昆明地区不同妊娠期妇女甲状腺功能指标参考区间的调查及变化分析

Investigation and Change Analysis of Reference Intervals of Thyroid Function Indicators for Women at Different Stages of Pregnancy in Kunming

目的调查昆明地区不同妊娠期妇女甲状腺功能指标的参考区间,探讨其临床意义,为妊娠期妇女甲状腺疾病的筛查和诊断提供依据。方法选择昆明医科大学第二附属医院2017年1月~2018年4月到产科门诊产检的731例妊娠妇女作为观察组,同期选择健康非妊娠期女性271例作为对照组,使用美国雅培i-2000SR化学发光免疫分析仪检测各组人群甲状腺激素水平,对其进行统计学分析,得出变化规律,并建立相应参考区间。结果昆明地区妊娠期妇女的甲状腺激素水平不同,妊娠早、中、晚三期的促甲状腺激素(TSH)分别为0.04~5.53,0.08~4.10和0.20~6.02mIU/L;总三碘甲状腺原氨酸(TT3)分别为1.16~2.90,1.29~2.77和1.11~2.65nmol/L;游离三碘甲状腺原氨酸(FT3)分别为3.40~5.85,2.98~5.01和2.31~4.63pmol/L;总甲状腺素(TT4)分别为65.30~169.81,77.41~170.71和62.34~150.80pmol/L;游离甲状腺素(FT4)分别为11.44~18.67,9.09~16.32和7.94~14.24nmol/L。昆明地区妊娠期妇女甲状腺激素水平与非妊娠期妇女相比差异均具有统计学意义,TSH(H=44.317,P<0.01),TT3(H=157.480,P<0.01),FT3(H=238.164,P<0.01),TT4(H=209.011,P<0.01),FT4(H=398.192,P<0.01)。在妊娠期随着孕周的增加,TT3,TT4先升高后下降,FT3,FT4呈下降趋势,TSH先下降后升高。结论妊娠期妇女甲状腺激素水平与非妊娠期妇女不同,因此建立当地实验室甲状腺功能指标的参考区间非常必要。

Objective To study the change analysis of reference intervals of thyroid function indicators for women at different stages of pregnancy in Kunming,and explore the clinical significance of it in order to provide a basis for screening and diagnosis of thyroid disease for pregnant women.Methods Selected 731 pregnant women who went to the obstetric clinic for prenatal examination at the Second Affiliated Hospital of Kunming Medical University from January 2017 to April 2018 as observation group,and 271 healthy non-pregnant women who went to the medical center for a medical examination at the same hospital and same time as control group.Detected the level of thyroid hormones indicators of the study subjects by using Abbott i-2000SR chemiluminescence immunoassay analyzer,carried out the statistical analysis to obtain the change rule,and established the corresponding reference intervals.Results The thyroid hormone levels of pregnant women in Kunming were different.The TSH in the early,middle and late stages of pregnancy were 0.04~5.53,0.08~4.10 and 0.20~6.02 mIU/L,respectively.The TIB were 1.16~2.90,1.29~2.77 and 1.11~2.65 nmol/L,respectively.The FT3 were 3.40~5.85,2.98~5.01 and 2.31~4.63 pmol/L,respectively.The TT4 were 65.30~169.81,77.41~170.71 and 62.34-150.80 pmol/Lt respectively and the FT4 were 11.44?18.67,9.09~16.32 and 7.94-14.24 nmol/L,respectively.Compared with non-pregnant women,the levels of thyroid hormones indicators of pregnant women in Kunming were different,and the differences were statisticaUy significant TSH(H=44.317,P<0.01),TI3(H=157.48,P<0.01),FT3(H=238.164,P<0.01),TT4(H=209.011,P<0.01)and FT4(H=398.192,P<0.01).With the increase of pregnancy,the TT3 and TT4 increased first and then decreased,the FT3 and FT4 showed a downward trend,and the TSH decreased first and then increased.Conclusion The thyroid hormone level of pregnant women was different from that of non-pregnant women,therefore it has very important clinical significance to establish the reference intervals for regional laboratories.