不同妊娠期孕妇甲状腺激素水平的研究分析

The analysis of thyroid hormone levels of different pregnant trimesters

目的探讨不同孕期妊娠妇女甲状腺相关激素水平并对妊娠期甲状腺常规检查提出建议。方法回顾性分析既往无甲状腺相关疾病史的不同妊娠期妇女（妊娠组）1 500例[其中早期妊娠（≤12周末）组500例、中期妊娠（13-27周末）组500例、晚期妊娠（28周~妊娠）组500例]和健康非孕女性（正常对照组）200名的血清甲状腺激素[包括游离三碘甲腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）、甲状腺球蛋白抗体（A-TG）、抗甲状腺过氧化物酶抗体（TPOAb）]水平,并进行统计学分析。结果早、中、晚期妊娠组血清甲状腺激素水平与正常对照组比较差异均有统计学意义（P〈0.05）,妊娠组甲状腺疾病患病率（8.53%）高于正常对照组。早、中、晚期妊娠3组之间FT3、FT4、TSH水平差异均有统计学意义（P〈0.05）;早期妊娠组、中期妊娠组和晚期妊娠组TSH水平逐渐上升,FT3、FT4则逐渐下降;晚期妊娠组ATG、TPOAb阳性率分别为4.6%和3.6%,均低于早期妊娠组（12.4%、11.4%）和中期妊娠组（9.0%、8.2%）。结论妊娠妇女血清甲状腺激素水平与孕期密切相关,应对孕产妇进行常规血清学甲状腺激素水平筛查和干预,以达到优生优育。

Objective To investigate the thyroid related hormones of differenct pregnant trimesters and put forward suggestions about related routine tests.Methods 1 500 cases of pregnant women at different trimesters were retrospectively analyzed,including 500 cases in first trimester（〈 12 weeks）,500 cases in second trimester（13-27 weeks） and 500 cases in third trimester（28 weeks to delivery）.200 healthy non-pregnant women were selected as control group.The serum thyroid hormone levels were tested,such as free 3,5,3＇-triiodothyronine（FT3）,free thyroxine（FT4）,thyroid stimulating hormone（TSH）,thyroglobulin antibody（A-TG） and anti-thyroid peroxidase antibody（TPOAb）.Statistical analysis were performed.Results There was statistical significance between the pregnant group and control group in terms of serum thyroid hormones levels（P〈0.05）.The morbidity rate of pregnant group was higher（8.53%） than that of control group.The difference among the different trimesters showed statistical significance（P〈0.05）.From first to third trimesters,TSH levels increased gradually while FT3,FT4 decreased gradually.The positive rates of ATG and TPOAb were 4.6% and3.6%,respectively for the third trimester,which were lower than first（12.4%,11.4%） and second trimester groups（9.0%,8.2%）.Conclusions There is close relationship between serum thyroid hormones level and trimesters.The pregnant women should be screened for serum thyroid hormones levels and intervened if necessary,in order to achieve better delivery.