妊娠期甲状腺筛查项目参考区间制定与分析

Establishment and analysis of reference intervals for thyroid tests in pregnant women

目的建立该实验室健康孕妇早、中、晚孕期甲状腺激素水平的参考区间并进行分析。方法对就诊于该院的孕妇进行严格筛查,选出符合纳入标准的420例妊娠6～37周的正常妊娠女性（妊娠组）和120例非妊娠女性（对照组）,采用化学发光免疫分析法检测纳入研究者的血清促甲状腺激素（TSH）、游离甲状腺素（FT4）、总甲状腺素（TT4）、游离三碘甲状腺原氨酸（FT3）、总三碘甲状腺原氨酸（TT3）水平,并建立不同妊娠期,包括早期（0～12周）、中期（13～27周）、晚期（28～40周）的甲状腺激素参考区间,参考区间采用双侧限值95%区间（P2.5～P97.5）表示。结果血清TSH、FT4、TT4、TT3水平妊娠组与对照组比较差异均有统计学意义（P〈0.05）,而FT3的比较差异无统计学意义（P=0.79）。TSH浓度值在妊娠中期与晚期差异无统计学意义（P=0.933）,参考区间可合并为（0.56～3.94）μIU/mL。结论建立妊娠不同时期特异性甲状腺激素的正常参考区间,有利于正确评估妊娠期甲状腺功能异常疾病的临床诊断和治疗。

Objective To establish the reference intervals of thyroid hormone levels fro the women in early ,middle and late preg‐nancy in the local area .Methods Through the strict screening for routine diagnosis of pregnant women who went to the hospital , we choose 420 women with 6-37 weeks of pregnancy and 120 non pregnancy women（control group） .Chemiluminescence was used to detect thyroid stimulating hormone（TSH） ,free thyroxine（FT4 ） ,total thyroxine（TT4 ） ,free triiodothyronine（FT3） ,total triiodo‐thyronine（TT3 ） for the pregnant women in early pregnancy（0-12 weeks） ,mid‐pregnancy（13-27 weeks） ,and late pregnancy（28-40 weeks） and women in control group .Using those data ,we established reference intervals of thyroid hormone and use bilateral limits P2 .5 - P97 .5 to represent .Results The differences of serum TSH ,FT4 ,TT4 ,TT3 concentration between pregnant group and control group were statistically significant（P〈0 .05）;while the difference of serum FT3 concentration between pregnant group and control group was not statistically significant（P=0 .79） .The concentration of TSH was not statistically significantly different in the mid‐pregnancy compared with late pregnancy（P=0 .933） ,the reference interval can be merged as 0 .56-3 .94μIU/mL .Conclu‐sion The establishment of normal reference interval of thyroid hormone concentration in different period of pregnancy respectively is conducive to the diagnosis and treatment of thyroid disease in pregnancy .