维吾尔族与汉族女性妊娠早期甲状腺激素水平比较

Comparison of thyroid hormone levels between Uyghur and Han women in early pregnancy

目的 通过比较维吾尔族和汉族女性妊娠早期甲状腺激素水平的差异,为初步建立本地区妊娠早期女性甲状腺激素正常参考值范围提供参考依据。方法 选取2015年10月至2016年1月于喀什地区第二人民医院产检的280例妊娠早期健康女性和同期于喀什地区妇幼保健院体检的216例非妊娠健康女性为研究对象,测定所有研究对象的血清促甲状腺激素（thyroid stimulating hormone,TSH）、游离甲状腺素（free thyroxine,FT_4）、游离三碘甲腺原氨酸（free triiodothyronine,FT_3）、总甲状腺素（total thyroxine,TT_4）、总三碘甲腺原氨酸（total triiodothyronine,TT_3）、甲状腺过氧化物酶抗体（thyroid peroxidase antibodies,TPOAb）及甲状腺球蛋白抗体（thyroglobulin antibody,TGAb）水平,比较妊娠早期与非妊娠期的维吾尔族、汉族女性甲状腺激素水平的差异。结果 非妊娠期维吾尔族女性FT_3水平高于非妊娠期汉族女性（P〈0.01）,FT_4水平低于非妊娠期汉族女性（P〈0.05）;但FT_3和FT_4水平之和两组间比较无显著差异（P〉0.05）。妊娠早期维吾尔族女性FT_3、FT_4、TT_4水平均低于妊娠早期汉族女性（P〈0.05）,TGAb水平高于妊娠早期汉族女性（P〈0.05）。维吾尔族与汉族妊娠早期女性的TT3、TT4、FT_4水平均高于同民族非妊娠期女性（P〈0.01）,TSH水平均低于同民族非妊娠期女性（P〈0.01）。以中位数及双侧限值（P2.5~P97.5）比较甲状腺激素测定值范围在妊娠早期及非妊娠期女性中的差异,初步确定妊娠早期维吾尔族和汉族女性TSH的正常参考值分别为〈5.5μIU/ml和4.8μIU/ml。结论 妊娠早期与非妊娠期的维吾尔族与汉族女性血甲状腺激素水平存在差异,因此应分别建立新疆喀什地区妊娠早期维吾尔族和汉族女性甲状腺激素水平正常值参考范围,以避免对妊娠早期女性甲状腺疾病的临床诊疗造成漏诊和误诊。

Objective To compare the thyroid hormones levels between Uyghur and Han women in earlypregnancy, and to provide the normal reference value ranges of preliminary establishment in early pregnancy. Method From October 2015 to January 2016, 280 healthy pregnant women in Kashgar Prefecture Second People＇s Hospital and 216 healthy non-pregnant women in Kashgar Prefecture Matemal and Child Health Hospital were selected as the study objects. Determined the blood samples for laboratory test of serum thyroid stimulating hormone level （TSH）, serum free thyroxine （FT4）, serum free triiodothyronine （FT3）, serum total thyroxine （TT4）, serum total triiodothyronine （TT3）, serum thyroid peroxidase antibodies （TPOAb） and serum thyroglobulin antibodies （TGAb） of all the subjects. Compared the differences of thyroid hormone levels between the Uygttr and Han women in early pregnancy and non-pregnant women. Result Serum FT3 level in Uyghur non-pregnant women was higher than that of Han non-pregnant women （P 〈 0.01）, while serum FT4 level was much lower （P 〈 0.05）, the differences of sum ofFT3 and FT4 were not significant （P 〉 0.05）. Among women in early pregnancy, all the serum levels of FT3, FT4 and TT4 were significantly lower in Uyghur women than those of Han women （P 〈 0.05）, while serum TGAb level was higher （P 〈 0.05）. However, serum levels of TT3, TSH and TPOAb showed no significant differences （P 〉 0.05）. Compared with non- pregnant women, women in early pregnancy showed increased serum levels of TT3, TT4 and FT4 （P 〈 0.01）, and a significant decrease of serum TSH level in both Uyghur and Han women （P 〈 0.01）. We have determined the normal reference range according to the value from the 2.5th percentile to the 97.5^th percentile and the normal reference value of serum TSH level for both Uyghur and Han women in early pregnancy should be lower than 5.5 μIU/ml and 4.8 ktlU/ml respectively. Conelusion Thyroid hormone levels in Uyghur women and Han women are different. Therefore, it is necessary to establish a normal reference value of thyroid hormone levels in local area for Uyghur and Han women in early pregnancy respectively, to prevent misdiagnosis in the clinical practice of thyroid disease in early pregnancy.