健康孕妇早中晚孕期甲状腺激素参考值及其变化的研究

目的研究本地区健康孕妇早、中、晚孕期的甲状腺激素参考值范围及变化规律。方法用化学发光免疫测定方法测定碘充足地区单胎妊娠的健康妇女及年龄匹配的非妊娠妇女甲状腺激素水平,其中孕早期196例,孕中期209例,孕晚期233例,非妊娠妇女138例,分别建立甲状腺激素参考值范围。结果以中位数(M值)及双侧限值(P2.5和P97.5)表示甲状腺激素在孕早、中、晚期及非妊娠妇女的参考值范围,除孕早期FT4外,其余各孕期甲状腺激素水平均与非妊娠妇女有统计学差异;各孕期比较,促甲状腺激素(TSH)在孕早期最低,孕晚期最高,各孕期两两比较有统计学差异(P<0.01);FT4水平在孕早期较中晚期升高(P<0.01);FT3水平在孕早期最高,孕晚期最低,3组间两两比较有统计学差异(P<0.01);TT4水平在孕早中期较孕晚期升高(P<0.01);TT3水平在孕中期最高,孕晚期最低,各孕期两两比较有统计学差异(P<0.01)。结论孕妇的甲状腺激素水平与非妊娠妇女存在明显差别,各孕期之间亦存在明显差异,建立各孕期的甲状腺激素参考值范围是非常必要的。

Trimester Specific Reference Data and Variation of Thyroid Hormones for Normal Pregnancy

Objective To set up the trimester-specific reference ranges and variation of thyroid hormones for normal pregnancy.Methods The thyroid hormones level was measured using automated chemiluminescence immunoassay for normal singleton pregnant women and age-matched non-pregnant women in iodine sufficient areas.The trimester-specific reference ranges of thyroid hormones was established with 196 cases of the early pregnancy,209 cases of the second trimester,233 cases of the third trimester,and 138 non-pregnant women.Results The reference range of each trimester hormone was calculated as median(M value) and two-sided limits(the 2.5th and 97.5th percentile values).Except FT4 at the early pregnancy,there were statistically differences in the rest thyroid hormone between all trimesters pregnancy and non-pregnant women.TSH level was the lowest during the early pregnancy,the highest during the 3rd trimester.There were statistically significant differences in TSH level among all trimesters.FT4 level was higher during the early pregnancy than that during the 2nd and 3rd trimester(P<0.01).FT3 level was the highest during early pregnancy and the lowest during the 3rd trimester.There were statistically significant differences in FT3 level among all trimesters(P<0.01).TT4 level was higher during the 2nd trimester than that during the 3rd one(P<0.01).TT3 level was the highest during the 2nd trimester and the lowest during 3rd trimester.There were statistically significant differences in TT3 level among all trimesters(P<0.01).Conclusion There were significantly differences in the thyroid hormone level between pregnancy and pregnant women,and there was also the significant difference among all trimesters.Therefore,to establish trimester-specific reference data of thyroid hormones during normal pregnancy may be important for clinical practice.