【摘要】 亚临床甲状腺功能减退(SCH)是妊娠期甲状腺常见疾病之一,美国甲状腺学会(ATA)制定的妊娠期甲状腺疾病的权威指南提出诊断SCH的2个标准,标准1:依据妊娠期特异的血清促甲状腺素(TSH)上限,标准2:根据血清TSH>2.5 mIU/L、游离甲状腺素(FT4)在正常范围。在中国如依据标准2诊断SCH,患病率高达27.8%,造成SCH的过度诊断和过度治疗。若想建立本单位或地区妊娠期特异性甲状腺功能指标参考值,需考虑影响因素除"正常"人群的筛选、采用的检测试剂及检测方法、种族、遗传、碘营养状态之外,还需关注采样方法(自身序贯或横断面)、妊娠早期具体孕周数。本文就妊娠特异性甲状腺功能指标参考值建立、影响因素以及SCH的合理诊断等方面所取得一些进展进行综述。更多还原

【Abstract】 Subclinical hypothyroidism is one of the most common thyroid diseases during pregnancy, and the American Thyroid Association(ATA) guidelines proposed two diagnostic criteria for subclinical hypothyroidism during the first trimester of pregnancy:(1) pregnancy-specific TSH reference range; and(2) serum TSH > 2.5 mIU/L with normal serum FT4. In China, the prevalence rate of subclinical hypothyroidism was as high as 27.8%, and the diagnosis based on criterion 2 may result in overdiagnosis and overtreatment. Establishing a hospital or region-specific thyroid function reference index during pregnancy needs considering many factors, including screening of normal people, detection reagents and methods, genetics, iodine nutritional status, race, sampling method(sequential or cross section), and the specific number of gestational weeks in early pregnancy. In this paper, we will review the progress in the establishment of the reference value of specific thyroid function index, the influencing factors, and the rational diagnosis of subclinical hypothyroidism.更多还原