妊娠期TSH、TPOAb、FT_4水平变化及其相关性探讨

Changes of TSH,TPOAb and FT_4 in Gestation Period and Their Correlation

目的分析妊娠期孕妇甲状腺功能状况,并通过检测提供相关性建议。方法抽取2012年6月至2013年6月我院收治的360例妊娠期孕妇作为研究对象,其中正常妊娠孕妇(A组)280例、甲状腺疾病高危(B组)80例,并根据TPOAb水平将孕妇分为C组(TPOAb阳性,TPOAb>34 Ku/L,120例),D组(TPOAb阴性,TPOAb≤34 Ku/L,240例);比较两组孕产妇甲状腺疾病患病情况,同时分析促甲状腺激素(TSH)与甲状腺过氧化物酶抗体(TPOAb)、血清游离甲状腺素(FT4)等的相关性。结果 (1)A组280例正常妊娠孕妇中,检出甲状腺疾病者共86例,占30.71%,B组80例甲状腺疾病高危孕产妇中,检出甲状腺疾病共32例,占40.00%;(2)基于整个妊娠期,C组TSH水平均高于D组;(3)C、D组血清TSH均和FT4呈负相关性。结论妊娠期孕妇给予甲状腺功能检测具有一定的应用价值,因此,需以该地区正常碘摄入水平的妊娠期特异性甲状腺功能检测标准为依据,进而使妊娠期甲状腺病灶在诊断方面更加准确、更加安全可靠。

Objective To analyze the thyroid function of pregnant women and provide the relevant advice based on testing results. Methods From June 2012 to June 2013, 360 cases of pregnant women adopted in our hospital were selected as research objects, in- cluding 280 cases of normal pregnant women （group A） and 80 cases of high -risk thyroid disease （group B）. According to the level of TPOAb, the pregnant women were divided into group C （TPOAb is positive and more than 34 Ku/L, 120 cases） and group D （TPOAb is negative and less than or equal to 34 Ku/L, 240 cases）. Then the prevalence of thyroid disease in two groups was com- pared, and analysis was made of the correlation between thyroid stimulating hormone （TSH）, thyroid peroxidase antibody （TPOAb）, and serum free thyroid hormone （ FT4 ）. Results （ 1 ） In group A, 86 out of 280 cases of normal pregnant women were detected to have thyroid disease, accounting for 30. 71% , in group B, 32 out of 80 cases of pregnant women with high risk of thyroid disease were detected to have thyroid disease, accounting for 40%. （2） During the whole gestation period, TSH level in group C was higher than that in group D. （3） TSH and FT4 in serum of group C and group D all showed a negative correlation. Conclusion In gestation period, thyroid function test used in pregnant women has certain application value. Therefore, when the iodine intake is at a normal level, it is necessary to take pregnancy specific thyroid function test standard as the basis, which can make the diagnosis of thyroid le- sions in pregnancy more accurate, safer and more reliable.