大庆地区469例妊娠期妇女甲状腺功能参考区间的建立

Establishment of reference interval for thyroid function in 469 pregnant women in Daqing area

目的建立不同妊娠期妇女甲状腺功能的参考区间。方法收集469例不同妊娠期妇女的血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)数据,采用中位数(M)及百分位数(P2.5～P97.5)建立95%参考区间。结果孕早期1组:FT33.98～7.49 pmol/L、FT48.04～20.32 pmol/L、TSH0.14～3.65 m IU/L;孕早期2组:FT33.91～6.43 pmol/L、FT48.1～15.42 pmol/L、TSH 0.06～5.12 m IU/L;孕中期:FT34.03～5.96 pmol/L、FT46.71～14.12 pmol/L、TSH 0.18～4.72 m IU/L;孕晚期:FT33.96～6.08 pmol/L、FT46.74～14.26 pmol/L、TSH 0.84～4.98 m IU/L。采用本标准和美国甲状腺协会指南标准筛查临床甲减的检出率分别是0%(0/469)和1.1%(5/469),指南标准检出率高于本标准的检出率(P=0.025)。本标准和指南标准筛查亚临床甲减的检出率分别是1.7%(8/469)和10.0%(47/469),指南标准检出率高于本标准的检出率(P=0.000)。结论建立妊娠期特异性参考值区间,可准确、及时诊断妊娠期甲状腺功能异常。

Objective To establish the reference intervals of thyroid function for pregnant women during different periods of pregnancy in Daqing area.Methods The data of serum free triiodothyronine(FT3),free thyroxine(FT4)and thyrotropin(TSH)were collected from469pregnant women during different periods of pregnancy,and95%reference interval was established with median(M)and percentile(P2.5~P97.5).Results The reference intervals:Early pregnancy group1:FT33.98~7.49pmol/L,FT48.04~20.32pmol/L,TSH0.14~3.65mIU/L;Early pregnancy group2:FT33.91~6.43pmol/L,FT48.1~15.42pmol/L,TSH0.06~5.12mIU/L;Mid-pregnancy:FT34.03~5.96pmol/L,FT46.71~14.12pmol/L,TSH0.18~4.72mIU/L;Late pregnancy:FT33.96~6.08pmol/L,FT46.74~14.26pmol/L,TSH0.84~4.98mIU/L.The detection rates of hypothyroidism screened by this standard and the Guidelines of Thyroid Disease Standard were0%(0/469)and1.1%(5/469)respectively.The detection rate of this standard was lower than that of the standard(P=0.025).The detection rates of subclinical hypothyroidism by this standard and the Guidelines of Thyroid Disease Standard were1.7%(8/469)and10.0%(47/469)respectively.The detection rate of the standard was higher than that of this standard(P=0.000).Conclusion Establishment of the specific reference intervals of gestation can diagnose thyroid dysfunction accurately and timely during pregnancy.