摘要
目的分析哈尔滨地区妊娠期孕妇甲状腺功能,建立本地区健康孕妇不同妊娠期甲状腺激素水平的参考范围。方法选取2013年12月至2018年11月哈尔滨市红十字中心医院进行产前检查的331例健康非妊娠女性作为对照组,1 812例妊娠期女性作为研究组,研究组分为妊娠早期组(1~12+6周)608例,妊娠中期组(13~27+6周)604例,妊娠晚期组(≥28周)600例。采用化学发光分析方法检测血清中促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(Tg Ab)浓度,分析其在孕期的变化特点,制定特异性甲状腺激素水平指标参考范围。结果TSH在妊娠早、中期组,FT4、FT3在妊娠早、中、晚期组与对照组比较,均有显著差异(P<0.05)。TPOAb和TgAb与对照组比无显著差异(P>0.05),妊娠各期相比均有显著差异(P<0.05)。TSH在妊娠早、中、晚期特异性参考范围分别为0.02~3.20μIU/ml、0.03~3.65μIU/ml、0.29~4.71μIU/ml。FT4在妊娠早、中、晚期分别为0.80~1.36 ng/ml、0.68~1.24 ng/ml,0.63~1.08 ng/ml。FT3在妊娠早、中、晚期分别为2.19~3.81 pg/ml、2.14~3.88 pg/ml、1.79~3.59 pg/ml。TPOAb在妊娠早、中、晚期分别为0.00~0.92 IU/ml、0.00~0.95 IU/ml、0.00~1.46 IU/ml。Tg Ab在妊娠早、中、晚期分别为0.26~3.06 IU/ml、0.42~2.92 IU/ml、0.00~2.61 IU/ml。结论使用非孕人群的参考范围评价妊娠妇女的甲状腺功能,可能会造成妊娠合并甲状腺疾病的误诊和漏诊,建立本地区和本实验室健康孕妇各妊娠期甲状腺激素水平参考范围有利于甲状腺疾病的诊断与治疗。
Objective To analyze the thyroid function in pregnant women with different stages of pregnancy in Harbin,and to establish the referential range of thyroid hormone levels in healthy pregnant women at different stages of pregnancy in Harbin.Methods A total of 331 healthy non-pregnant women underwent antenatal check-up during December 2013 to November 2018 in Harbin Red-Cross Central Hospital were selected as control group,and 1 812 pregnant women were selected as study group.Pregnant women in study group were divided into early pregnancy group(608 cases with 1~12+6 weeks)608 cases,and 604 cases in the middle pregnancy group(608 and 604 cases with 13~27+6 weeks),and 600 cases in late pregnancy group(≥28 weeks).The serum levels of thyroid stimulating hormone(TSH),free thyroxine(FT 4),free triiodothyronine(FT 3),thyroid peroxidase antibody(TPOAb)and thyroglobulin antibody(TgAb)were detected by chemiluminescence method.The characteristics of their changes during pregnancy and to establish the reference range of specific thyroid hormone level.Results In comparison with control group,TSH in early and mid-term pregnancy groups,FT 4 and FT 3 in early,middle and late pregnancy groups had difference(P<0.05).TPOAb and TgAb had no significant difference compared with those of control group,but there is significant difference in different gestational stages.The specific reference ranges of TSH in early,middle and late pregnancy stages were 0.02~3.20μIU/ml,0.03~3.65μIU/ml and 0.29~4.71μIU/ml respectively.The ranges of FT 4 were 0.80~1.36 ng/ml,0.68~1.24 ng/ml and 0.63~1.08 ng/ml in early,middle and late pregnancy stages respectively.Levels of FT 3 were 2.19~3.81 pg/ml,2.14~3.88 pg/ml and 1.79~3.59 pg/ml in early,mid and late pregnancy stages respectively.Levels of TPOAb were 0.00~0.92 IU/ml,0.00~0.95 IU/ml and 0.00~1.46 IU/ml in early,mid and late pregnancy stages respectively.Levels of TgAb were 0.26~3.06 IU/ml,0.42~2.92 IU/ml and 0.00~2.61 IU/ml in early,mid and late pregnancy stages respectively.Conclusion By using the referential value of non-pregnant women to evaluate the thyroid function of pregnant women may lead to misdiagnosis and missed diagnosis of pregnancy with thyroid disease.Establishment of the referential range of thyroid hormone level in healthy pregnant women with different stages in this region is conducive to diagnosis and treatment of thyroid diseases.
作者
陈琳
王君龙
刘晓丽
杜建明
张昕炜
张艳影
杨威
CHEN Lin;WANG Jun-long;LIU Xiao-li(Department of Clinical laboratory,Harbin Red-cross Central Hospital,Harbin,Heilongjiang 150076,China)
出处
《临床和实验医学杂志》
2019年第21期2335-2338,共4页
Journal of Clinical and Experimental Medicine
基金
哈尔滨市科技局优秀学科带头人基金项目(编号:2017RAXQJ051)
关键词
妊娠期
甲状腺激素
参考范围
Pregnancy
Thyroid hormones
Referential ranges
