临床进展妊娠甲状腺疾病指南.ppt

* * * * * * * * 妊娠16-20周母亲低T4血症组后代智力评分比对照组后代低9.30分（p=0.004），运动评分低7.57分（p=0.007）。 甲功正常的TPOAb阳性妊娠妇女自然流产和人工受孕失败的危险性提高 发生产后甲状腺炎（PPT）的危险性增加 妊娠早期TPOAb阳性的妇女40～60%发生PPT TPOAb阳性妇女发生PPT的危险性是TPOAb阴性妇女的20倍 TPOAb阳性是甲减的主要原因 妊娠中期55%的亚临床甲减妇女和80%的临床甲减妇女的甲状腺自身抗体阳性 * * * 3 妊娠期TPOAb阳性者的亚临床甲减发病率显著高于TPOAb阴性者。妊娠前半期，亚临床甲减中28.86%为TPOAb阳性 * FIG. 3. Top, TSH values during gestation in group A (TPOAb treated with LT4), group B (TPOAb), and group C (TPOAb). At 10 wk, groups A and B were higher than group C; at 20 and 30 wk and after delivery, groups A and C were lower than group B. Bottom, FT4 values during gestation. At 30 wk and after delivery, groups A and C were higher than group B. , P 0.05. FIG. 2. TSH trends in the three subgroups treated with different dosages of LT4 on the basis of their initial TSH values. * 0.5ug.kg/d TSH 1.0;0.75ug TSH 1.0-2.0;1ug TSH 2.0 6: Hum Reprod. 2005 Jun;20(6):1529-33. Epub 2005 May 5.Related Articles, Links ?Levothyroxine treatment in thyroid peroxidase antibody-positive women undergoing assisted reproduction technologies: a prospective study.Negro R, Mangieri T, Coppola L, Presicce G, Casavola EC, Gismondi R, Locorotondo G, Caroli P, Pezzarossa A, Dazzi D, Hassan H.Department of Internal Medicine, Division of Physiopathology of Human Reproduction, Casa di Cura Salus, Brindisi. robnegro@tiscali.itBACKGROUND: Infertile women positive for thyroid antibodies suffer from a poor pregnancy/delivery outcome, although conflicting data have been published. Our objective was to investigate if levothyroxine (LT4) exerts any effect on pregnancy and/or delivery rates in thyroid peroxidase antibody (TPOAb)-positive (+) women undergoing assisted reproductive technologies. METHODS: Patients undergoing treatment were screened for TPOAb, thyroid-stimulating hormone (TSH) and free thyroxine (FT4). A total of 72 (15%) out of the 484 euthyroid women selected were TPOAb (+). These 72 patients were randomly divided into two groups: group A (n = 36) underwent LT