自贡地区不同年龄阶段妊娠早期妇女甲状腺功能指标参考区间的建立

Establishment of reference intervals for thyroid function indicators in early pregnant women at different ages in Zigong

目的:采用间接法建立四川自贡地区健康妊娠早期妇女不同年龄阶段甲状腺激素测定的参考区间,为临床诊断和治疗提供依据。方法:选取自贡市第一人民医院妇产科建档的2019年1月至2021年12月健康妊娠早期妇女的数据,共1518例。根据孕妇年龄分为A组(<26岁)、B组(26~34岁)、C组(>34岁)3组,以2.5%至97.5%的百分位点数所在区域作为参考区间。对3个年龄阶段目标人群的促甲状腺激素(TSH)、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、血清游离三碘甲状腺原氨酸(FT3)和血清游离甲状腺素(FT4)这5项甲状腺激素数据进行统计分析。结果:不同年龄妊娠早期妇女的TSH、FT3和FT4这3项指标之间无统计学差异,3组年龄合并的参考区间分别为TSH(0.12~3.81 mIU/L)、FT3(2.20~5.03 pmol/L)、FT4(4.79~16.13 pmol/L);不同年龄的TT3、TT4水平有统计学差异,其中年龄小于26岁的妊娠早期妇女的TT3、TT4的参考区间分别为1.04~2.78 nmol/L和91.80~204.88 nmol/L,而年龄大于26岁的妊娠早期妇女的TT3、TT4的参考区间分别为1.04~2.55 nmol/L和82.70~190.00 nmol/L。各指标年龄组A、B、C组与非妊娠组比较,差异均有统计学意义(P<0.05)。结论:建立的自贡地区不同年龄阶段妊娠早期妇女甲状腺激素5项指标参考区间,可为临床疾病诊断、治疗和预后判断提供参考。

Objective:To establish the reference intervals for thyroid hormone measurements in healthy early pregnant women at different ages in Zigong,Sichuan Province,by using the indirect method,to provide evidence for clinical diagnosis and treatment.Methods:Data from healthy early pregnant women who had medical records in the Department of Obstetrics and Gynecology of the First People s Hospital of Zigong from January 2019 to December 2021,1518 cases in total,were selected.The data were categorized into three groups according to the ages of pregnant women:group A(<26 years old),group B(26~34 years old),and group C(>34 years old),and the range from 2.5%to 97.5%was used as the reference interval.Conduct statistical analysis of the five thyroid hormones,including thyroid stimulating hormone(TSH),total triiodothyronine(TT3),total thyroxine(TT4),serum free triiodothyronine(FT3),and serum free thyroxine(FT4),in the data of three age groups.Results:There is no statistical difference among the three indicators of TSH,FT3 and FT4 in early pregnancy women of different ages,and the reference intervals for the three age groups were TSH(0.12~3.81 mIU/L),FT3(2.20~5.03 pmol/L)and FT4(4.79~16.13 pmol/L).There are statistical differences in TT3 and TT4 levels at different ages.The reference intervals of TT3 and TT4 in early pregnancy women under the age of 26 were 1.04~2.78 nmol/L and 91.80~204.88 nmol/L,while those in early pregnancy women over the age of 26 were 1.04~2.55 nmol/L and 82.70~190.00 nmol/L.The differences between group A,B,C and the non-pregnant group were statistically significant(P<0.05).Conclusion:The reference intervals for five thyroid hormone indicators in early pregnant women at different ages in Zigong,Sichuan Province have been established,providing a reference for clinical disease diagnosis,treatment,and prognosis judgment.