青岛地区不同妊娠时期妇女甲状腺素的检测  

DETERMINATION OF SERUM THYROID HORMONES IN PREGNANT WOMEN AT DIFFERENT STAGES OF PREGNANCY IN QINGDAO, CHINA

作　　者：刘德春 亢林萍[1] 李宝来[1] 瓮占平[1] LIU Dechun;KANG Linping;LI Baolai;WENG Zhanping(Obstetrics Department of Qingdao Municipal Hospita,Qingdao 266000,China)

机构地区：[1]青岛市市立医院产科

出　　处：《青岛大学学报（医学版）》2019年第6期726-729,共4页Journal of Qingdao University(Medical Sciences)

基　　金：青岛市科技局科研项目(15-9-2-78-nsh)

摘　　要：目的检测青岛地区妊娠不同时期妇女甲状腺素水平,为其参考值建立提供临床依据。方法选取青岛市市立医院产科门诊2016年1—11月常规产检的正常妊娠妇女1124例,其中妊娠早期366例(早孕组),妊娠中期399例(中孕组),妊娠晚期359例(晚孕组);随机选取同期查体中心22~42岁健康非妊娠妇女643例作为对照组。采用化学发光免疫分析法检测各组妇女促甲状腺素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)水平,以中位数及双侧限值(M,P 2.5~P 97.5)表示妊娠各期甲状腺素的生物参考区间。结果早孕组、中孕组、晚孕组及对照组血清TSH中位数及参考范围分别为(1.46,0.06~4.62)、(1.62,0.06~4.70)、(1.78,0.06~4.82)、(1.89,0.67~4.91)mU/L,FT4则分别为(11.12,8.43~16.41)、(9.53,6.74~13.59)、(8.66,6.24~15.05)、(10.85,8.39~16.03)pmol/L;FT3分别为(4.80,4.00~6.34)、(4.63,3.68~5.93)、(4.33,3.25~5.73)、(4.83,4.00~6.47)pmol/L。早孕组TSH水平显著低于对照组,差异有统计学意义(Z=-6.676,P<0.01);随着妊娠进展,TSH水平逐渐升高,早孕组与中孕组、中孕组与晚孕组比较差异均有统计学意义(Z=-2.005、-1.982,P<0.05)。早孕组FT4水平显著高于对照组,FT3水平显著低于对照组,差异均有统计学意义(Z=-2.891、-3.593,P<0.01),FT4、FT3均随着妊娠进展逐渐下降。结论青岛地区妊娠不同阶段妇女甲状腺素参考值存在差异。Objective To measure serum thyroid hormones in pregnant women at different stages of pregnancy in Qing-dao,China,and to provide a clinical basis for establishing the reference values of serum thyroid hormones in different stages of pregnancy.Methods A total of 1124 healthy pregnant women who underwent routine antenatal examination in the obstetrics outpatient clinic of Qingdao Municipal Hospital from January to November,2016 were selected for this study.They were divided into early pregnancy group(366 cases),mid-pregnancy group(399 cases),and late pregnancy group(359 cases).A total of 643 healthy non-pregnant women aged between 22-42 years in the same period were selected as control group from the Regular Physical Examination Center in Qingdao Municipal Hospital.Thyroid stimulating hormone(TSH),free thyroxine(FT4),and free triiodothyronine(FT3)levels were measured for the women in each group using chemiluminescent immunoassay,and the biological reference intervals of thyroid hormones at different stages of pregnancy were expressed as median and bilateral limits(M,P 2.5-P 97.5).Results The medians and reference ranges of serum TSH,FT4,and FT3 in the early pregnancy group,mid-pregnancy group,and late pregnancy group were as follows:TSH,(1.46,0.06-4.62),(1.62,0.06-4.70),(1.78,0.06-4.82),and(1.89,0.67-4.91)mU/L,respectively;FT4,(11.12,8.43-16.41),(9.53,6.74-13.59),(8.66,6.24-15.05),and(10.85,8.39-16.03)pmol/L,respectively;FT3,(4.80,4.00-6.34),(4.63,3.68-5.93),(4.33,3.25-5.73),and(4.83,4.00-6.47)pmol/L,respectively.The early pregnancy group had a significantly lower TSH level than the control group(Z=-6.676,P<0.01).TSH level gradually increased as pregnancy progressed;TSH was significantly lower in the early pregnancy group than in the mid-pregnancy group,and in the mid-pregnancy group than in the late pregnancy group(Z=-2.005,-1.982;P<0.05).Compared with the control group,the early pregnancy group had a significantly higher FT4 level and a significantly lower FT3 level(Z=-2.891,-3.593;P<0.01);both serum FT4 and FT3 l

关 键 词：妊娠 参考值 促甲状腺素 甲状腺素 

分 类 号：R339.2[医药卫生—人体生理学]