摘要
目的:探讨郯城地区健康孕妇各孕期的甲状腺激素(TSH)水平,建立郯城地区孕期特异性TSH参考值范围。方法:筛选2019年1月-2020年4月郯城地区健康孕妇300例,分析同期孕检的健康孕妇5488例,均进行亚临床甲减筛查,并对两者进行比较。结果:妊娠Ⅲ期促甲状腺素中位数及95%参考范围分别为孕早期TSH 1.10(0.10~3.09)μIU/mL;孕中期TSH 1.14(0.21~3.75)μIU/mL;孕晚期TSH 2.04(0.51~3.96)μIU/mL。采用本研究标准和美国甲状腺医师学会(ATA)指南标准筛查5488例孕妇甲状腺功能,亚临床甲减的检出率分别是孕早期3.06%(9/294)和0.68%(2/294),孕中期5.84%(280/4788)和4.97%(238/4788),孕晚期3.45%(14/406)和3.20%(13/406)。结论:TSH值在孕早期明显低于孕中、晚期,不建议使用4.0 mIU/L作为本地区孕早期TSH参考值上限;建立郯城地区孕期特异性TSH参考范围,可减少孕期亚临床甲减的漏诊率。
Objective:To explore the changes of thyroid hormone levels of healthy pregnant women during different pregnancy in Tancheng district and to establish the reference range of specific TSH levels during pregnancy in this area.Methods:From January 2019 to April 2020,300 cases of healthy pregnant women in Tancheng county were enrolled.5488 healthy pregnant women who came to the hospital for routine pregnancy test in the same time period were analyzed together,subclinical hypothyroidism was screened and compared.Results:The median and 95%reference ranges of serum thyrotrophin were as followed:TSH 1.10(0.10~3.09)μIU/mL in the early trimester.TSH 1.14(0.21~3.75)μIU/mL in the second trimester.TSH 2.04(0.51~3.96)μIU/mL in the third trimester.The detection rates for subclinical hypothyroidism were 3.06%(9/294)and 0.68%(2/294)in the first trimester of pregnancy,5.84%(280/4788)and 4.97%(238/4788)in the second trimester and 3.45%(14/406)and 3.20%(13/406)in the third trimester of pregnancy,respectively,by using the study criteria and ATA guidelines.Conclusion:TSH value in early pregnancy is significantly lower than that in middle and late pregnancy,it is not recommended to use 4.0 mIU/L as the upper limit of TSH reference value in early pregnancy in this region.Establishing the reference range of TSH in each pregnancy in this region can reduce the missed diagnosis rate of subclinical hypothyroidism in early pregnancy.
作者
王开红
Wang Kaihong(Department of Endocrinology,the First People's Hospital of Tancheng County,Shandong Province,Shandong Linyi 276100)
出处
《中国社区医师》
2020年第36期171-172,共2页
Chinese Community Doctors
关键词
郯城地区
孕期
甲状腺激素
参考范围
Tancheng area
Pregnancy
Thyroid hormone
Reference range
