西安地区妊娠期女性甲状腺激素正常参考值范围的建立

The establishment of normal reference range of thyroid hormone for pregnant women in Xi′an area

目的建立西安地区女性妊娠各期甲状腺激素正常参考值范围。方法收集2017年12月至2018年7月于陕西西安市中心医院产科进行常规产检的孕妇536人,按孕周分为妊娠早期组(T1期,孕周小于或等于12+6周)194人、妊娠中期组(T2期,孕周13~27+6周)212人、妊娠晚期组(T3期,孕周28~40周)130人,61例正常非妊娠期育龄期女性作为对照组。研究对象完成一般情况调查并测定游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、促甲状腺素(TSH)、甲状腺过氧化物酶抗体(TPO-Ab)、抗甲状腺球蛋白抗体(Tg-Ab)、肝肾功能、空腹静脉血糖等指标,参考值范围取95%置信区间(95%CI)。结果妊娠后女性TSH在整个孕期均低于非妊娠期组,随着孕周递增,TSH有逐渐回升趋势;妊娠后FT3、FT4随孕周的增加呈现逐渐下降的趋势。TSH参考值范围在T1、T2、T3期分别为0.12~4.15、0.29~4.20、0.76~4.23 uIU/mL;FT4的参考范围分别是12.59~21.59、11.09~21.11、10.78~17.58 pmol/L;FT3的参考范围分别是4.09~6.66 pmol/L、3.48~6.17 pmol/L、3.51~5.36 pmol/L。结论建立了西安地区妊娠期女性甲状腺激素水平的正常参考值范围,为西安地区妊娠期女性甲状腺疾病的诊断提供依据。

Objective To establish the normal reference value range of thyroid hormones during pregnancy for women in Xi′an.Methods A total of 536 pregnant women who underwent routine obstetric check-ups in the Department of Obstetrics of Xi′an Central Hospital from December 2017 to July 2018 were collected.According to the gestational weeks,194 people were divided into the early pregnancy group(T1 phase,gestational weeks≤12+6 weeks),212 people were the second trimester group(T2,13-27+6 weeks),and 130 people were the late pregnancy group(T3,28-40 weeks),61 normal non-pregnant healthy women of childbearing age were chosen as the control group.The subjects completed the general survey and measured FT3,FT4,TSH,TPO-Ab,TgAb,liver and kidney function,fasting venous blood glucose and other indicators.The reference value range was 95%confidence interval(95%CI).Results The TSH of pregnant women was lower than that of the non-pregnancy group during the entire pregnancy.As the gestational week increased,TSH gradually increased.After pregnancy,FT3 and FT4 showed a gradual decreasing trend with the increase of gestational week.The reference ranges of TSH in T1,T2,and T3 were 0.12-4.15,0.29-4.20,0.76-4.23 uIU/mL,respectively;FT4 were 12.59-21.59,11.09-21.11,10.78-17.58 pmol/L,respectively;FT3 were 4.09-6.66 pmol/L,3.48-6.17 pmol/L,3.51-5.36 pmol/L,respectively.Conclusion The normal reference value range of thyroid hormone levels in pregnant women in Xi′an has been established,which provided a basis for the diagnosis of thyroid diseases during pregnancy in Xi′an area.