永康地区正常妊娠妇女甲状腺功能指标参考值的研究

Survey on the reference range for thyroid-ralated indicators in normal pregnant women in Yongkang area

目的建立永康市正常孕妇妊娠各期甲状腺功能指标的参考值。方法收集2017年6月-12月在永康市妇幼保健院产检妊娠妇女为研究对象,经过筛选共纳入449例。采用全自动电化学发光免疫分析方法进行甲状腺功能7个项目的测定,并依测定数据统计分析得到各个项目的双侧95%医学参考值范围。结果研究获得本院正常妊娠妇女各孕期甲状腺激素的参考值如下:早孕期,TSH:0.04μIU/ml^4.14μIU/ml,FT4:1.01 ng/dl^1.78 ng/dl,FT3:2.52 pg/ml^4.31 pg/ml;中孕期,TSH:0.02μIU/ml^4.77μIU/ml,FT4:0.85 ng/dl^1.71 ng/dl,FT3:2.34 pg/ml^4.39 pg/ml;晚孕期,TSH:0.24μIU/ml^5.63μIU/ml,FT4:0.74 ng/dl^1.30 ng/dl,FT3:2.11 pg/ml^3.58 pg/ml。年龄对妊娠妇女甲状腺功能影响并不大。根据美国甲状腺协会推荐标准和本研究的参考值诊断本院妊娠妇女亚临床甲状腺功能减退的患病率分别为17.59%和2.23%。结论甲状腺激素在妊娠各期之间的差异有统计学意义,不同地区妊娠妇女甲状腺激素参考值也存在差异,建立适合本地区的特异性甲状腺激素参考值有助于妊娠期甲状腺疾病的诊疗。

Objective To establish the reference range of thyroid-related indicators in normal pregnant women in Yongkang area.Methods A total of 449 pregnant women were collected in Yongkang Maternity and Children's Hospital from June to December 2017.Seven thyroid-related indicators were measured by electrochemiluminescence immunoassay.To establish their two-sided reference range.Results The reference range of thyroid-related indicators during pregnancy in normal pregnant women in our hospital were as follows,in the first trimester:TSH:0.04μIU/ml-4.14μIU/ml,FT4:1.01 ng/dl-1.78 ng/dl,FT3:2.52 pg/ml-4.31 pg/ml,in the second trimester:TSH:0.02μIU/ml-4.77μIU/ml,FT4:0.85 ng/dl-1.71 ng/dl,FT3:2.34 pg/ml-4.39 pg/ml,in the third trimester:TSH:0.24μIU/ml-5.63μIU/ml,FT4:0.74 ng/dl-1.30 ng/dl,FT3:2.11 pg/ml-3.58 pg/ml.Age had no significant effect on thyroid function in pregnant women.The prevalence of subclinical hypothyroidism in pregnant women in our hospital was 17.59%and 2.23%according to the recommended standard of the American thyroid association and the reference range of our study.Conclusion The difference of thyroid hormone at 3 pregnancy stages was statistically significant.Thyroid hormone reference range of pregnant women is also different in different regions.The establishment of specific thyroid hormone reference range is conducive to the diagnosis and treatment of thyroid diseases during pregnancy.