基于婚前检查平台的孕前女性甲状腺功能筛查模式分析

Analysis on screening model of thyroid function among progestational women based on premarital examination platform

目的分析基于婚前检查平台的孕前女性甲状腺功能筛查模式。方法选取2017年10月-2018年9月在宜兴市妇幼保健院婚检中心进行孕前优生检查的女性3032例,采用罗氏电化学发光法检查血清促甲状腺素(TSH),采用"二步法"筛查模式,根据TSH情况进一步检查,发现甲状腺功能异常女性。结果甲状腺功能初筛异常检出率是28.43%。TSH≤0.1 mIU/L、TSH≥10.0 mIU/L、4.2 mIU/L≤TSH<10 mIU/L、2.5 mIU/L≤TSH<4.2 mIU/L和TSH≥2.5 mIU/L的检出率分别为0.92%、0.59%、6.27%、20.65%和27.51%。28例TSH≤0.1 mIU/L的女性复查后确诊甲状腺功能亢进25例;834例TSH≥2.5 mIU/L的女性中,749例进行了复查,228例需要药物治疗。发现9.19%的女性存在需要药物干预的甲状腺功能异常。结论利用婚前检查平台对孕前女性进行甲状腺功能筛查对优生意义重大,值得全面推广,目前的"二步法"筛查模式有待不断完善。

Objective To analyze screening model of thyroid function among progestational women based on premarital examination platform.Methods A total of 3032 progestational women receiving progestational eugenic examination in Premarital Examination Center of Yixing Municipal Maternal and Child Health Care Hospital from October 2017 to September 2018 were selected,Roche electrochemical luminescence method was used to detect serum thyroid stimulating hormone(TSH),two step method screening model was used,further examination was conducted according to TSH levels to find the women with abnormal thyroid function.Results The detection rate of abnormal thyroid function was 28.43%.The detection rates of TSH≤0.1 mIU/L,TSH≥10.0 mIU/L,4.2 mIU/L≤TSH<10.0 mIU/L,2.5 mIU/L≤TSH<4.2 mIU/L,and TSH≥2.5 mIU/L were 0.92%,0.59%,6.27%,20.65%,and 27.51%,respectively.Among 28 women with TSH≤0.1 mIU/L,after reexamination,25 women were diagnosed as hyperthyroidism;among 834 women with TSH≥2.5 mIU/L,749 women underwent reexamination,228 women needed drug therapy,and 9.19%of the women had abnormal thyroid function needing drug intervention.Conclusion Thyroid function screening among progestational women based on premarital examination platform has important significance for eugenics,which is worthy of overall popularization,two step method screening model needs to be improved.