妊娠期亚临床甲状腺功能减退症与妊娠期高血压疾病关系的研究进展

Research Progress on the Relationship between Subclinical Hypothyroidism in Pregnancy and Hypertensive Disorders of Pregnancy

亚临床甲状腺功能减退症(subclinical hypothyroidism,SCH)是妊娠期最常见的甲状腺疾病,SCH患者存在血管内皮功能损伤和自主神经功能障碍,可能会增加心血管疾病的发病风险。妊娠期高血压疾病(hypertensive disorders of pregnancy,HDP)使妊娠复杂化,并导致孕产妇和胎儿不良妊娠结局发生率和死亡率升高。已有研究发现SCH与HDP发病率增加有关,但目前没有统一结论,且SCH孕妇应用左旋甲状腺素(levothyroxine,L-T4)治疗对HDP是否有益也尚存争议。综述妊娠期SCH对HDP的影响及L-T4的治疗效果,以规范临床妊娠管理方案,减少孕妇和胎儿围产期不良妊娠结局的发生。

Subclinical hypothyroidism(SCH)is the most common thyroid diseases during pregnancy.The vascular endothelial function injury and autonomic nervous dysfunction in SCH patients may increase the risk of cardiovascular diseases.Hypertensive disorders of pregnancy(HDP)complicate pregnancy and lead to increased rates of adverse pregnancy outcomes and mortality for both mothers and fetuses.Studies have found that SCH is associated with the increased incidence of HDP,but there is no uniform conclusion at present,and the potential benefits of levothyroxine(L-T4)treatment for HDP in SCH pregnant women are still controversial.This article reviews the impact of SCH on HDP during pregnancy and the effectiveness of L-T4 treatment,so as to standardize the clinical pregnancy management program and reduce the occurrence of perinatal adverse pregnancy outcomes in pregnant women and fetus.