建立本地区妊娠各期甲状腺激素参考范围及甲状腺激素变化探讨.docVIP

建立本地区妊娠各期甲状腺激素参考范围及甲状腺激素变化探讨 　　[摘要] 目的 建立徐州地区健康孕妇妊娠各期甲状腺激素的参考值， 探讨其变化规律。 方法 整群选取2015年1―5月正常单胎妊娠孕妇，按孕早、中、晚期分组，以年龄匹配非妊娠健康妇女作为对照组，用电化学发光法测定其甲状腺激素水平并建立各自的参考范围。其中孕早、中、晚期各988、1 734、1 052例，非妊娠妇女 1 203 例，孕期患甲状腺疾病的483例。 结果 早、 中、 晚期孕妇及非妊娠妇女的甲状腺激素水平均呈偏态分布，参考值选择95%可信区间。TSH 在早[1.93（0.37～5.79）]、 中[1.97（0.46～5.10）]、 晚孕期[2.28（0.48～6.37）] 逐渐上升，晚孕期略高于非妊娠妇女 [2.14（0.79～5.30）] 但差异无统计学意义（P 0.05）。FT3 和 FT4 在早 [5.71（4.03～6.26）；16.65（12.86～22.45）]、中 [4.71（3.59～5.99）； 15.24（9.89～20.63）]、 晚孕期 [4.28（3.36～5.54）； 12.33（8.82～16.82）] 逐渐降低，早孕期低于非妊娠妇女 [5.95（4.17～6.60）；17.28（13.01～21.30）]且差异有统计学意义（P 0.05） 。亚临床甲减、甲减和甲亢的发生率分别是9.07%、2.03%、0.23%。结论 正常孕妇的甲状腺激素水平不同于非妊娠妇女， 各孕期之间差异有统计学意义；妊娠期孕激素的变化不足以引起其甲状腺功能的紊乱。 　　[关键词] 妊娠；孕早期；孕中期；孕晚期；甲状腺激素；参考范围；孕激素变化 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2016）04（c）-0061-04 　　[Abstract] Objective To discuss its change law by establishing the reference value of thyroid hormone in each period of pregnancy of healthy pregnant women in Xuzhou region. Methods The normal singleton pregnant women treated from January 2015 to May 2015 were selected and divided into the early， middle and late periods of pregnancy groups with 988， 1 734 and 1 052 cases in each group， and 1 203 cases of healthy and non-pregnancy women at the same age were regarded as the control group， and the thyroid hormone levels were measured by the electrochemiluminescence method and each reference range was established， and there were 483 cases with thyroid disease in pregnancy. Results The thyroid hormone levels of pregnant women in early， middle and late periods of pregnancy and non-pregnancy women showed a biased distribution， 95% confident interval was selected as the reference value， TSH in the early， middle and late periods of pregnancy were respectively [1.93 （0.37～5.79）]， [1.97 （0.46～5.10）] and [2.28 （0.48～6.37）]， which gradually increased， and the TSH in late period of pregnancy was slightly higher than that in non-pregnancy women， which was [2.14 （0.79-5.30）]， but he difference had no statistical