石家庄地区正常妊娠妇女甲状腺功能指标正常值范围探讨

目的 通过测定石家庄地区妊娠女性在妊娠各个时期血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)以及血清促甲状腺激素(TSH)的水平,建立该地妊娠妇女的特异性正常参考值范围。方法 试验组按筛选标准纳入妊娠妇女442例,对照组按入组标准纳入健康非妊娠育龄妇女123例。血清FT3、FT4、TSH采用免疫发光化学法测定,按不同孕周分层后对化验指标进行统计分析。结果 血清FT3在妊娠早期、妊娠中期、妊娠晚期的参考值范围分别为:3.39~5.97 pmol/L,3.39~5.14 pmol/L,2.91~5.03 pmol/L;血清FT4在妊娠早期、妊娠中期、妊娠晚期的参考值范围分别为:12.72~18.15 pmol/L,8.81~17.15 pmol/L,6.65~16.82 pmol/L;血清TSH在妊娠早期、妊娠中期、妊娠晚期的参考值范围分别为:1.24~2.46 mU/L,1.46~3.13 mU/L,1.75~3.47 mU/L。按照该参考值为标准,妊娠期临床甲状腺功能减退症(甲减)患病率0.5%,亚临床甲减患病率3.6%,单纯低T4血症的患病率2.0%,TPOAb阳性患病率6.8%。结论 石家庄地区正常妊娠妇女血清甲状腺激素水平正常范围的制定有利于妊娠期甲状腺功能异常疾病的正常诊断和治疗。

Thyroid function tests and normal reference intervals in normal pregnant women of Shijiazhuang area

Objective To establish the gestational month-specific reference intervals (the first trimester of pregnancy, the second trimester of pregnancy, the third trimester of pregnancy) for free triiodothyronine(FT3), free thyroxine (FT4), thyroid stimulating hormone(TSH)in women in Shijiazhuang area.Methods A total of 412 women in pregnancy based on enrollment guidelines were selected as experimental group. Another 123 normal women without pregnancy served as control group. According to the different periods of pregnancy, 412 pregnant women were sub grouped. Taking 2 ml venous blood from everyone after the physical examination on the next day stored in the procoagulant for centralized testing. Serum samples were used to measure free FT3, FT4 and TSH. All the data were processed for statistical analysis.Results The reference range of FT3 during pregnancy in the trimester, middle and late stage respectively were 3.39-5.97 pmol/L,3.39-5.14 pmol/L,2.91-5.03 pmol/L; The reference range of FT4 during pregnancy in the trimester, middle and late stage respectively were 12.72-18.15 pmol/L,8.81-17.15 pmol/L,6.65-16.82 pmol/L; The reference range of TSH during pregnancy in the trimester, middle and late stage respectively were 1.24-2.46 mU/L,1.46-3.13 mU/L,1.75-3.47 mU/L. According to the standard, the gestational hypothyroidism prevalence rate was 0.5% of the reference values and subclinical hypothyroidism prevalence rate 3.6%, simple hypothyroxinemia prevalence 2.0%, TPOAb positive rate 6.8%.Conclusion The normal range defined in thyroid hormones by the methods for pregnant women in Shijiazhuang area benefits the abnormal disease diagnosis and treatment of thyroid in pregnancy.