妊娠妇女甲状腺功能正常参考范围研究

Reference Range of Normal Thyroid Function in Pregnant Women

目的建立核工业四一六医院健康孕妇不同妊娠时期血清甲状腺激素正常参考范围,为评估孕期甲状腺功能及筛查、诊断治疗甲状腺疾病提供依据。方法依据美国临床生化研究院(NACB)的标准:孕妇样本量共1451例为研究组(按孕周分为孕早、中、晚期),选取同期在我院体检中心体检的非妊娠健康妇女共123例作为对照组,比较两组间甲状腺激素水平有无差异。结果非妊娠期妇女与孕妇甲状腺激素比较有统计学意义(P<0.01)。孕妇FT3水平在妊娠早、中、晚期的参考值范围分别为3.52～5.24、3.33～5.53、2.82～5.68pmol/L,血清FT4水平在妊娠早、中、晚期的参考范围分别为13.02～19.8、11.9～20.18、10.41～20.44pomL/L,血清TSH在妊娠早、中、晚期参考范围为0.01～4.12、0.01～3.42、0.02～4.42mIU/L。结论孕妇的甲状腺激素与非妊娠期妇女存在明显的差异,且激素水平有明显的波动,对妊娠不同时期,需需建立不同的血清TSH参考范围。

Objective To establish a normal reference range of serum thyroid hormone in pregnant women of the 416 hospitals in the nuclear industry, and to provide evidence for evaluating thyroid function during pregnancy and screening, diagnosis and treatment of thyroid diseases. Methods According to the American Clinical Biochemical Research Institute(NACB) standard: a total of 1451 pregnant women sample group for the study group(divided into gestational weeks, early, middle and late), selected non-pregnant women in the physical examination at the same time in our hospital. A total of 123 patients were used as a control group, and there was no difference in thyroid hormone levels between the two groups. Results There was a statistically significant difference in thyroid hormone between non-pregnant women and pregnant women(P<0.01). The reference values of FT3 levels in pregnant women in the early, middle and late stages of pregnancy were 3.52~5.24, 3.33~5.53, 2.82~5.68 pmol/L, respectively. The reference range of serum FT4 levels in early, middle and late pregnancy was respectively 13.02~19.8, 11.9~20.18,10.41~20.44 pomL/L, serum TSH in the early, middle and late pregnancy reference range is 0.01~4.12, 0.01~3.42,0.02~4.42 mIU/L. Conclusion There is a significant difference between pregnant women’s thyroid hormones and nonpregnant women, and the hormone levels fluctuate significantly. Different serum TSH reference ranges need to be established for different periods of pregnancy.