黄河三角洲地区正常孕妇不同孕期甲状腺激素的生物参考区间的研究与建立

目的 研究黄河三角洲地区不同孕期妇女甲状腺激素水平变化的特点,建立适用于黄河三角洲地区正常孕妇早、中、晚孕期的甲状腺激素的生物参考区间。方法 选取黄河三角洲地区身体健康的不同孕期的孕妇765例,应用电化学发光免疫分析法检测其早、中、晚孕期的血清TSH、FT3、FT4、TPO-Ab、TG-Ab,另选身体健康年龄相当的孕龄未孕妇女188例作为对照组,建立无甲状腺疾病孕妇的正常生物参考区间。结果 不同孕期孕妇甲状腺激素水平均有一定的变化,各期孕妇甲状腺激素水平均呈偏态分布,以中位数(M)及双侧限值(P_2.5～P_97.5)表示妊娠各期甲状腺激素的生物参考区间。非妊娠育龄妇女与早、中、晚孕妇组比较,TSH、FT3、FT4差异均有统计学意义(P＜0.05),孕期各组之间比较差异也均有统计学意义(P＜0.05)。与以往各地的报道结果基本相似,但也有个别差异。结论 正常妊娠各孕期妇女的甲状腺激素水平不同,存在差异,且与非妊娠育龄妇女有明显的不同。建立本地区正常孕妇各孕期的甲状腺激素生物参考区间应用于本地区,将有助于鉴别妊娠期妇女甲状腺功能紊乱,给临床诊疗提供帮助。

Study and establishment of thyroid hormones biological reference interval of normal pregnant women during different pregnancy periods in Yellow River Delta

Objective To study the change characteristics of thyroid hormone levels in different pregnant women in the Yellow River Delta, thus to establish a biological reference range of thyroid hormones for normal pregnant women in their early,middle and late stages in the Yellow River Delta.Methods Totally 765 healthy pregnant women were selected in the the Yellow River delta,electro chemiluminescence immunoassay were used to detect their serum TSH,FT3,FT4,TPO-Ab,and TG-Ab, in early, middle and late stages, and at the same time, 188 healthy age-matched non pregnant women were selected as the control group,so as to establish normal reference ranges of thyroid hormones for pregnant women in the Yellow River Delta.Results There were some changes in thyroid hormone levels in pregnant women at different pregnancy stages.The levels of thyroid hormones in pregnant women in different stages showed a partial distribution of thyroid hormones in each stage.The biological reference intervals of thyroid hormone in each stage of pregnancy were indicated by median value (M) and bilateral limit value (P_2.5～P_97.5).Levels of TSH ,FT3 and FT4 were significantly different between non pregnant women of childbearing age and different stages of pregnant women (P＜0.05 ),which were similar to previous reports from other areas apart from few differences.Conclusion The thyroid hormone levels were different among different stages of pregnant women and normal no pregnant women. It is useful to establish a biological reference range of thyroid hormones for pregnant women in their different stages in the Yellow River Delta, which will help to distinguish thyroid dysfunction in pregnant women and to provide useful assistance for clinical diagnosis and treatment.