摘要
目的探讨建立惠州地区妊娠三期特异性甲状腺激素水平的参考值范围。方法选取2018年6月—2019年6月本院健康孕妇450名,其中妊娠早期(早孕组)、妊娠中期(中孕组)、妊娠晚期(晚孕组)各150名,所有孕妇均进行常规产检检测血清促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平,采用非参数方法计算95%(P2.5~P97.5)参考区间建立TSH、FT3、FT4的正常参考范围。结果早孕组血清TSH水平明显低于中孕组,中孕组血清TSH水平明显低于晚孕组,早孕组血清FT3、FT4水平明显高于中孕组,中孕组血清FT3、FT4水平明显高于晚孕组,差异有统计学意义(P<0.05);在TSH、FT3、FT4的正常参考范围中,早孕组分别为0.09~3.82 mIU/L、4.45~5.56 pg/ml、1.03~1.47 ng/dl,中孕组分别为0.16~4.18 mIU/L、4.33~5.52 pg/ml、0.95~1.46 ng/dl,晚孕组分别为0.35~4.58 mIU/L、4.10~5.18 pg/ml、0.85~1.52 ng/dl;本研究建立的参考值、非妊娠的参考值、美国甲状腺学会(ATA)的参考值对甲状腺功能异常的总检出率比较,差异无统计学意义(P>0.05),非妊娠的参考值对亚临床甲减的检出率明显低于本研究建立的参考值、ATA的参考值,差异有统计学意义(P<0.05),本研究建立的参考值、ATA的参考值对亚临床甲减的检出率比较差异无统计学意义(P>0.05)。结论惠州地区妊娠三期特异性甲状腺激素水平存在显著差异,随着孕周增加,TSH上升而FT3、FT4下降,建立本地区参考值范围对孕妇甲状腺功能异常具有重要的诊断意义。
Objective To discuss the establishment of reference range of specific thyroid hormone level in third trimester pregnancy in Huizhou area.Methods 450 healthy pregnant women in our hospital from June 2018 to June 2019 were selected,there were 150 cases in early pregnancy(early pregnancy group),150 cases in middle pregnancy(middle pregnancy group)and 150 cases in late pregnancy(late pregnancy group),all pregnant women were detected the serum thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4)underwent routine obstetric examination,the normal reference ranges of TSH,FT3 and FT4 were established by calculating 95%(P2.5-P97.5)reference intervals with non-parametric method.Results The level of serum TSH in early pregnancy group was significantly lower than that in middle pregnancy group,the level of serum TSH in middle pregnancy group was significantly lower than that in late pregnancy group,the level of serum FT3 and FT4 in early pregnancy group were significantly higher than those in middle pregnancy group,the level of serum FT3 and FT4 in middle pregnancy group were significantly higher than those in late pregnancy group,the difference was statistically significant(P<0.05).In the normal reference range of TSH,FT3 and FT 4,the early pregnancy group were 0.09~3.82 mIU/L,4.45~5.56 pg/ml,1.03~1.47 ng/dl,the middle pregnancy group was 0.16~4.18 mIU/L,4.33~5.52 pg/ml,0.95~1.46 ng/dl,and the late pregnancy group was 0.35~4.58 mIU/L,4.10~5.18 pg/ml,0.85~1.52 ng/dl.There was no significant difference in the total detection rate of thyroid dysfunction between the reference values established in this study,the reference values of non-pregnancy and the reference values of American Thyroid Association(ATA)(P>0.05),the detection rate of subclinical hypothyroidism in the reference value of non-pregnancy was significantly higher than that in the reference value of ATA and the reference values established in this study,the difference was statistically significant(P<0.05),there was no significant difference in the detection rate of subclinical hypothyroidism between the reference values established in this study and the reference values of ATA(P>0.05).Conclusions There is a significant difference in the level of thyroid hormones between the three stages of pregnancy in Huizhou,and with the increase of gestational age,the rise of TSH and the decrease of FT3 and FT4,the establishment of the reference range in this area has important diagnostic significance for thyroid dysfunction in pregnant women.
作者
苏小苗
SU Xiao-miao(The People’s Hospital of Huidong County,Huidong 516300,China)
出处
《中国地方病防治》
CAS
2019年第6期616-619,共4页
Chinese Journal of Control of Endemic Diseases
关键词
惠州地区
妊娠三期
甲状腺激素
健康孕妇
参考值范围
Huizhou area
Third trimester pregnancy
Thyroid hormone
Healthy pregnant women
Reference range
