultrasound.
The differential diagnostic significance of each of these indicators is summarised here with the goal of providing a better reference for the differential diagnosis of hyperthyroidism during pregnancy in clinical practice.
怀孕期间发生的甲状腺毒症主要归因于妊娠一过性甲状腺毒症（GTT）和 Graves 病（GD）。区分 GTT 和 Graves 病很重要，因为这两种疾病的治疗方法非常不同。然而，目前缺乏区分这两种疾病的金标准，最常见的鉴别方法是基于既往病史和临床表现，并结合甲状腺相关抗体。
对电子数据库 PubMed、Embase、Medline、Google Scholar、Cochrane Library、中国知识基础设施、万方数据库、中国科技期刊全文数据库和中国生物医学光盘数据库进行了文献检索。检索时间范围从期刊创刊到 2022 年。我们在“所有字段”中使用了以下搜索词：{["thyroid"（通用字段）或"thyroid"（标题行）]或"hyperthyroidism"（通用字段）}和{["pregnancy"（标题）或"pregnancy"（标题）]和"one over"（通用字段）}或{["pregnancy"（通用字段）或"pregnancy"（通用字段）或"pregnancy"（标题行）]和"Graves'"（通用字段）}。
近年来，国内外一些临床研究提出了其他有意义的鉴别指标，如促甲状腺激素、绒毛膜促性腺激素、甲状腺激素水平和甲状腺超声。
总结了这些指标的鉴别诊断意义，以期为临床实践中妊娠期间甲状腺毒症的鉴别诊断提供更好的参考。
