妊娠中期妇女甲状腺功能筛查结果分析

目的 探讨妊娠中期妇女甲状腺功能筛查的重要性,为妊娠中期妇女甲状腺疾病的诊疗提供依据.方法 选择277例妊娠中期妇女为妊娠组,162位非妊娠育龄妇女为对照组.采用放射免疫法(RIA)检测FT3、FT4,采用免疫放射法(IRMA)检测TSH.结果 ①妊娠组甲状腺疾病总患病率为14.08％ (39/277),对照组甲状腺疾病总患病率为8.02％(13/162),两组比较差异有统计学意义(P＜0.05).②妊娠组中甲亢(包含亚临床甲亢)患病率为1.44％(4/277),和甲减(包含亚临床甲减)患病率为12.64％(35/277)比较,差异有统计学意义(P＜0.05).对照组甲亢(包含亚临床甲亢)患病率为1.23％(2/162),和甲减(包含亚临床甲减)患病率为6.79％(11/162),差异有统计学意义(P＜0.05).妊娠组甲减(包含亚临床甲减)患病率较对照组升高,差异有统计学意义(P＜0.05).③两组FT3、FT4、TSH结果比较,妊娠组FT4水平低于对照组,差异有统计学意义(P＜0.05);妊娠组TSH水平低于对照组,差异有统计学意义(P ＜0.05);FT3水平无显著差异(P＞0.05).结论 妊娠中期妇女甲状腺疾病患病率增高,以甲减(包含亚临床甲减)居多,对妊娠中期妇女甲状腺功能进行筛查具有重要意义,妊娠期特异性甲状腺激素参考值范围有待明确.

Screening and Analysis of Thyroid Function of Mid-Term Pregnancy

Objective To investigate importance of screening of thyroid function of mid-term pregnant women,and to provide basis for diagnosis and treatment of thyroid disease during the pregnancy.Methods We enrolled 277 mid-term pregnant women(pregnant group) and 162 cases of non-pregnant women (control group) in the study.The FT3 and FT4 were determined by radioimmunoassay (RIA) and the TSH was determined by immunoradiometric assay (IRMA).Results 1.The total prevalence of thyroid disease in pregnancy group was 14.08％ (39/277),the control group was 8.02％ (13/162).The difference of prevalence between two groups was statistically significant(P ＜0.05).2.The prevalence of hypothyroidism (including subclinical hypothyroidism) 12.64％ (35/277) was significantly higher than that of hyperthyroidism(including subclinical hyperthyroidism) 1.44％ (4/277) in pregnant group (P ＜ 0.05).3.FT4 in pregnant group was significantly lower than that in control group (P ＜ 0.05) and so was the level of TSH (P ＜ 0.05).There was no significant difference in the level of FT3 (P ＞ 0.05) between the two groups.Conclusion The prevalence of thyroid diseases during mid-term pregnancy,especially hypothyroidism (including subclinical hypothyroidism) is high.Screening of thyroid function among mid-term pregnant women suggests a significant benefit.The reference range of pregnancy specific thyroid hormone needs to be defined.