甲状腺疾病与妊娠_单忠艳.pdfVIP

2006 9 26 5　Intern J Endocrinol Metab, Sep 2006, Vol 26,No.5 ·295 · ·· 单忠艳　滕卫平 　　【】　、、、 。:(1)。 (2) (TSH)。 (3) 。, , TSH、T T 。, 。 4 4 ,TSH ,TSH , 0.2～0.4 mIU/L , 2.5 mIU/L TSH 。TT 4 , 1.5 。 T (L-T ), TSH 2.5 mIU/L, L-T 4 4 4 30%～50%。, 。 、 , 。 【】　; Thyroid diseases and pregnancy　SHAN Zhong-yan, TENG Wei-ping.Department of Endocrinology, TheFirst Aff iliated Hospital of China Medical Uni ersity, Shenyang 110001, China 【Abstract】　The production, circulation, metabolism, regulation of thyroid hormone as ell as thyroid immu- nity in pregnancy change ithgestational age.The changesinthyroidfunction during pregnancy are related to:(1)es- trogen-mediated increase in circulating levels of thyroid-binding globulin, (2)thyroid stimulation by human chorionic gonadotropin resulting from structural homology ith thyroid stimulating hormone (TSH), and (3)a relative decline of iodide related to increased renal clearance and overall losses to the fetus and placenta.These changesinmaternal thyroid physiology can lead to confusion in the diagnosis or evaluation of thyroid abnormalities.Therefore, establish- ment of trimester-specific reference ranges for TSH, TT and FT is urgently needed.Unfortunately, currently there 4 4 are no reliable trimester-specific reference ranges for these parameters.TSH can be used as first-selected marker for diagnosis of thyroid disease in pregnancy like nonpregnant status.The lo er limits of TSH are fairly comparable be- t een TSH assays ranging bet een0.2 and 0.4 mIU/L.TSH of 2.5 mIU/L is recommended as an appropriate con- servative upper limit for first trimester pregnancy.The TT reference range