妊娠合并甲状旁腺功能减退症的诊治

Diagnosis and treatment of hypoparathyroidism in pregnancy

甲状旁腺功能减退症是妊娠期罕见的合并症,是由于甲状旁腺素产生过少或作用缺陷而导致的一组以低钙、高磷血症和神经肌肉兴奋性增加为临床特点的疾病,临床表现多样,实验室检查为低钙血症、高磷血症、血甲状旁腺素降低或反常的正常。妊娠合并甲状旁腺功能减退症的治疗目标是维持血钙在正常值的低限,治疗药物选择活性维生素D和钙剂。重视患者教育、妊娠期和哺乳期精细化监测和管理、以及及时调整用药方案,是改善母儿预后的保证。

Hypoparathyroidism is a rare complication of pregnancy, which is a group of diseases characterized by hypocalcemia, hyperphosphatemia, and increased neuromuscular excitability due to insufficient production or defective action of parathyroid hormone (PTH). In some aspects, it is similar to the physiological response of pregnancy and is difficult to distinguish. The clinical manifestations are diverse, and the laboratory examination shows hypocalcemia, hyperphosphatemia, decreased blood PTH, or abnormal normal. The therapeutic target for pregnancy complicated with hypothyroidism is to maintain blood calcium at a normal low limit, and active vitamin D and calcium supplements are suggested. Valuing patient education, fine monitoring and management during pregnancy and lactation, and timely adjusting medication plans are the guarantees for improving the prognosis of mothers and infants.