母体甲状腺疾病所致复发性流产的研究进展

Recurrent spontaneous abortion caused by maternal thyroid disease:research progress

甲状腺疾病是复发性流产(RSA)的常见病因之一,主要从内分泌及免疫层面参与RSA的发生。甲状腺激素的异常、甲状腺自身抗体(ATA)的存在均可影响妊娠期间母体的正常生理变化及胚胎发育,导致流产的发生。对于甲状腺功能异常的RSA患者,再次妊娠前应接受诊治,在甲状腺功能正常后方可考虑妊娠;对于甲状腺功能正常但ATA阳性的RSA患者,再次妊娠前是否使用左甲状腺素治疗仍存在争议。

Thyroid disease is one of the common causes of recurrent spontaneous abortion(RSA),and it is involved in the occurrence of RSA mainly from the endocrine and immune levels.Abnormal thyroid hormone levels and the presence of anti-thyroid autoantibody(ATA)can affect the normal physiological changes of the mother and embryonic development during pregnancy,leading to abortion.For RSA patients with abnormal thyroid dysfunction,diagnosis and treatment should be given before pregnancy,and pregnancy should be considered when thyroid function is normal.For RSA patients with normal thyroid function but with positive ATA,the use of levothyroxine before pregnancy remains controversial.