Brent G A
Department of Medicine, West Los Angeles VA Medical Center 90073, USA.
Clin Obstet Gynecol. 1997 Mar;40(1):3-15. doi: 10.1097/00003081-199703000-00004.
Thyroid status is frequently assessed during pregnancy, both to evaluate suspected thyroid abnormalities, and to monitor the status, of pre-existing thyroid disease. However, the production, circulation, and disposal of thyroid hormone are all altered in pregnancy. Interpretation of thyroid function studies in the pregnant patient must be performed based on an understanding of the normal physiologic changes at each stage of pregnancy. Examples of pregnancy-associated changes include, estrogen-stimulated increase in serum thyroxine binding globulin, chorionic gonadotropin stimulated T4 and T3 production from the thyroid gland, and accelerated degradation of thyroid hormone by the placenta. The serum-TSH alone is usually not adequate to assess thyroid status in pregnancy, and the various conditions that can effect this measurement are described. The pattern of thyroid studies in pregnancy is important in diagnosing thyroid disease, and it may indicate physiologic adaptations to optimize maternal thyroid status for fetal development.
孕期经常会评估甲状腺状态，这既是为了评估疑似甲状腺异常情况，也是为了监测已存在的甲状腺疾病的状况。然而，孕期甲状腺激素的产生、循环及代谢均会发生改变。对孕妇甲状腺功能检查结果的解读必须基于对孕期各阶段正常生理变化的了解。与妊娠相关的变化包括：雌激素刺激血清甲状腺素结合球蛋白增加、绒毛膜促性腺激素刺激甲状腺产生T4和T3，以及胎盘加速甲状腺激素的降解。仅血清促甲状腺激素通常不足以评估孕期甲状腺状态，本文还描述了可能影响该测量结果的各种情况。孕期甲状腺检查结果模式对诊断甲状腺疾病很重要，它可能表明为优化母体甲状腺状态以促进胎儿发育而出现的生理适应性变化。
