摘要
目的 了解妊娠前半期甲状腺功能的变化,为今后开展孕期筛查甲状腺功能减退症提供依据.方法 选取妊娠前半期（≤孕20周）的孕妇作为对象,测定其血清促甲状腺素、游离三碘甲状腺原氨酸、游离甲状腺素的水平,并采用妊娠期特异性甲状腺功能的参考值范围和非妊娠人群甲状腺功能的参考值范围标准对其进行综合判断.结果 146例孕妇妊娠前半期的甲状腺功能变化随着孕周的增加而变化,游离三碘甲状腺原氨酸、游离甲状腺素水平随着孕周的增加而逐渐下降,促甲状腺素水平随着孕周的增加而升高.采用妊娠特异性甲状腺功能正常参考值范围评估,诊断低四碘甲状腺原氨酸血症6例,患病率为4.11%,诊断亚临床型甲状腺功能减退症共12例,患病率8.22%,其均随着孕周的增加而升高.妊娠早期和妊娠中期比较,亚临床型甲状腺功能减退症的患病率差异有统计学意义（χ2=7.68,P＆lt;0.01）.结论 妊娠期甲状腺功能的变化不能采用非妊娠人群的甲状腺功能正常参考值范围来评估,而采用妊娠特异性甲状腺功能正常参考值范围来评估,可减少对亚临床型甲状腺功能减退症患病率的漏诊.在妊娠前或妊娠前半期筛查甲状腺功能是必要的,可尽早发现甲状腺功能异常的孕妇.
Objective To monitor changes in thyroid function of pregnant women during the first half of pregnancy, so as to provide basis for carrying out screening of hypothyroidism. Methods In the first half of pregnancy（ ≤20 weeks of gestation） , the serum levels of TSH, FT3 and FT4 of pregnant women were measured and the results were compared with pregnancy specific reference ranges of thyroid function and normal standard reference values of thyroid function of normal non-pregnant population. Results The thyroid function of 146 pregnant women in the first half of pregnancy changed with increase in gestational weeks： the serum levels of ~l＂3 and FT4 were decreased with increase of gestational weeks, while the serum level of TSH was increased with increase of gestational weeks. Refering to normal pregnancy- specific reference values, 6 pregnant women were diagnosed as hypotetraiodothyroidism （the prevalence was 4.11% ）, 12 pregnant women were diagnosed as subclinical hypothyroidism （the prevalence was 8.22% ）, and the prevalences of hypotetraiodothyroidism and subclinical hypothyroidism were increased along with increase of gestational weeks. In prevalence of subclinical hypothyroidism among pregnant women in early and middle pregnancy, there was a significant difference （X2 = 7.68, P 〈 0.01 ）. Conclusion The changes in thyroid function during pregnancy can not be assessed by reference values of normal thyroid function in non-pregnant population but pregnancy-specific reference values. The assessment of thyroid function of pregnant women refering to pregnancy-specific reference values could reduce missed diagnosis rate of subclinical hypothyroidism. It is necessary to screen thyroid function before pregnancy or in the first half of pregnancy, because it can identify those pregnant women with thyroid dysfunction in early time.
出处
《中国妇幼健康研究》
2010年第5期598-600,共3页
Chinese Journal of Woman and Child Health Research
关键词
妊娠前半期
甲状腺功能
变化
筛查及分析
the first half of pregnancy
thyroid function
change
screening and analysis
