合肥地区正常孕妇甲状腺功能指标参考范围的初步建立

Preliminary establishment of reference ranges of maternal thyroid function indexes during pregnancy in Hefei area

目的分析合肥地区正常妊娠妇女甲状腺激素水平,初步建立该地区正常孕妇游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)的参考范围。方法选择2015年1月-12月就诊于安徽省第二人民医院的健康孕早期妇女(T1组)440例、孕中期(T2组)372例、孕晚期(T3组)276例及作为对照组的年龄相仿未妊娠妇女(T0组)80例,用贝克曼库尔特DXI800化学发光仪检测以上4组人群FT_3、FT_4、TSH指标。结果以中位数(M)及双侧限值(P_(2.5)和P_(97.5))表示甲状腺激素FT3、FT4、TSH的参考范围。TSH在T1期明显下降,T2期逐渐回升,各期的参考范围分别为1.86(0.11,4.06)m U/L、2.17(0.40,4.98)m U/L、2.48(0.36,5.22)m U/L。FT4在T2期开始下降,各期的参考范围分别为11.86(7.85,16.25)pmol/L、9.85(6.96,12.05)pmol/L、10.92(6.98,11.93)pmol/L。FT3在T1期稍有上升,T2期后逐步下降,各期参考范围分别为4.56(3.59,5.79)pmol/L、4.18(3.35,4.95)pmol/L、4.08(3.24,4.72)pmol/L。结论孕妇的甲状腺激素水平与非妊娠妇女存在明显差异,妊娠各期之间亦存在差异。建立适合该地区各孕期甲状腺功能指标的参考范围有着重要价值。

Objective To analyze thyroid hormone levels of normal pregnant women in Hefei area, preliminarily establish the reference ranges of free triiodothyronine （ FT3 ）, free thyroxine （ FTn ）, thyroid stimulating hormone （TSH） among normal pregnant women in Hefei area. Methods A total of 440 healthy pregnant women during the first trimester of pregnancy （T1 group）, 372 healthy pregnant women during the second trimester of pregnancy （ T2 group）, 276 healthy pregnant women during the third trimester of pregnancy （ T3 group）, and 80 unpregnant women of similar age （TO group） were selected from the hospital from January to December in 2015, DXI800 chemiluminescence apparatus was used to detect FT3 , FT4, and TSH levels in the four groups. Results Median （M） and bilateral limit values （ P25 and P97. 5 ） were used to express reference ranges of FT3 , FT4 , and TSH. TSH level in T1 group decreased significantly, gradually increased in T2 group, the reference ranges of TSH were 1.86 （0. 11 , 4.06） mU/L, 2. 17 （0. 40, 4. 98） mU/L, and 2. 48 （0. 36, 5.22） mU/L, respectively. FT4 level in T2 group decreased significantly, the reference ranges of FT4 were 11.86 （7.85, 16. 25） pmol/L, 9.85 （6.96, 12. 05） pmol/L, and 10. 92 （ 6. 98, 11.93 ） pmol/L, respectively. FF3 level in T1 group increased slightly, gradually increased in T2 group, the reference ranges of FT3 were 4. 56 （3.59, 5.79） pmol/L, 4. 18 （3.35, 4. 95） pmol/L, and 4. 08 （3.24, 4.72） pmol/L, respectively. Conclusion There were significant differences in thyroid hormone levels between pregnant women and unpregnant women, there were significant differences among different stages of pregnancy. The establishment of reference ranges of thyroid hormone during pregnancy in Hefei area has important clinical value.