妊娠合并亚临床甲状腺功能减退症的研究进展

Research Progress in Pregnancy Complicated with Subclinical Hypothyroidism

妊娠期亚临床甲状腺功能减退症(SCH)会增加不良妊娠结局的风险,同时也增加胎儿神经认知障碍的风险。近年来在妊娠合并SCH的研究成果颇多,大量的临床及实验成果陆续发表,有学者提出甲状腺素(TH)缺乏影响神经元烟碱受体α4亚单位表达可能是SCH影响胎儿智力的机制之一,妊娠期口服固定剂量的TH素能更好地控制血清促甲状腺激素(TSH)水平,以及妊娠期碘摄入和SCH的发生有一定关系等观点。从近年来国内外在妊娠合并SCH的诊断标准、对胎儿智力影响机制、治疗方案以及妊娠期碘摄入等方面取得的最新研究进展进行综述。

Subclinical hypothyroidism （SCH） during pregnancy increases the risk of adverse pregnancy outcomes, and increases fetal neurocognitive disorders. In recent years, a lot of clinical and experimental results in field of gestational SCH were published. Some studys suggested that thyroid hormone （TH） deficiency affected the expression of the neuronal nicotinic acetylcholine receptor alpha 4 subunit. It may be one of SCH mechanisms of fetal intelligence. The fixed dose of oral thyroxine during pregnancy can better regulate the thyroid stimulating hormone （TSH） level and the iodine intake during pregnancy which is related with SCH pathophysiology. This article reviewed the research progress on the diagnostic criteria of gestational SCH,the pathological mechanism of fetal intelligence,the new therapeutic method and the iodine intake standard on pregnancy.