呼和浩特地区女性妊娠期甲状腺激素水平参考范围研究

目的建立适合呼和浩特地区女性妊娠期血清促甲状腺激素(thyroid-stimulating hormone,TSH),游离三碘甲状腺原氨酸(free teiiodothyronine,FT3),游离甲状腺素(free thyroxine,FT4)水平参考范围。方法选取2018年6月至2019年6月内蒙古自治区人民医院产科门诊收治进行产检并分娩的妊娠期甲状腺功能正常女性778例作为观察组,其中孕早期263例,孕中期390例,孕晚期125例,另选取非孕期甲状腺功能正常女性150例作为对照组。利用电化学发光法测定TSH、FT3、FT4水平,进行统计学对比分析。结果孕早、中、晚期TSH参考范围为:0.02~3.95 m IU/L、0.47~4.30 m IU/L、0.68~4.54 m IU/L,FT3为:3.64~5.37 pmol/L、3.26~5.18 pmol/L、3.13~4.85 pmol/L;FT4为:11.83~17.68 pmol/L、10.79~15.89 pmol/L、10.14~16.54pmol/L,TSH水平在整个妊娠期逐渐升高,FT3、FT4水平逐渐降低。孕晚期TSH、孕早期FT4水平与对照组相比,差异无统计学意义(P>0.05),其余各期组别之间相比以及与对照组相比,差异均有统计学意义(P<0.05)。采用本实验诊断标准得到临床、亚临床甲减、低甲状腺素血症的患病率与试剂盒诊断标准所得结果不同;两种诊断标准下,孕早、中期患病率相比,差异有统计学意义(P<0.05),孕晚期差异无统计学意义(P>0.05)。结论建立该地区妊娠期女性的甲状腺激素水平的特异参考范围,为临床医生提供早期诊断和治疗依据,具有指导性意义。

Study on reference range of thyroid hormone levels of women during pregnancy in Hohhot

Objective Establish a reference range of serum levels of thyroid-stimulating hormone( TSH),free triiodothyronine( FT3),and free thyroxine( FT4) for women in Hohhot during pregnancy. Methods From June 2018 to June 2019,778 women with normal thyroid function during pregnancy from the obstetrics outpatient department of Inner Mongolia People’s Hospital were admitted to the observation group until pregnancy and delivery,including 263 cases during the first trimester,390 cases during the second trimester,and 125 cases during the third trimester. Another 150 non-pregnant women with normal thyroid function were selected as the control group. The levels of TSH,FT3 and FT4 were measured by electrochemical luminescence method for statistical comparison and analysis. Results The reference ranges of early,middle and late pregnancy TSH were: 0. 02 ~ 3. 95 m IU/L,0. 47 ~ 4. 30 m IU/L,0. 68 ~ 4. 54 m IU/L,and FT3 were: 3. 64 ~ 5. 37 pmol/L,3. 26 ~ 5. 18 pmol/L,3. 13 ~ 4. 85 pmol/L;FT4: 11. 83 ~ 17. 68 pmol/L,10. 79 ~ 15. 89 pmol/L,10. 14 ~ 16. 54 pmol/L,TSH level gradually increased throughout the pregnancy,and FT3 and FT4 levels gradually decreased. Compared with the control group,the levels of TSH and FT4 in the third trimester were not statistically significant( P > 0. 05). The differences between the other groups and the control group were statistically significant( P < 0. 05). The prevalence of clinical,subclinical hypothyroidism,and hypothyroxinemia obtained using this experimental diagnostic criteria was different from the results obtained by the kit diagnostic criteria;under the two diagnostic criteria,there was a statistical difference in the prevalence of pregnancy in the first and second trimesters. The significance was statistically significant( P < 0. 05),and there was no significant difference in the third trimester( P > 0. 05). Conclusion The specific reference range of thyroid hormone levels in pregnant women in this area is established,which provides guidance for clinicians in this area to provide early diagnosis and treatment basis.