摘要
目的:探讨建立深圳地区正常孕妇各妊娠时期的甲状腺功能指标参考区间。方法:收集本院产科门诊不同妊娠期正常孕妇611例作为妊娠组,另选同期接受健康体检的225例非妊娠育龄妇女作为非妊娠组。检测血清甲状腺功能指标(T3、T4、TSH、FT3、FT4),对比检测结果并制定妊娠各时期的甲状腺功能指标参考区间。结果:妊娠组T3、T4、FT4水平高于非妊娠组(P<0.05),FT3、TSH水平两组无差异(P>0.05)。不同孕期比较显示,妊娠组孕早期T3、FT4水平与非妊娠组无差异(P>0.05)。孕中期FT3水平与非妊娠组有差异(P<0.05)。根据试剂厂家提供的各甲状腺激素参考区间对不同孕周甲状腺功能评估显示,27.8%的T3指标被误判,5.9%的FT4指标被误判,T4、FT3和TSH未见误判。孕早期T3指标的误判率为9.0%,FT4的误判率为5.3%;孕中期T3的误判率为38.3%,FT4的误判率为3.6%;孕晚期T3的误判率为34.7%,FT4的误判率为8.4%。结论:妊娠时期孕妇甲状腺功能指标会发生明显变化,且妊娠早期、中期、晚期的甲状腺功能指标参考范围差异明显,建立本地区、各妊娠时期的甲状腺功能指标参考范围有助于减少过度诊疗。
Objective:To investigate the reference interval establish of thyroid function of normal pregnant women during different pregnancy period in Shenzhen.Methods:611 normal pregnant women during different gestational periods were selected in study group,and 225 normal non-pregnant women of childbearing age were selected in control group during the same period.Serum thyroid function indicators,such as the levels of T3,T4,TSH,FT3,and FT4 of women in both groups were tested,and the reference intervals of thyroid function indicators of pregnant women during different pregnant period were established.Results:The levels of T3,T4,and FT4 of women in the study group were significant higher than those of women in the control group(P<0.05),and there were no significant different in the FT3 and TSH levels of women between the two groups(P>0.05).There were no significant different in T3 and FT4 levels between pregnant women during the first trimester of pregnancy and the non-pregnant women(P>0.05),but the level of FT3 of pregnant women during the second trimester of pregnancy had significant different from that of non-pregnant women(P<0.05).According to the thyroid hormone reference intervals provided by the reagent manufacturer,T3 level of 27.8%women had been misjudged,FT4 level of 5.9%women had been misjudged,but no misjudgments were observed in the levels of T4,FT3 and TSH.The misdiagnosis rates of T3 and FT4 of women during the first trimester of pregnancy were 9.0%and 5.3%,respectively.The misdiagnosis rate of T3 and FT4 of women during the second trimester of pregnancy were 38.3%and 3.6%,respectively.And the misdiagnosis rate of T3 and FT4 of women during the third trimester of pregnancy were 34.7%and 8.4%,respectively.Conclusion:The thyroid function indicators of pregnant women during different pregnant period changes significantly,and the reference ranges of thyroid function indicators during the first,the second,and the third trimester of pregnancy has significant difference.Establishing the local reference ranges of thyroid function indicators of pregnant women will help to reduce over diagnosis and treatment.
作者
何植华
朱岩
段纯
段桂开
谭健辉
HE Zhihua;ZHU Yan;DUAN Chun;DUAN Guikai;TAN Jianhui(Shenzhen Maternal and child Health Care Hospital Affiliated to Southern Medical University,Shenzhen, 518028)
出处
《中国计划生育学杂志》
2020年第8期1262-1265,共4页
Chinese Journal of Family Planning
关键词
妊娠期
甲状腺功能指标
促甲状腺激素
游离甲状腺素
参考区间
深圳
Pregnant period
Thyroid function indicators
Tthyroid-stimulating hormone
Free thyroxine
Reference interval
Shenzhen
作者简介
通信作者:朱岩,zhuyane@hotmail.com。
