陕西省铜川地区妊娠妇女血清甲状腺激素水平参考范围的建立及临床应用  

Establishment and Clinical Application of Reference Intervals of Serum Thyroid Hormone Level of Pregnant Women in Tongchuan

作　　者：周莉莉 刘栋 宋宏庆 ZHOU Li-li;LIU Dong;SONG Hong-qing(Department of Clinical Laboratory,Tongchuan People’s Hospital,Shaanxi Tongchuan 727000,China)

机构地区：[1]铜川市人民医院检验科,陕西铜川727000

出　　处：《现代检验医学杂志》2022年第5期164-167,共4页Journal of Modern Laboratory Medicine

摘　　要：目的建立陕西省铜川地区妊娠妇女血清甲状腺激素水平参考范围,为铜川地区临床诊治妊娠妇女甲状腺疾病提供参考依据。方法①回顾性分析2017年6月1日~2020年10月31日在铜川市人民医院进行甲状腺激素水平检查的健康妇女样本,按照标准筛选后纳入9442例,其中对照组(T_(0))3169例,早孕组(T_(1))2642例,中孕组(T_(2))1895例和晚孕组(T_(3))1736例。使用西门子ADVIA centaur XP全自动化学发光免疫分析仪检测受试者血清中的促甲状腺激素(thyroid stimulating hormone,TSH)、总三碘甲状腺原氨酸(total triiodothyronine,TT3)、甲状腺素(total thyroxine hormone,TT4)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)和游离甲状腺素(free thyroxine hormone,FT4)水平。②使用该研究建立的参考范围和《妊娠及产后甲状腺疾病诊治指南》第二版提供的参考范围,对纳入人群进行筛查,比较不同孕期甲状腺疾病的检出率。结果①妊娠三期血清甲状腺激素水平不同,早、中、晚期和对照组TSH参考范围分别为1.64(0.06~6.74)mIU/L,1.94(0.06~5.80)mIU/L,2.35(0.74~4.71)mIU/L和2.42(0.55~7.59)mIU/L;TT3分别为2.01(1.30~3.24)nmol/L,2.51(1.62~3.71)nmol/L,2.44(1.48~3.53)nmol/L和1.69(1.16~2.39)nmol/L;TT4分别为131.30(77.83~230.80)nmol/L,159.40(96.60~246.20)nmol/L,155.30(92.10~247.00)nmol/L和104.40(65.10~152.70)nmol/L;FT3分别为4.89(4.00~6.12)pmol/L,4.59(3.65~5.79)pmol/L,4.02(3.22~4.96)pmol/L和5.04(3.97~6.19)pmol/L;FT4分别为14.33(11.16~19.23)pmol/L,13.64(10.22~18.55)pmol/L,12.84(10.05~20.09)pmol/L和14.81(11.54~17.20)pmol/L。TSH在妊娠期低于非妊娠期,早孕期最低,中晚孕期有逐渐回升趋势;TT3和TT4在整个妊娠期高于未妊娠期;FT3和FT4在整个妊娠期低于未妊娠期。四组间TSH,TT3,TT4,FT3和FT4比较,差异均有统计学意义(Z=457.225~2927.436,均P<0.05)。②相较于《指南》中的通用参考范围,使用新建的参考范围时,妊娠期单纯低甲状腺素血症、妊娠期亚临床Objective To establish the reference intervals of serum thyroid hormone level of pregnant women in Tongchuan,so as to provide reference basis for clinical diagnosis and treatment of thyroid diseases during pregnancy.Methods①A retrospective analysis was made on the samples of healthy women who underwent thyroid hormone level examination in Tongchuan People’s Hospital from June 1,2017 to October 31,2020.9442 cases were included after screening according to the standard,of which the control group(T_(0))3169 cases,2642 cases in early pregnancy group(T_(1)),1895 cases in middle pregnancy group(T_(2))and 1736 cases in late pregnancy group(T_(3)).The serum thyroid stimulating hormone(TSH),total triiodothyronine(TT3),total thyroxine hormone(TT4),free triiodothyronine(FT3)and free thyroxine hormone(FT4)were detected by ADVIA centaur XP automatic luminescence immune analyzer.②Using the reference intervals established by this study and the reference intervals provided by the guide Chinese Medical Association Guideline on diagnosis and management of thyroid diseases during pregnancy and postpartum(2nd edition)to screen and compare the detection rates of thyroid diseases in different pregnancy periods for the included population.Results①The levels of serum thyroid hormones were different among three periods of pregnancy women.Reference interval of TSH were 1.64(0.06~6.74)mIU/L,1.94(0.06~5.80)mIU/L,2.35(0.74~4.71)mIU/L and 2.42(0.55~7.59)mIU/L respectively in the early pregnancy,middle pregnancy,late pregnancy and control group.TT3 were 2.01(1.30~3.24)nmol/L,2.51(1.62~3.71)nmol/L,2.44(1.48~3.53)nmol/L and 1.69(1.16~2.39)nmol/L,respectively.TT4 were 131.30(77.83~230.80)nmol/L,159.40(96.60~246.20)nmol/L,155.30(92.10~247.00)nmol/L and 104.40(65.10~152.70)nmol/L,respectively.FT3 were 4.89(4.00~6.12)pmol/L,4.59(3.65~5.79)pmol/L,4.02(3.22~4.96)pmol/L and 5.04(3.97~6.19)pmol/L,respectively.FT4 were14.33(11.16~19.23)pmol/L,13.64(10.22~18.55) pmol/L,12.84(10.05~20.09)pmol/L and 14.81(11.54~17.20)pmol/L,respectively.TSH in pregn

关 键 词：妊娠 甲状腺激素 

分 类 号：R446.11[医药卫生—诊断学]