孕37~40周不同年龄妇女甲状腺功能比较

Comparison of thyroid function in different ages of pregnant women with 37~40 weeks of pregnancy

目的:探讨孕37~40周不同年龄段孕妇的甲状腺相关激素水平,并分析甲状腺功能减退(甲减)的发病情况。方法:选取2018年5月至2019年2月既往无甲状腺及其他重大器官疾病史的孕37~40周孕妇,其中<28岁者890例、28~34岁者1137例、35~44岁者393例。电化学发光法检测游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)以及血清促甲状腺素(TSH)水平。结果:3组孕妇间TSH、FT3和FT4水平比较,差异均有统计学意义(P均<0.05)。35~44岁组的TSH水平较<28岁组和28~34岁组明显升高,差异均有统计学意义(P均<0.01);28~34岁组的TSH水平较<28岁组轻微下降,差异无统计学意义(P>0.05)。28~34岁组、35~44岁组的FT3和FT4水平较<28岁组明显下降,差异均有统计学意义(P均<0.01);35~44岁组的FT3和FT4水平较28~34岁组略下降,差异无统计学意义(P>0.05)。3组孕妇的甲减、亚临床甲减患病率比较,差异均无统计学意义(P均>0.05)。结论:甲状腺激素水平与妊娠晚期孕妇的年龄密切相关。甲状腺功能检测对筛查和干预甲减有重要的指导作用,对妊娠晚期妇女极有必要。

Objective:To investigate the levels of thyroid related hormone and to analyze the incidence of hypothyroidism in pregnant women with 37~40 weeks of pregnancy at different ages.Methods:The pregnant women with 37~40 weeks of pregnancy were selected for the study without thyroid and/or other organ medical history from May 2018 to Feb.2019.All these gravidas were divided into different groups by age,group A(<28 years,890 cases)、group B(28~34 years,1137 cases) and group C(35~44 years,393 cases).The chemiluminescent method was used to detect the levels of free triiodothyronire(FT3),free thyroxine(FT4) and serum thyroid stimulating hormone(TSH).Results:The differences of TSH,FT3 and FT4 levels were statistical significance among the three groups(P<0.05).The levels of TSH in group C were significantly higher than those in group A and B,and the differences were statistically significant(P<0.01).The levels of TSH in group B were slightly lower than those in group A,and the difference were not statistically significant(P>0.05).The levels of FT3 and FT4 in groups B and C were significantly lower than those in group A,and the differences were both statistically significant(P<0.01).However,the levels of FT3 and FT4 in group C were slightly lower than those in group B,and there was no significant difference between the two groups(P>0.05).The difference in the prevalence rate of hypothyroidism and subclinical hypothyroidism was not statistically significant among three pregnant(P>0.05).Conclusion:The levels of thyroid related hormone were closely related to gestational age in late pregnancy.Detection of thyroid related hormone levels plays an important role in screening and invention of hypothyroidism,which is also necessary for women in the third trimester of pregnancy.