济南地区妊娠各期甲状腺激素生物参考区间设定及临床应用

Establishment and Clinical Significance of the Biological Reference Interval of Thyroid Hormone during Different Gestation Periods among Pregnant Women in Jinan

目的:了解济南地区女性妊娠各期甲状腺激素水平变化情况,建立妊娠各期甲状腺激素的生物参考区间.方法:采用电化学发光法,检测932名济南地区健康女性妊娠各期及非妊娠期血清中TSH、FT3、FT4的水平,观察其变化情况,建立妊娠各期甲状腺激素的生物参考区间.结果:妊娠各期甲状腺激素生物参考区间用中位数(M)以及双侧限值M (P25~P975)表示,妊娠期TSH生物参考区间均低于非妊娠期,妊娠早期1.35 (0.24~3.94) uIU/L,妊娠中期1.76 (0.22~4.71) uIU/L,妊娠晚期2.17 (0.61~5.04) uIU/L,妊娠早、中、晚期两两比较,差异具有显著性(P<0.05),妊娠晚期与非妊娠期比较,差异无显著性(P>0.05);妊娠期FT3生物参考区间均低于非妊娠期,妊娠早期4.63 (3.47~5.85) pmol/L,妊娠中期4.41 (3.56~5.64) pmol/L,妊娠晚期4.17 (3.25~5.28) pmol/L,妊娠早、中、晚期及非妊娠期两两比较,差异具有显著性(P<0.05);妊娠期FT4生物参考区间均低于非妊娠期,妊娠早期15.07 (10.46~20.77) pmol/L,妊娠中期13.82 (9.21~18.54) pmol/L,妊娠晚期11.92 (9.77~16.72) pmol/L,妊娠早、中、晚期两两比较,差异具有显著性(P<0.05),妊娠早期与非妊娠期比较,差异无显著性(P>0.05).结论:妊娠各期与非妊娠妇女的甲状腺激素水平存在显著性差异,因此,建立本地区健康女性妊娠各期甲状腺激素的生物参考区间对诊断、治疗妊娠期甲状腺疾病以及相关研究有重要的临床意义.

Objective: To establish the indicators of different gestation periods thyroid hormone of normal pregnant women in Jinan for prepotency guide, detect and analyze the range ofthyroid hormone during different gestation periods among normal pregnant women in our hospital. Methods: 932 healthy pregnant and non-pregnant women inJinan were selected, TSH, FT3 and FT4 levels were measured by using the electro—chemiluminescence method. The biological reference interval ofthyroid hormone during different gestation periods was established among pregnant women. Results: The hormone level and the range ofthyroid hormones in two groups were compared and analyzed, and further represented by the median M and two-sided limits P2.5-P97.5. In study group, the early gestation TSH level was 1.35 (0.24—3.94) uIU/L, the medium—gestation TSH level was 1.76 (0.22—4.71) uIU/L, the late gestation TSH level was 2.17 (0.61—5.04) uIU/L, the TSH levels ofwomen in early middle and late pregnancy were compared, the differences were statistically significant (P<0.05) . There was no significant difference between the late gestation and the control group (P>0.05);In the study group, the early gestation FT3 level was 4.63 (3.47—5.85) pmol/L, the medium—gestation FT3 level was 4.41 (3.56—5.64) pmol/L, the late gestation FT3 level was 4.17 (3.25—5.28) pmol/L, The difference was significant in FT3 level among all the three groups and the control group (P<0.05);In the study group, the early gestation FT4 level was 15.07 (10.46 —20.77) pmol/L, the medium—gestation FT4 level was 13.82 (9.21—18.54) pmol/L, the late gestation FT4 level was 11.92 (9.77-16.72) pmol/L. The FT4 level among all the three groups was significantly different (P<0.05), but there was no significant difference between the early gestation and the control group (P>0.05) . Conelusion: The thyroid hormone levels of normal pregnant women are different from those in non —pregnant women, and the levels show significant deviation during different gestation periods. Therefore, establish trimester—specific reference ranges of thyroid hormones among normal pregnancy is important for clinical practice.