摘要
目的建立武汉地区不同妊娠期女性特异性血清甲状腺功能指标的参考范围,并观察甲状腺激素水平变化。方法随机选取产科门诊进行正规孕前咨询的女性及产前检查的孕妇1 186名,检测其血清促甲状腺激素(TSH)、血清游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)。统计学分析妊娠各期各指标特异性,并建立武汉地区不同妊娠期TSH、FT3、FT4参考范围。结果与未孕女性相比,妊娠各期女性血清甲状腺激素表达水平不同且差异具有统计学意义。(1)孕前FT3水平高于妊娠期,且随着妊娠进程逐渐降低;(2)中孕和晚孕时期FT4水平较孕前和早孕时期略有降低;(3)TSH水平从孕前到早孕时期降低、早孕到中孕时期差异不大、而中孕到晚孕时期又回升至与孕前相近水平。如果以孕前范围为参考,早孕、中孕和晚孕TSH错误比例分别为5.84%、19.09%和28.91%。结论武汉地区不同妊娠期女性血清甲状腺激素水平呈现地区特异性变化,建立本地区本实验室参考范围,能有效减少妊娠期甲状腺相关疾病漏诊。
Objective To establish the laboratory and geography-specific reference intervals for thyroid hormones during pregnancy and changes of serum thyroid hormone in Wuhan. Methods According to NACB guidelines,a total of 1 186 female including in or without pregnancy were recruited in our hospital randomly when they came to routine antenatal clinic. The 2.5 th and 97.5 th percentiles were calculated as the reference intervals for specialty of serum thyroid function including serum thyroid stimulating hormone（TSH）,serum free three io-dine thyroid（FT3）,serum free thyroxine（FT4）levels during each trimester by chemiluminescence.Results On comparing to non-pregnant women,the serum thyroid hormone in pregnant women had significant difference as the following：（1）FT3 concentrations showed decreased median centile throughout gestation step by step;（2）FT4 lev-els in second and third trimester had slightly decreased;（3）TSH levels had significant decreased in first and sec-ond trimeste and had no significant difference between the early pregnancy and middle pregnancy,and had recoved to the similar level of before pregnancy in middle pregnancy and late pregnancy.Compared with control group,the serum thyroid function levels of pregnant women had significant differences in trimesters. There were 5.84%, 19.09% and 28.91% of women in the first,second and third trimester,respectively,with serum TSH higher than the upper reference limit,or lower than the lower reference limit.Conclusions Serum thyroid function had signifi-cant correlations with pregnancy in Wuhan area. To establish pregnancy-specific thyroid function reference inter-vals of local area can reduce underdiagnosis effectively in thyroid gland related diseases.
出处
《实用医学杂志》
CAS
北大核心
2017年第24期4082-4086,共5页
The Journal of Practical Medicine
基金
2017年湖北省知识创新专项(自然科学基金)项目(编号:2017CFB254)
2017年武汉市卫生计生科研基金资助项目(编号:WX17Q24)
关键词
妊娠
甲状腺激素
参考范围
pregnancy
thyroid hormones
reference intervals
