国际妇产科学杂志2026，Vol.53Issue(3)：255-260,6.DOI:10.12280/gjfckx.20251241
妊娠期TPOAb阳性与流产:独立风险、与SCH的协同机制及干预策略
TPOAb Positivity during Pregnancy and Miscarriage:Independent Risk,Synergistic Mechanisms with SCH,and Intervention Strategies
摘要
Abstract
Miscarriage is a common complication during pregnancy with a high incidence and complex etiology.Thyroid peroxidase antibody(TPOAb)positivity serves as an independent risk factor for miscarriage.It can directly damage the placenta via mechanisms such as immune inflammation and oxidative stress,independent of thyroid function,ultimately leading to miscarriage.Furthermore,TPOAb positivity can induce subclinical hypothyroidism(SCH).When they coexist,a vicious cycle of immune damage and thyroid hormone insufficiency can significantly exacerbate the risk of miscarriage.Levothyroxine(L-T4)is the primary medication for treating SCH during pregnancy.However,its efficacy in preventing miscarriage and improving live birth outcomes remains controversial,particularly in patients with isolated TPOAb positivity or mild SCH,where the benefits are unclear.The optimal timing of intervention and dosing regimen also require further optimization.Future research should focus on precise risk stratification and early intervention strategies to provide evidence-based medical support for clinical practice.关键词
甲状腺过氧化物酶抗体/亚临床甲状腺功能减退症/妊娠/流产,自然/左甲状腺素Key words
Thyroid peroxidase antibody/Subclinical hypothyroidism/Pregnancy/Abortion,spontaneous/Levothyroxine引用本文复制引用
何曾田田,余健楠,高竹薇,刘宇,张茜,吴效科..妊娠期TPOAb阳性与流产:独立风险、与SCH的协同机制及干预策略[J].国际妇产科学杂志,2026,53(3):255-260,6.基金项目
中医药循证能力提升项目(国中医药科技中药便函[2023]24号) （国中医药科技中药便函[2023]24号）
黑龙江省"头雁"团队-中西医结合妇科特色技术创新团队(LH2019H046) （LH2019H046）
