巴中地区妊娠期特异性甲状腺功能正常参考值范围的建立  

Establishment of the reference ranges for thyroid-related indicators during pregnancy in Bazhong

作　　者：李黎 马昌军[1] 冯潇宇 张兰[2] 王华[3] LI Li;MA Chang-jun;FENG Xiao-yu;ZHANG Lan;WANG Hua(Department of Endocrinology,Bazhong Central Hospital,Bazhong 636000,Sichuan,China;Department of Obstetrical,Bazhong Central Hospital,Bazhong 636000,Sichuan,China;Department of Clinical Laboratory,Bazhong Central Hospital,Bazhong 636000,Sichuan,China)

机构地区：[1]巴中市中心医院内分泌科,四川巴中636000 [2]巴中市中心医院产科,四川巴中636000 [3]巴中市中心医院检验科,四川巴中636000

出　　处：《川北医学院学报》2023年第8期1134-1137,共4页Journal of North Sichuan Medical College

摘　　要：目的:建立本地区各妊娠期特异性甲状腺功能正常参考值范围。方法:选取850例妊娠期女性为试验组,同期129名备孕的育龄期正常女性为对照组;再根据孕周不同将试验组分为妊娠早期组(孕周≤12+6周,n=277)、妊娠中期组(13~27+6周,n=283)、妊娠晚期组(28~40周,n=290)。化学发光法检测研究对象血清促甲状腺素(TSH)、游离四碘甲腺原氨酸(FT4)、游离三碘甲腺原氨酸(FT3)水平,根据各检测指标95%CI(P_(2.5)~P_(97.5)),建立妊娠各期甲状腺功能正常参考值范围,并与试剂厂家提供的参考值范围运用于实验组诊断,比较两种参考值范围内例数占比。结果:对照组及妊娠早、中、晚期组TSH的参考范围为0.65~4.30 uIU/mL、0.02~3.47 uIU/mL、0.03~3.52 uIU/mL、0.08~3.37 uIU/Ml;FT4的参考范围分别为12.82~21.39 pmol/L、10.43~19.46 pmol/L、10.00~18.53 pmol/L、9.08~16.68 pmol/L;FT3的参考范围分别为3.91~6.34 pmol/L、3.51~5.69 pmol/L、3.40~5.53 pmol/L、3.12~5.14 pmol/L。试验组孕妇血清TSH水平低于对照组(P<0.05),且随妊娠时间延长,TSH水平逐渐上升(P<0.05);FT4、FT3水平均低于对照组(P<0.05),且随妊娠时间延长,FT4、FT3水平逐渐下降(P<0.05)。本研究建立的参考值范围与试剂厂家提供的比较,妊娠早期组血清TSH及FT3水平、妊娠中期组血清FT4及FT3水平、妊娠晚期组血清TSH及FT4水平差异均有统计学意义(P<0.05)。结论:甲状腺激素参考值范围随孕周变化,且有地区差异,有必要针对各地区建立妊娠期特异性甲状腺功能参考值范围,以减少临床误诊或漏诊。Objective:To establish normal reference ranges for specific thyroid function markers during each gestational period in the region.Methods:850 pregnant women were selected as the experimental group,while 129 normal women of childbearing age who were preparing for pregnancy during the same period were selected as the control group.According to different gestational weeks,the experimental group was divided into early pregnancy group(gestational weeks≤12+6 weeks,n=277),mid pregnancy group(13~27+6 weeks,n=283),and late pregnancy group(28~40 weeks,n=290).The levels of serum thyroxine(TSH),free tetraiodothyronine(FT4)and free triiodothyronine(FT3)in all subjects were detected by chemiluminescence method,The 95%CI(P_(2.5)~P_(97.5))of the collected data was used to establish the reference value ranges for each gestation period,and the above reference value range and the manufacturer s reference value range were applied to the same clinical population and the percentage of cases within the two reference value ranges were compared.Results:The reference ranges for TSH in the control group and in early,middle,and late pregnancy were 0.65~4.30 uIU/mL,0.02~3.47 uIU/mL,0.03~3.52 uIU/mL,and 0.08~3.37 uIU/mL,respectively.The reference ranges for FT4 were 12.82~21.39 pmol/L,10.43~19.46 pmol/L,10.00~18.53 pmol/L,and 9.08~16.68 pmol/L,respectively.The reference ranges for FT3 were 3.91~6.34 pmol/L,3.51~5.69 pmol/L,3.40~5.53 pmol/L,and 3.12~5.14 pmol/L,respectively.Pregnant women during pregnancy exhibited lower serum TSH levels compared with the control group,and the TSH levels gradually increased with the prolongation of pregnancy(P<0.05).Serum FT4 and FT3 levels in pregnant women were also lower than those of the control group,and these levels gradually decreased with the prolongation of pregnancy(P<0.05).The reference value ranges established in this study were compared with those provided by the reagent manufacturer,serum TSH and FT3 levels in the early pregnancy group,serum FT4 and FT3 levels in the mid-pregnancy group,and ser

关 键 词：甲状腺激素 妊娠期 参考范围 测定方法 

分 类 号：R714.14[医药卫生—妇产科学] R335.2[医药卫生—临床医学]