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妊娠和产后甲状腺疾病诊治指南（第2版）
《妊娠和产后甲状腺疾病诊治指南》（第2版）编撰委员会
中华医学会内分泌学分会
中华医学会围产医学分会
作者及单位信息
·
DOI： 10.3760/cma.j.issn.1007-9408.2019.08.001
Guideline on Diagnosis and Management of Thyroid Diseases during Pregnancy and Postpartum (2 nd edition)
Ad Hoc Writing Committee for Guideline on Diagnosis and Management of Thyroid Diseases during Pregnancy and Postpartum (2nd edition)
Chinese Society of Endocrinology, Chinese Medical Association
Chinese Society of Perinatology, Chinese Medical Association
Authors Info & Affiliations
Ad Hoc Writing Committee for Guideline on Diagnosis and Management of Thyroid Diseases during Pregnancy and Postpartum (2nd edition)
Chinese Society of Endocrinology, Chinese Medical Association
Chinese Society of Perinatology, Chinese Medical Association
·
DOI： 10.3760/cma.j.issn.1007-9408.2019.08.001
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摘要

《妊娠和产后甲状腺疾病诊治指南》（第2版）是2012年版指南的更新。本版指南新增1个章节，提出78个问题，提供66条推荐；修定了妊娠期甲状腺功能减退症促甲状腺激素诊断切点值、妊娠期甲状腺功能减退症和甲状腺功能亢进症药物治疗等，制定了妊娠前促甲状腺激素筛查后处理流程图，旨在为临床医师对相关问题做出临床决策提供参考。

妊娠;产后;甲状腺疾病;指南;管理
ABSTRACT

The Guideline on Diagnosis and Management of Thyroid Diseases during Pregnancy and Postpartum (2 nd edition) is an update of the previous version published in 2012. This new edition consists of 78 questions and 66 recommendations. There is also an additional chapter. Moreover, the diagnostic cut-off point and the pharmaceutic treatment of hypothyroidism and hyperthyroidism during pregnancy were revised. In addition, a flow chart was developed to elaborate the management strategy after pre-pregnancy thyrotropin screening. This guideline aims to present all the relevant evidence on the diagnosis and management of thyroid diseases during pregnancy and postpartum to facilitate clinical decision-making.

Pregnancy;Postpartum;Thyroid diseases;Guidelines;Management
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引用本文

《妊娠和产后甲状腺疾病诊治指南》（第2版）编撰委员会,中华医学会内分泌学分会,中华医学会围产医学分会. 妊娠和产后甲状腺疾病诊治指南（第2版）[J]. 中华围产医学杂志,2019,22(8)：505-539.

DOI:10.3760/cma.j.issn.1007-9408.2019.08.001

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目录
内容 页码
本指南中常见英文缩略语及释义 506
本指南编撰委员会 507
再版前言 508
一、妊娠期甲状腺功能相关指标参考范围 509
二、妊娠期临床甲状腺功能减退症 510
三、妊娠期亚临床甲状腺功能减退症 511
四、妊娠期单纯低甲状腺素血症 513
五、妊娠期甲状腺自身抗体阳性 514
六、产后甲状腺炎 516
七、妊娠期甲状腺毒症 517
八、妊娠期碘营养 520
九、妊娠期甲状腺结节和甲状腺癌 522
十、先天性甲状腺功能减退症 524
十一、妊娠期和妊娠前甲状腺疾病筛查 526
十二、不孕和辅助生殖与甲状腺疾病 528
本指南全部推荐条款 529
缩略语 英文全称 中文全称
AACE American Association of Clinical Endocrinologists 美国临床内分泌医师学会
AITD Autoimmune thyroid diseases 自身免疫甲状腺病
ATA American Thyroid Association 美国甲状腺学会
ATD Antithyroid drug 抗甲状腺药物
CATS The Controlled Antenatal Thyroid Screening study 产前甲状腺疾病筛查和干预对照研究
CH Congenital hypothyroidism 先天性甲状腺功能减退症
DTC Differentiated thyroid cancer 分化型甲状腺癌
ETA European Thyroid Association 欧洲甲状腺学会
FNA Fine needle aspiration 细针穿刺抽吸
FT 3 Free triiodothyronine 游离三碘甲状腺原氨酸
FT 4 Free thyroxine 游离甲状腺素
FT 4I Free thyroxine index 游离甲状腺素指数
GTT Gestational transient thyrotoxicosis 妊娠一过性甲状腺毒症
hCG Human chorionic gonadotropin 人绒毛膜促性腺激素
ICSI Intracytoplasmic sperm injection 卵胞浆内单精子显微注射
IQ Intelligence quotient 智力商数
IVF-ET In vitro fertilization-embryo transfer 体外受精-胚胎移植
LT 3 Levotriiodothyronine 左三碘甲状腺原氨酸
LT 4 Levothyroxine 左甲状腺素
MDI Mental development index 智力发育指数
MMI Methimazole 甲巯咪唑
MRI Magnetic resonance imaging 磁共振成像
MUI Median urinary iodine 尿碘中位数
NACB National Academy of Clinical Biochemistry 美国临床生化研究院
PDI Psychomotor development index 精神运动发育指数
POSTAL Pregnancy Outcome Study in euthyroid women with ThyroidAutoimmunity after Levothyroxine 甲状腺功能正常的甲状腺自身免疫异常妇女接受LT 4治疗后的妊娠结局研究
PPT Postpartum thyroiditis 产后甲状腺炎
PTU Propylthiouracil 丙硫氧嘧啶
RCT Randomized controlled trial 随机对照试验
SCH Subclinical hypothyroidism 亚临床甲状腺功能减退症
T 3 Triiodothyronine 三碘甲状腺原氨酸
T 3RUR T 3 resin uptake ratio T 3树脂摄取率试验
T 4 Tetraiodothyronine 四碘甲状腺原氨酸（甲状腺素）
TBG Thyroxine binding globulin 甲状腺素结合球蛋白
TES The Endocrine Society 美国内分泌学会
Tg Thyroglobulin 甲状腺球蛋白
TgAb Thyroglobulin antibody 甲状腺球蛋白抗体
TPOAb Thyroid peroxidase antibody 甲状腺过氧化物酶抗体
TRAb TSH receptor antibody 促甲状腺激素受体抗体
TRBAb Thyrotropin receptor blocking antibody 促甲状腺素受体抑制抗体
TRH Thyrotrophin releasing hormone 促甲状腺激素释放激素
TSAb Thyroid stimulating antibody 甲状腺刺激性抗体
TSBAb Thyroid stimulating blocking antibody 甲状腺刺激阻断性抗体
TSH Thyroid stimulating hormone 促甲状腺激素
TT 4 Total thyroxine 总甲状腺素
UIC Urinary iodine concentration 尿碘浓度
WHO World Health Organization 世界卫生组织
本指南中常见英文缩略语及释义
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本指南由《中华内分泌代谢杂志》2019年第35卷第8期与本刊同步发表

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