妊娠甲状腺功能亢进患者抗甲状腺药物治疗

妊娠合并甲状腺功能亢进(甲亢),尤其是临床甲亢易出现不良妊娠结局,包括子痫、流产、早产、妊娠期糖尿病、胎儿宫内生长受限等,严重威胁孕妇和后代健康。抗甲状腺药物(ATD)是此时治疗甲亢的首选方案,但是近年来研究发现甲巯咪唑和丙基硫氧嘧啶均有致畸作用,此外还可能引起肝损害等严重不良反应,但它们影响的程度不同。因此,如何合理给予ATD治疗妊娠合并甲亢对于保障孕妇和后代健康十分重要,特别应注意严格控制妊娠早期(6～10周)ATD的使用。

Recent progress in treatment of anti-thyroid drugs on pregnant women with hyperthyroidism

Hyperthyroidism in pregnancy, especially overt hyperthyroidism can cause adverse pregnancy outcomes, including eclampsia, abortion, preterm birth,gestational diabetes and fetal intrauterine growth restriction, which is a serious threat to the mother and fetus' health. Anti-thyroid drug (ATD) is the first line of choice for those patients, but recent studies found methimazole and propylthiouracil have teratogenic effects. Moreover, they are possible to cause liver function failure and other serious adverse effects, but the degree is different. Therefore, it is very important to appropriately use ATD to protect the health of mother and fetus, especially to restrict the use in the first trimester of pregnancy (6-10 weeks).