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妊娠期亚临床甲状腺功能减退症与甲状腺自身免疫:治疗还是不治疗。

Subclinical Hypothyroidism and Thyroid Autoimmunity in Pregnancy: To Treat or Not to Treat.

机构信息

Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, University of Askansas for Medical Sciences, 4301 West Markham Street, Slot 587, Little Rock, AR 72205, USA; Section of Endocrinology, Medicine Service, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA.

Division of Endocrinology, Department of Internal Medicine, Stanford University School of Medicine, Stanford, CA, USA.

出版信息

Endocrinol Metab Clin North Am. 2024 Sep;53(3):363-376. doi: 10.1016/j.ecl.2024.05.010. Epub 2024 Jun 15.

Abstract

Subclinical hypothyroidism and thyroid autoimmunity in pregnancy are common conditions. They are both associated with adverse maternal and offspring outcomes. Women with thyroid autoimmunity should be monitored with regular thyroid function tests preconception and during gestation to identify women who develop hypothyroidism. The effectiveness of thyroid hormone treatment in reducing adverse outcomes in pregnancy has been studied in a number of randomized controlled trials. Current evidence shows obstetrical benefits of levothyroxine treatment in pregnant women with a thyroid-stimulating hormone level greater than 4 mU/L.

摘要

亚临床甲状腺功能减退症和甲状腺自身免疫在妊娠中很常见。它们都与不良的母婴结局有关。甲状腺自身免疫的妇女应在受孕前和妊娠期间定期进行甲状腺功能检查,以发现发生甲状腺功能减退症的妇女。一些随机对照试验已经研究了甲状腺激素治疗在降低妊娠不良结局方面的效果。目前的证据表明,对于促甲状腺激素水平大于 4 mU/L 的孕妇,左甲状腺素治疗具有产科益处。

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