滨州市汉族妇女妊娠期特异的甲状腺激素参考值  

Establishment of specific reference values of thyroid hormone in Han women during pregnancy in Binzhou

作　　者：高淑红[1] 魏双燕[1] 刘超 徐彦 王丽婷 韩静怡 李小菊 郭山伟 GAO Shuhong;WEI Shuangyan;LIU Chao;XU Yan;WANG Liting;HAN Jingyi;LI Xiaoju;GUO Shanwei(Binzhou Medical University Hospital,Binzhou 256603,Shandong,P.R.China;Binzhou Medical University,Yantai 264003,Shandong,P.R.China)

机构地区：[1]滨州医学院附属医院,山东滨州256603 [2]滨州医学院,山东烟台264003

出　　处：《滨州医学院学报》2022年第2期106-111,共6页Journal of Binzhou Medical University

基　　金：山东省医药卫生科技发展计划(2017WS363);山东省医药卫生科技发展计划(2017WS152)。

摘　　要：目的本研究旨在建立滨州市汉族妇女妊娠期特异的甲状腺激素(TH)参考值。方法采集自2018年1月至12月在滨州医学院附属医院就诊的18~45岁的单活胎健康妊娠期妇女,并根据孕周分为早期妊娠、中期妊娠、晚期妊娠三组;同时选择同一时期的非妊娠期健康妇女作为正常对照组。用电化学发光法检测研究组和对照组的血清游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPO-Ab)、血清抗甲状腺球蛋白抗体(Tg-Ab)五个项目。以95%置信区间为参考值范围,获取妊娠各期的参考值。用本研究建立的妊娠期参考值、非妊娠期参考值和指南推荐的妊娠期参考值三种标准对719例妊娠期妇女进行甲状腺疾病筛查并进行一致性检验。结果建立了我院滨州市汉族妇女妊娠期特异的TH参考值,具体如下TSH、FT_(3)、FT_(4)的参考值在妊娠早期分别是0.25~4.18 mIU/L、3.70~6.13pmol/L、12.66~22.36pmol/L;在妊娠中期分别是0.46~4.41 mIU/L、3.53~5.90 pmol/L、10.17~18.82 pmol/L;在妊娠晚期分别是0.71~5.89 mIU/L、2.98~5.12 pmol/L、9.03~17.03 pmol/L。统计结果显示妊娠早期FT_(3)与非妊娠期无差异,其余均有差异。筛查结果显示,三种标准对妊娠各期临床甲状腺功能减退的筛查均不一致。除妊娠期临床甲状腺功能减退、妊娠中期低甲状腺素血症外,用本研究建立的妊娠期参考值和指南推荐的妊娠期参考值对本院其他妊娠期甲状腺疾病的筛查具有较高的一致性。结论本研究建立了我院滨州市汉族妇女妊娠期特异的TH参考值,为早期诊断和治疗妊娠期甲状腺疾病提供了临床证据。Objective To establish the specific reference values of thyroid hormone(TH)in pregnant Han women in Binzhou City.Methods Healthy pregnant women with a single live fetus and aged 18-45 who visited the Binzhou Medical University Hospital from January to December 2018 were collected and divided into the first trimester,the second trimester and the third trimester according to the gestational age.Non-pregnant healthy women of the same period were selected as the normal control group.The serum FT_(3),FT_(4),TSH,TPO-Ab and Tg-Ab were detected by electrochemiluminescence method in the study groups and the control group.The 95%confidence interval was used as the reference range,so as to obtain the reference values of each pregnant period.And 719 pregnant women were screened for thyroid diseases using three criteria:gestational reference values established by this study,non-gestational reference values established by this study and guideline recommended gestational reference values,and the consistency test was carried out.Results Our hospital′s reference values of TH in Binzhou Han women during pregnancy were established as follows:the reference values of TSH,FT_(3) and FT_(4) in the first trimester were 0.25-4.18 mIU/L,3.70-6.13 pmol/L and 12.66-22.36 pmol/L,respectively;in the second trimester,they were 0.46-4.41 mIU/L,3.53-5.90 pmol/L and 10.17-18.82 pmol/L,respectively;in the third trimester,they were 0.71-5.89 mIU/L,2.98-5.12 pmol/L and 9.03-17.03 pmol/L,respectively.The statistical results showed that there was no difference in FT_(3) between the first trimester and the non-pregnant period,while the rest were different.The screening results showed that the three criteria were not consistent in the screening of clinical hypothyroidism in all stages of pregnancy.Except for clinical hypothyroidism during pregnancy and hypothyroxidemia during the second trimester,the gestational reference values established in this study and the gestational reference values recommended by the guidelines have a high consistency in the

关 键 词：甲状腺激素 参考值 妊娠期 滨州 汉族 

分 类 号：R714.12[医药卫生—妇产科学]