摘要
目的建立合肥地区健康育龄期女性甲状腺功能参考值范围,并探讨碘营养状况与月经周期对其的影响。方法选取月经规律的健康女性128例(18～29岁62例,30～39岁66例),碘足量92例,碘过量36例;处于卵泡早期36例,卵泡晚期26例,黄体中期33例,黄体晚期33例。年龄匹配的健康男性81例(碘足量53例,碘过量28例)作为对照组。化学发光法测定血清三碘甲状腺原氨酸(TT3)、甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体、甲状腺球蛋白抗体、甲状腺素结合球蛋白(TBG)、卵泡刺激素、黄体生成素、雌二醇、孕酮,过硫酸铵法测定尿碘。结果 (1)18～39岁女性参考值:TT3(1.24～2.26)nmol/L,TT4(66.22～133.04)nmol/L,FT3(3.82～5.60)pmol/L,FT4(11.51～16.03)pmol/L,TSH(1.07～4.13)mI U/L。女性两年龄段甲状腺功能血清各指标无明显差异。(2)男性参考值:TT3(1.58～2.72)nmol/L,TT4(71.95～156.15)nmol/L,FT3(4.66～6.47)pmol/L,FT4(11.77～20.91)pmol/L,TSH(0.91～4.09)mI U/L。男女总体参考值:TT3(1.25～2.60)nmol/L,TT4(68.66～144.86)nmol/L,FT3(3.85～6.23)pmol/L,FT4(11.51～19.75)pmol/L,TSH(0.96～4.12)mI U/L。(3)女性与男性和总体比较,血清TSH无明显差异,而TT3、TT4、FT3、FT4均降低(P<0.01)。(4)与碘足量组比较,碘过量组女性仅血清TT4浓度降低(P<0.05),而男性各指标无明显变化。(5)月经周期各阶段血清TT3、TT4、FT3、FT4、TSH、TBG差异无统计学意义。结论育龄女性甲状腺功能参考值具有独特性,其受碘营养状况的影响,但不受月经周期变化的影响。因此需建立本地区育龄女性甲状腺功能参考值,并科学指导其加碘食盐摄入量,有助于优生优育。
Objective To establish reference intervals of thyroid function, and to explore the effects of iodine nutrit- ure and menstrual cycle on its determination in healthy reproductive woman, in Hefei. Methods Serum samples were collected from 128 cases of healthy reproductive woman with menstrual regularity （62 cases aged from 18 to 29 years and 66 cases from 30 ~ 39 years）, including iodine adequate （ n = 92 ）, iodine excessive （ n = 36 ） ; in early follicular phase （ n = 36） ,late follicular phase （ n = 26 ）, corpus luteum （ n = 33 ）, and late corpus luteum （ n = 33 ） ;age matched 81 apparently healthy man iodine adequate （n = 53 ） ,iodine excessive （n = 28 ）as control group. All serum samples were tested for total triiodothyronine （TT3）, total thyroxine （TT4）, free triiodothyronine（ FT3 ）, free thyroxine （ FT4）, thyroid stimulating hormone （ TSH）, thyroid peroxidase antibodies, and thyroglobulin antibod- ies; females＇ serum samples were tested for thyroxine-binding globulin （TBG） , follicle stimulating hormone,lutein- izing hormone , estradiol, progesterone, using chemiluminescent detection technology, urine iodine concentration was determined by the ammonium persulfate method. Results ① The reference intervals were 333 （1.24 -2.26 ） nmol/L,q374（66.22 - 133.04） nmol/L,FT3 （3.82 -5.60） pmol/L,FT4（ 11.51 ~ 16. 03） pmol/L,TSH（ 1.07 - 4. 13 ） mIU/L, in female. The levels of serum TI3, TY4, FT3, FT4, TSH were no significant differences at different ages in female. ② The reference intervals were TT3 （ 1.58 - 2.72） nmol/L, TT4 （71.95 ~ 156. 15 ） nmol/L, FT3 （4.66 -6. 47） pmol/L, FT4 （ 11.77 - 20. 91 ） pmol/L,TSH （0. 91 ~ 4. 09） mlU/L, inmale;TT3 （ 1.25 - 2.60） nmol/L, TY4 （ 68.66 - 144. 86） nmol/L, FT3 （3.85 - 6.23 ） pmol/L, FT4 （ 11.51 - 19.75 ） pmol/L, TSH （0. 96 4. 12） mIU/L,in male and female overall. ③ Compared to male and overall group ,the leves of serum TSH was no significant differences, serum TT3, TY4, FT3, FT4 were lower （ P 〈 0. 01 ） in female. ④ Compared to iodine ade- quate group, only the levels of serum TF4 was decreased （ P 〈 0.05 ） in female, but it had no effect on thyroid function in male, iniodine excessive group. ⑤ The levels of serum 3373 ,TT4, TT3, FT4 ,TSH ,TBG were no signifi- cant differences in the four phases of menstrual cycle. Conclusion The reference intervals of serum thyroid func- tionis unique in reproductive woman ,which is affected by iodine nutrition status, but is not affected by the changes of menstrual cycle. Therefore, it is necessary to establish the reference intervalsof thyroid function for reproductive woman in local region, and to guide the intake of iodized salt by science, which will contribute to optimize the prena- tal and postnatal care.
作者
陈婷婷
金秀兰
邓大同
王佑民
Chen Tingting, Jin Xiulan, Deng Datong, et al(Dept of Endocinology, The Frist Affiliated Hospital of Anhui Medical University, Anhui Provincial Laboratory of Endocrinology and Metabolism,Hefei 23002)
出处
《安徽医科大学学报》
CAS
北大核心
2018年第3期462-466,共5页
Acta Universitatis Medicinalis Anhui
基金
公益性行为专项基金(编号:201402005)
安徽省自然科学基金(编号:1608085MH207)
关键词
甲状腺功能
育龄期
参考值
月经周期
尿碘
thyroid function
reproductive age
reference intervals
menstrual cycle
urinary iodine
