西宁地区不同妊娠期女性甲状腺功能参考范围的建立及比较

Establish and comparison of female thyroid function reference range for different pregnant stages in Xining area

目的建立西宁地区妊娠女性甲状腺特异性血清检测指标的正常参考值范围。方法选取西宁地区905名妊娠女性,按孕周分为孕早期(T1期)、孕中期(T2期)、孕晚期(T3期),采用回顾性横断面调查方法,以中位数及95%可信区间统计方法建立妊娠各期特异性血清促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)正常参考值范围,并进行相关性分析。结果西宁地区血清TSH 95%CI为T1期2.08(0.01~4.97)mIU/L、T2期2.30(0.45~4.97)mIU/L、T3期2.35(0.46~4.98)mIU/L。血清FT395%CI为T1期4.57(3.63~5.70)pmol/L,T2期4.43(3.56~5.71)pmol/L,T3期4.31(3.55~5.52)pmol/L。血清FT495%CI为T1期10.65(6.87~12.90)pmol/L,T2期10.31(6.97~12.95)pmol/L,T3期10.22(6.98~12.88)pmol/L。T1期血清TSH与FT3呈负相关。结论该参考范围与美国甲状腺协会(ATA)推荐参考值范围相比,更适用于青海省妊娠期妇女甲状腺功能监测。

Objective To establish the normal reference value range of thyroid specific serum test indexes among pregnant females in Xining area.Methods A total of 905 pregnant females were selected from Xining area and divided into the early pregnancy stage(T1),middle pregnancy stage(T2)and late pregnancy stage(T3)according to the gestational weeks.The retrospective cross-sectional survey method was adopted.The normal reference value ranges of specific serum TSH,FT3 and FT4 in different stages of pregnancy were established by using the median and 95%confidence interval(CI)statistical methods and the correlation analysis was conducted.Results The 95%CI of serum TSH in the early,middle and late pregnant stages in Xining area was 2.08(0.01-4.97)mIU/L in the T1 stage,2.30(0.45-4.97)mIU/L in the T2 stage and 2.35(0.46-4.98)mIU/L in the T3 stage.The 95%CI of serum FT3 in the early,middle and late pregnant stages was 4.57(3.63-5.70)pmol/L in the T1 stage,4.43(3.56-5.71)pmol/L in the T2 stage and 4.31(3.55-5.52)pmol/L in the T3 stage.The 95%CI of serum FT4 in the early,middle and late stages of pregnancy was 10.65(6.87-12.90)pmol/L in the T1 stage,10.31(6.97-12.95)pmol/L in the T2 stage and 10.22(6.98-12.88)pmol/L in the T3 stage.Serum TSH was negatively correlated with FT3 in the T1 stage.Conclusion Compared with the reference value ranges recommended by ATA,the established reference ranges of serum TSH,FT3 and FT4 are more suitable for the thyroid function monitoring among pregnant women in Qinghai Province.