妊娠期特异性甲状腺激素水平参考值范围建立的初探

Preliminary study on the reference range of specific thyroid hormone levels during pregnancy

目的探索本院妊娠期特异性甲状腺激素参考值范围,为当地妊娠期妇女甲状腺功能评估提供依据。方法选取常规产检门诊建档立卡的425例妊娠期妇女作为妊娠期组;另选取同期53名健康非妊娠妇女作为非妊娠对照组。以中位数及95%可信区间统计方法建立促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺激素(FT_(4))、抗甲状腺过氧化物酶抗体(TPO-Ab)及抗甲状腺球蛋白抗体(TG-Ab)正常参考值范围,比较不同妊娠时期正常孕妇的甲状腺激素水平。结果妊娠期孕妇特异性甲状腺功能的正常参考值为FT_(3):2.16-3.42 pg/ml,FT_(4):0.83-1.35 ng/dl,TSH:0.48-3.76 μIU/ml,妊娠早、中、晚期的参考值范围存在一定差异。妊娠早期、妊娠晚期正常孕妇的FT_(3)、FT_(4)、TPO-Ab及TG-Ab水平较妊娠中期有所增高,而TSH水平有所降低。结论妊娠期与非妊娠期的甲状腺激素水平有所不同。本研究初探的妊娠期甲状腺激素参考范围与国内其他地区的文献大体一致,但仍存在部分差异,因此,有必要根据本地区正常孕妇甲状腺激素的情况,建立符合实际情况的参考值范围,从而降低误诊率。

Objective To explore the reference range of pregnance-specific thyroid honnone in our hospital,and provide evidence for thyroid function assessment of local pregnant women.Methods 425 pregnant women who had been documented in routine delivery clinics were selected as the pregnancy group.Fifty-three healthy non-pregnant women in the same period were selected as non-pregnant control group.The normal reference ranges of thyrotropin(TSH),free triiodothyronine(FT_(3)),free thyroid hormone(FT_(4)),anti-thyroid peroxidase antibody(TPO-Ab)and anti-thyroglobulin antibody(TG-Ab)were established by means of median and 95%confidence interval statistics.To compare thyroid hormone levels in normal pregnant women during difFerent gestation periods.Results The normal reference values of specific thyroid fimction in pregnant women during pregnancy are FT_(3):2.16~3.42 pg/ml,FT_(4):0.83〜1.35 μg/dl,TSH:0.48~3.76μIU/ml,and there are some differences in the reference ranges of early,middle and late pregnancy.Compared with the second trimester,the levels of FT_(3),FT_(4),TPO-Ab and TG-Ab in normal pregnant women in the first and third trimester were increased,while the levels of TSH were decreased.Conclusion The thyroid hormone level in pregnancy is different from that in non-pregnancy.The reference range developed in this study is different from that in China His literatures are generally consistent,but there are still some differences.Therefore,it is very necessary to establish the reference value range of thyroid hormone in early pregnancy in this region.