摘要
目的:建立本地区育龄期妇女孕早期甲状腺功能的参考范围,并研究其变化趋势,探讨不同参考区间对甲状腺功能异常的检出情况。方法:收集2022年8月-2023年8月常住安顺本地区(户籍及生活均为安顺地区)在我院产检并生产的孕妇,经过筛选纳入364例孕早期(4~13+6周)正常育龄期妇女为研究组,同时对照组选择同期在我院健康体检的健康非妊娠女性165例。采用化学发光免疫分析仪测定两组血清TSH、FT_(3)、FT_(4)、TPOAb、TGAb水平,采用中位数及百分位数[M(P2.5~P97.5)]建立参考范围。探讨孕早期血清TSH、FT_(3)、FT_(4)变化趋势,应用新建参考范围对比试剂参考范围及指南建议的参考范围对本地区364名孕妇进行评估。结果:拟定孕早期甲状腺功能参考范围:TSH1.315(0.108~4.047)uIU/ml、FT_(3)4.62(3.64~5.86)pmol/L(P=0.758)、FT_(4)16.00(12.31~20.70)pmol/L,与对照组参考范围比较TSH、FT_(4)有统计学差异(P<0.001),FT_(3)差异无统计学意义(P=0.758)。孕早期TSH血清浓度在孕4周开始下降,孕10周达最低,孕7周前与孕7~13+6周的TSH中位数有明显差异(P<0.001)。本研究所得参考范围诊断异常甲状腺功能检出率,GGT(妊娠一过性甲状腺毒症)2.74%,高于指南检出率,亚甲减2.19%接近指南范围的发生率。结论:本地区育龄期妇女孕早期甲状腺功能的血清指标与非妊娠期女性有区别,建立当地妊娠早期特异性甲状腺功能参考值指导临床诊断甲状腺疾病有重要意义。
Objective:To establish the reference range of thyroid function in early pregnancy of resident women of childbearing age in this area,and study its change trend,and explore the detection of thyroid function abnormality in different reference range.Methods:From August 2022 to August 2023,pregnant women who lived in Anshun area(household registration and living in Anshun area)and gave birth in our hospital were collected.364 normal women of childbearing age in the first tripregnancy period(4~13+6 weeks)were selected as the study group,while 165 healthy non-pregnant women who underwent physical examination in our hospital during the same period were selected as the control group.Serum TSH,FT_(3),FT_(4),TPOAb and TGAb levels were measured by chemiluminescence immunoassay,and the reference range was established by median and percentile[M(P2.5~P97.5)].To investigate the change trend of serum TSH,FT_(3)and FT_(4)in the first trimester of pregnancy.The new reference range was compared with the reference range of reagent and the reference range recommended by the guidelines.Results:To develop a reference range for thyroid function in early pregnancy:TSH 1.315(0.108~4.047)uIU/ml、FT_(3)4.62(3.64~5.86)pmol/L、FT_(4)16.00(12.31~20.70)pmol/L,Compared with the control group,the reference range of TSH and FT_(4)were significantly different(P<0.001),There was no significant difference in FT_(3)(P=0.758).The serum concentration of TSH in the first trimester began to decrease at 4 weeks of gestation and reached the lowest at 10 weeks of gestation.The median TSH before 7 weeks of gestation had a significant difference from 7 to 13+6 weeks of gestation(P<0.001).In the reference range of this study,the incidence of diagnosis of thyroid dysfunction was 2.74%for GGT(transient thyrotoxicosis of pregnancy),which was higher than the guideline detection rate,and 2.19%for subthyroidism,which was close to the guideline range.The detection rate of abnormal thyroid function in the reference range of this study was 2.74%for GGT(transient thyrotoxicosis of pregnancy),higher than the guideline detection rate,and 2.19%for subhypothyroidism was close to the guideline range.Conclusion:The serum indexes of thyroid function in early pregnancy of women of childbearing age in this region are different from those of non-pregnant women.It is of great significance to establish local specific thyroid function reference value in early pregnancy to guide clinical diagnosis of thyroid diseases.
作者
王洪美
刘洪胜
岳龙飞
陆国梁
杨武
吕镁
WANG Hong-mei;LIU Hong-sheng;YUE Long-fei(The People's Hospital of Anshun,Guizhou Anshun 561000)
出处
《医学检验与临床》
2025年第6期26-30,共5页
Medical Laboratory Science and Clinics
基金
安顺市科技计划项目,项目编号:安市科社2023-03号,项目编号:安市社科(2024)51号。
关键词
孕早期
甲状腺功能
参考范围
Early pregnancy
Thyroid function
Reference range
作者简介
通讯作者:刘洪胜,E-mail:337316217@qq.com。
