妊娠期女性甲状腺功能指标参考区间的建立与分析  

Establishment and Analysis of Reference Intervals for Thyroid Function During Pregnant Women

作　　者：朱婷婷[1] 李清茹[1] 桑士标[1] 陈志强[1] ZHU Ting-ting;LI Qing-ru;SANG Shi-biao;CHEN Zhi-qiang(Department of Nuclear Medicine,The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属第一医院核医学科,江苏苏州215006

出　　处：《中国血液流变学杂志》2018年第3期320-323,共4页Chinese Journal of Hemorheology

摘　　要：目的建立该实验室妊娠早、中、晚期女性甲状腺激素指标FT4、TSH的参考区间.方法选取就诊于产科且符合美国生化研究院(NACB)纳入标准的妊娠女性1048例作为研究组,220名非妊娠健康女性作为对照组.采用电化学发光法测定血清FT4、TSH浓度水平.结果以中位数(M)和双侧限值(P2.5~P97.5)表示参考区间:(1)孕早、中、晚期FT4的参考区间分别为:15.07(11.39~21.66)pmol/L、12.55(9.81~16.03)pmol/L、9.84(8.03~14.92)pmol/L,孕早、中、晚期FT4水平均低于对照组(P<0.05),且呈逐渐下降趋势,至孕晚期最低;(2)孕早、中、晚期TSH的参考区间分别为:1.47(0.01~4.80)mIU/L、2.05(0.46~4.88)mIU/L、2.10(0.49~5.24)mIU/L,其中孕早期TSH水平明显低于对照组(P<0.05),TSH水平随孕周呈上升趋势,至孕晚期与非妊娠期接近.结论建立该实验室妊娠期女性FT4、TSH的参考区间,有利于降低误诊率,对预防不良妊娠结局有重要的临床价值.Objective To establish the reference intervals of free thyroxine(FT4)and thyroid stimulating hormone(TSH)for thyroid function for the women in early,middle and late pregnancy in the local area.Methods A total of 1 048 pregnant women who were examined in our hospital maternity were selected as study group based on the standard of the National Academy of Clinical Biochemistry(NACB)guidelines,another 220 non-pregnancy healthy women were selected as control group.The levels of FT4 and TSH were determined by electrochemiluminescence immunoassay(ECLIA).Results The reference intervals were calculated by median(M)and two-sided limits(P2.5-P97.5):(1)The reference intervals of FT4 in the first,second and third trimester of pregnancy were 15.07(11.39-21.66)pmol/L,12.55(9.81-16.03)pmol/L,9.84(8.03-14.92)pmol/L respectively.The levels of FT4 in the first,second and third trimester of pregnancy were lower than those in the control group(P<0.05),and presented the downward trend gradually,which were the lowest in the third trimester.(2)The reference intervals of TSH in the first,second and third trimester of pregnancy were 1.47(0.01~4.80)mIU/L,2.05(0.46.4.88)mIU/L,2.10(0.49-5.24)mIU/L respectively.The level of TSH in early pregnancy was significantly lower than that in the control group(P<0.05),which increased with the gestational age,and it was close to the non-pregnancy level in the third trimester.Conclusion Establishing the reference intervals of FT4 and TSH for pregnant women in each laboratory is beneficial to provide more accurate diagnostic basis for clinical.It has important clinical reference value to reduce the misdiagnosis rate and prevent adverse pregnancy outcomes.

关 键 词：妊娠 FT4 TSH 参考区间 

分 类 号：R817.4[医药卫生—影像医学与核医学]