沧州地区妊娠妇女甲状腺功能及参考值范围的初步研究

A preliminary study on reference value of thyroid function of pregnant women in Cangzhou

目的建立沧州地区妊娠妇女妊娠期甲状腺功能及参考值范围,为本地区筛查和监测孕妇甲状腺功能异常提供依据。方法于2013年8月至2014年12月选取正常妊娠妇女647例作为研究组,由于甲状腺功能参考值具有孕龄特异性,故按孕周分为孕早期（1～12周）、孕中期（13～27周）、孕晚期（28～40周）三组,另选取健康非孕妇女174例作为对照组,采用电化学免疫分析法测定其血清促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT_3）、游离甲状腺素（FT_4）水平。结果妊娠妇女血清TSH水平在孕早期、孕中期低于对照组,差异均有统计学意义（P〈0.05）;血清FT_3、FT_4水平变化相似,孕早期、孕中期、孕晚期均低于对照组,孕早期高于孕中期,孕中期高于孕晚期,差异均有统计学意义（P〈0.05）。结论妊娠期妇女甲状腺激素水平随妊娠期不同发生相应改变,孕早期血清TSH较低,FT_3、FT_4较高。

Objective To establish the reference range of thyroid function during three pregnancy phases in Cangzhou and to provide the evidence for the screening and monitoring of thyroid function in pregnant women. Methods In August, 2013 to December, 2014,647 normal pregnant women were selected as the object group and were divided into early pregnancy period（1-12 weeks）, middle pregnancy period（13-27 weeks） and late pregnancy period（28-40 weeks）. A total of 174 healthy non-pregnant women were selected as the control group. The serum levels of TSH, FT_3 and FT_4 were determined by electrochemical immunoassay. Results Serum TSH levels in early pregnancy and middle pregnancy phase were significantly lower than those in control group（P〈0.05）, while in the late pregnancy phase it was slightly higher than that in control group（P〈0.05）; As for the changes of serum FT_3 and FT_4 levels, they were significantly lower in early pregnancy, middle pregnancy and late pregnancy phases compared with the control group（P〈0.05）, and with a significant rank of early pregnancy middle pregnancy late pregnancy（P 0.05）. Conclusion Thyroid hormones levels of pregnant women may change in different pregnancy phases and the development of the reference values of thyroid function in pregnant women is of great significance.