妊娠期甲状腺毒症鉴别诊断的研究进展

Research progress on differential diagnosis of thyrotoxicosis during pregnancy

  • 摘要: 妊娠期甲状腺毒症主要包括妊娠一过性甲状腺功能亢进(GTT)和Graves病(GD),2种疾病的治疗方法截然不同,因此鉴别诊断尤为重要。但目前鉴别GTT与GD缺乏金标准,根据患者既往病史、临床表现结合甲状腺相关抗体是目前最常用的鉴别方法。近几年国内外一些研究者提出其他有意义的鉴别指标,例如:甲状腺相关抗体、甲状腺彩色多普勒超声检查中的甲状腺上动脉收缩期平均峰值血流速度、甲状腺激素及绒毛膜促性腺激素等。该文对每个指标的鉴别诊断意义进行总结,以期为鉴别妊娠期GTT与GD提供更好的参考依据。

     

    Abstract: Thyrotoxicosis during pregnancy mainly includes gestational transient thyrotoxicosis (GTT) and Graves’ disease (GD). It is important to distinguish between GTT and GD because these two diseases are treated differently. At present, gold standard is lacking for the differential diagnosis of two diseases. Detection of thyroid-related antibodies combined with medical history and clinical manifestations are the most common differential methods. In recent years, researchers at home and abroad have proposed alternative valuable differential indexes, such as thyroid-related antibody, superior thyroid artery peak systolic velocity of color Doppler ultrasound of the thyroid, thyroid hormone and human chorionic gonadotropin, etc. In this article, the differential diagnosis significance of each index was summarized, aiming to provide better reference for the differential diagnosis of GTT in pregnancy and GD.

     

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