摘要
目的 了解妊娠妇女妊娠期甲状腺功能指标的动态变化,建立妊娠期甲状腺功能指标参考区间,为临床诊断孕妇甲状腺疾病提供更为准确的依据。方法 选取2020年1月至2021年12月在我院建档进行产前检查的孕妇孕早期315例、孕中期539例、孕晚期338例作为研究组,另选取同期在我院进行常规检查的未孕健康女性132例作为对照组。采用安图全自动化学发光测定仪检测两组血清FT_(3)、FT_(4)、TSH、TPOAb水平,分析年龄对妊娠期甲状腺功能指标的影响、比较两组研究对象及研究组不同孕期甲状腺功能指标的变化,建立妊娠期参考区间,分析采用不同参考区间时妊娠期甲状腺疾病发生率。结果 在孕晚期,年龄对FT_(3)有影响,不同年龄组间差异有统计学意义(P<0.05),在孕早中期差异无统计学意义,年龄对不同孕期FT_(4)、TSH、TPOAb无明显影响(P>0.05);与对照组比较,FT_(3)、FT_(4)、TSH在不同孕期差异均有统计学意义(P<0.05);随着孕期的增加,FT_(3)、FT_(4)呈下降趋势,TSH呈上升趋势,差异有统计学意义(P<0.05),TPOAb变化趋势不明显(P>0.05)。妊娠期甲状腺功能指标参考区间拟定:FT_(3)、FT_(4)、TSH孕早期分别为4.13~6.34pmol/L、12.16~20.44pmol/L、0.06~3.35μIU/mL,孕中期分别为3.80~6.19pmol/L、9.53~17.95pmol/L、0.28~4.13μIU/mL,孕晚期分别为3.66~5.82pmol/L、9.09~16.56pmol/L、0.46~4.45μIU/mL,TPOAb在整个孕期为0~9.18IU/mL。运用不同的参考区间,妊娠期甲状腺疾病的发生率不同,妊娠期亚临床甲状腺功能减退差异有统计学意义(P<0.05)。结论 妊娠期妇女甲状腺功能指标与非妊娠期有明显差异,且不同年龄组FT_(3)孕晚期差异显著,建立区分孕妇妊娠期及年龄的甲状腺功能指标参考区间,能为临床及时发现甲状腺疾病提供重要参考价值,准确的诊断和及时的处理有利于优生优育。
Objective To understand the dynamic changes of thyroid function indexes in pregnant women,establish the reference interval of thyroid function indexes during pregnancy,and to provide more accurate reference basis for the clinical diagnosis of thyroid diseases in pregnant women.Methods From January,2020 to December,2021,315 pregnant women in the first trimester,539 in the second trimester and 338 in the third trimester were selected as the study group,while 132 healthy non-pregnant women who underwent routine examinations in our hospital during the same period were selected as the control group.Serum FT_(3),FT_(4),TSH and TPOAb levels of the two groups were detected by Antu automatic chemiluminescence apparatus.The influence of age on thyroid function indexes during pregnancy was analyzed and the changes of thyroid function indexes during pregnancy were compared between the two groups and the research groups.The reference interval during pregnancy was then established.The incidence of thyroid disease during pregnancy was analyzed with different reference intervals.Results In the third trimester,FT_(3) was affected by age,and there were significant differences among different age groups(P<0.05),but no significant difference was found in the first and second trimester.Age had no significant effect on FT_(4),TSH and TPOAb in different pregnancies(P>0.05).Compared with the control group,FT_(3),FT_(4) and TSH were different in different pregnancies(P<0.05).With the increase of pregnancy,FT_(3) and FT_(4) showed a downward trend,while TSH showed an upward trend,the differences were statistically significant(P<0.05),while the change trend of TPOAb was not significant(P>0.05).Reference interval of thyroid function indicators in pregnancy was proposed:FT_(3),FT_(4) and TSH were 4.13-6.34pmol/L,12.16-20.44pmol/L,0.06-3.35μIU/mL,respectively.The second trimester were 3.80-6.19pmol/L,9.53-17.95pmol/L,0.28-4.13μIU/mL,and the third trimester were 3.66-5.82pmol/L,9.09-16.56pmol/L,0.46-4.45μIU/mL,respectively.TPOAb was 0-9.18IU/mL throughout pregnancy.Using different reference intervals,the incidence of thyroid disease during pregnancy was different,and the difference of subclinical hypothyroidism(SCH)during pregnancy was statistically significant(P<0.05).Conclusion There are significant differences between the thyroid function indexes of pregnant women and those of non-pregnant women,and FT_(3) are significant differences among different age groups during the third trimester.Establishing the reference interval of thyroid function indexes to distinguish the pregnancy period and age of pregnant women can provide an important reference value for the timely detection of thyroid diseases in clinic,and accurate diagnosis and timely treatment are conducive to the good birth and good fertility.
作者
孙树荣
覃英
李娜
武佳蕾
郭岩岩
杨铁英
SUN Shurong;QIN Ying;LI Na;WU Jialei;GUO Yanyan;YANG Tieying(Department of Clinical Laboratory,Aviation General Hospital,Beijing 100012,China)
出处
《标记免疫分析与临床》
CAS
2023年第2期228-232,共5页
Labeled Immunoassays and Clinical Medicine
关键词
妊娠期
甲状腺功能指标
参考区间
Pregnancy period
Thyroid function index
Reference interval
