Postpartum thyroiditis and autoimmune thyroiditis in women of childbearing age: recent insights and consequences for antenatal and postnatal care.
Postpartum thyroiditis and autoimmune thyroiditis in women of childbearing age: recent insights and consequences for antenatal and postnatal care.
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DOI：
10.1210/edrv.22.5.0441
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发表时间：
2001-10
影响因子：
20.3
通讯作者：
A. Muller;H. Drexhage;A. Berghout
中科院分区：
文献类型：
--
作者：
A. Muller;H. Drexhage;A. Berghout
产后甲状腺炎是一种发生在分娩后第一年的暂时性或永久性甲状腺功能障碍综合征，基于甲状腺的自身免疫性炎症。患病率为5- 7%。我们讨论的作用，抗体（特别是甲状腺过氧化物酶抗体），补体，活化的T细胞和细胞凋亡在产后甲状腺炎的爆发。产后甲状腺炎被认为是一个急性期的自身免疫性甲状腺破坏的背景下，现有的和正在进行的过程中的甲状腺自身敏化。从怀孕开始，免疫耐受增强。分娩后对这种妊娠相关免疫抑制的反弹反应解释了产褥期自身免疫综合征的加重，例如，临床上明显的产后甲状腺炎的发生。自身免疫性甲状腺炎引起的甲状腺储备功能低下越来越被认为是一个严重的健康问题。1)甲状腺自身免疫增加自发性流产的可能性。2)由于自身免疫性甲状腺炎引起的甲状腺功能衰竭通常是轻度和亚临床的，可导致后代神经心理学表现的永久性和重大损害。3)有证据表明，随着妇女年龄的增长，亚临床甲状腺功能减退症--产后甲状腺炎的后遗症--易使她们患心血管疾病。因此，产后甲状腺炎不再被认为是一种轻度和短暂的疾病。筛选被考虑。
Postpartum thyroiditis is a syndrome of transient or permanent thyroid dysfunction occurring in the first year after delivery and based on an autoimmune inflammation of the thyroid. The prevalence ranges from 5-7%. We discuss the role of antibodies (especially thyroid peroxidase antibodies), complement, activated T cells, and apoptosis in the outbreak of postpartum thyroiditis. Postpartum thyroiditis is conceptualized as an acute phase of autoimmune thyroid destruction in the context of an existing and ongoing process of thyroid autosensitization. From pregnancy an enhanced state of immune tolerance ensues. A rebound reaction to this pregnancy-associated immune suppression after delivery explains the aggravation of autoimmune syndromes in the puerperal period, e.g., the occurrence of clinically overt postpartum thyroiditis. Low thyroid reserve due to autoimmune thyroiditis is increasingly recognized as a serious health problem. 1) Thyroid autoimmunity increases the probability of spontaneous fetal loss. 2) Thyroid failure due to autoimmune thyroiditis-often mild and subclinical-can lead to permanent and significant impairment in neuropsychological performance of the offspring. 3) Evidence is emerging that as women age subclinical hypothyroidism-as a sequel of postpartum thyroiditis-predisposes them to cardiovascular disease. Hence, postpartum thyroiditis is no longer considered a mild and transient disorder. Screening is considered.