甲状腺功能指标在妊娠期妇女中的表达及临床意义  

Expression and Clinical Significance of Thyroid Function Indicators in Pregnant Women

作　　者：张彬 ZHANG Bin(Department of Clinical Laboratory,Women and Infants Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]郑州市妇幼保健院检验科,河南郑州450000

出　　处：《河南医学研究》2025年第8期1442-1445,共4页Henan Medical Research

摘　　要：目的探讨甲状腺功能指标在妊娠期妇女中的表达及临床意义。方法回顾性收集2021年10月至2023年9月郑州市妇幼保健院收治的612例孕妇的临床资料,且均于孕早期、孕中期、孕晚期进行甲状腺功能指标[促甲状腺激素(TSH)、游离甲状腺素(FT_(4))、游离三碘甲状腺原氨酸(FT_(3))]检测,并根据孕妇妊娠结局分为妊娠结局良好组(521例)和妊娠结局不良组(91例)。比较两组一般资料和血清TSH、FT_(4)、FT_(3)水平,分析甲状腺功能指标与孕妇妊娠结局的相关性。结果孕妇孕早期时TSH水平低于孕中期、孕晚期,FT_(3)、FT_(4)水平高于孕中期、孕晚期,且孕中期时TSH水平低于孕晚期,FT_(3)、FT_(4)水平高于孕晚期,差异有统计学意义(P<0.05);妊娠结局不良组年龄、孕期天数、孕前体重指数、吸烟史、孕期补充叶酸与妊娠结局良好组比较,差异无统计学意义(P>0.05);妊娠结局不良组孕早期、孕中期、孕晚期TSH水平均高于妊娠结局良好组,FT_(3)、FT_(4)均低于妊娠结局良好组,差异有统计学意义(P<0.05);经点二列相关性分析,结果显示,孕早期、孕中期、孕晚期时TSH水平与孕妇妊娠结局呈正相关(r>0,P<0.05);孕早期、孕中期、孕晚期时FT_(3)、FT_(4)水平与孕妇妊娠结局呈负相关(r<0,P<0.05);受试者工作特征曲线结果显示,孕早期、孕中期、孕晚期TSH、FT_(3)、FT_(4)水平联合预测孕妇妊娠结局的曲线下面积分别为0.943、0.958、0.975,均具有一定预测价值,且3个不同妊娠时期TSH、FT_(3)、FT_(4)联合检测预测孕妇妊娠结局比较,差异无统计学意义(Z_(1)=0.247,P_(1)=0.805;Z_(2)=0.526,P_(2)=0.599;Z_(3)=0.279,P_(3)=0.780)。结论妊娠不同时期孕妇TSH水平呈下降趋势,FT_(3)、FT_(4)水平呈上升趋势,TSH、FT_(3)、FT_(4)水平与孕妇妊娠结局密切相关,且有一定预测价值。Objective To explore the expression and clinical significance of thyroid function indicators in pregnant women.Methods Clinical data of 612 pregnant women admitted to Women and Infants Hospital of Zhengzhou from October 2021 to September 2023 were retrospectively collected.Thyroid function indicators[thyroid stimulating hormone(TSH),free thyroxine(FT_(4)),and free triiodothyronine(FT_(3))]were tested in early,mid,and late pregnancy,and were divided into a good pregnancy outcome group(521 cases)and a poor pregnancy outcome group(91 cases)based on pregnancy outcomes.Baseline data and serum TSH,FT_(4),and FT_(3) levels were compared between two groups,and the correlation was analyzed between thyroid function indicators and pregnancy outcomes in pregnant women.Results In early pregnancy,TSH levels were lower than those in mid pregnancy and late pregnancy,while FT_(3) and FT_(4) levels were higher than those in mid pregnancy and late pregnancy.Moreover,TSH levels in mid pregnancy were lower than those in late pregnancy,and FT_(3) and FT_(4) levels were higher than those in late pregnancy,with a statistical significant difference(P<0.05).There was no statistical significant difference in the age,duration of pregnancy,pre pregnancy body mass index,smoking history,and supplementation of folic acid during pregnancy between the group with poor pregnancy outcomes and the group with good pregnancy outcomes(P>0.05).The TSH levels in the early,mid,and late stages of pregnancy in the group with poor pregnancy outcomes were higher than those in the group with good pregnancy outcomes,while FT_(3) and FT_(4) were lower than those in the group with good pregnancy outcomes,with a statistical significant difference(P<0.05).Through point two column correlation analysis,the results showed that TSH levels in early pregnancy,mid pregnancy,and late pregnancy were positively correlated with pregnancy outcomes(r>0,P<0.05).The levels of FT_(3) and FT_(4) in early,mid,and late pregnancy are negatively correlated with pregnancy outcomes(r<0,P<

关 键 词：甲状腺功能 孕妇 妊娠结局 

分 类 号：R714.25[医药卫生—妇产科学]