首页|三明市妊娠期甲状腺激素参考范围的建立及分析

三明市妊娠期甲状腺激素参考范围的建立及分析

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[目的]建立福建省三明地区妊娠期特异性甲状腺激素参考范围,研究各指标在妊娠期的变化趋势并与国内其他地区水平进行比较.[方法]收集2023年3月29日至2023年6月28日在三明市第一医院产科就诊且符合研究纳入标准的605名单胎妊娠孕妇的临床资料,并纳入同期229名非妊娠妇女作为对照组.检测研究对象的促甲状腺激素(TSH)、游离甲状腺素(FT4)及游离三碘甲状腺原氨酸(FT3)水平.建立妊娠早、中、晚期甲状腺激素参考范围,以P2.5~P97.5区间表示,对比各指标在妊娠期的变化趋势,并与全国各地区相同类型研究结果进行比较.[结果]TSH、FT4、FT3在妊娠各期的总体差异具有统计学意义(P均<0.05).与非妊娠妇女相比,妊娠早期TSH、FT4水平明显降低,妊娠早期FT3水平与非孕期妇女相似.妊娠中期开始,TSH水平升高、FT3及FT4水平逐渐下降.本研究建立的妊娠期甲状腺相关指标参考范围如下:妊娠早期:TSH(0.068,2.943)μU/mL,FT3(4.302,6.888)pmol/L,FT4(8.240,14.719)pmol/L;妊娠中期:TSH(0.419,3.274)μU/mL,FT3(4.074,6.629)pmol/L,FT4(6.726,11.980)pmol/L;妊娠晚期:TSH(0.422,3.570)μU/mL,FT3(3.741,5.850)pmol/L,FT4(6.103,10.347)pmol/L.全国各省市建立的妊娠期甲状腺激素参考范围具有较大差异.[结论]妊娠妇女甲状腺功能与非妊娠妇女不同,且妊娠各期孕妇TSH、FT3、FT4水平存在显著差异.妊娠期甲状腺激素受到地域、人群、实验室检测方法等多因素的影响.因此,建立三明地区特异性的妊娠期甲状腺激素参考范围有益于本地区妊娠人群甲状腺疾病的诊治.
Establishment and Analysis of Reference Intervals for Thyroid Hormones in Pregnant Women from Sanming City
[Objective]To establish the reference intervals of thyroid hormones in pregnant women from Sanming city and compare them with those from other areas in China.[Methods]The study recruited 605 pregnant women and 229 non-pregnant healthy women who visited Sanming First Hospital between March 29 and June 28,2023.Blood samples were se-quentially collected from the participants to determine the serum levels of thyroid stimulating hormone(TSH),free triiodo-thyronine(FT3)and free thyroxine(FT4).The reference intervals of thyroid hormones were established by using a percen-tile range of P2.5 to P97.5 and their changes in different periods of pregnancy were analyzed and compared with those from oth-er areas in China.[Results]There were significant differences in levels of TSH,FT4 and FT3 at different periods of pregnan-cy(all P<0.05).Compared with non-pregnant women,women in first trimester had significantly decreased levels of TSH and FT4,but similar level of FT3.Since the second trimester,TSH level displayed rising tendency,while FT3 and FT4 lev-els showed gradual decrease.The reference intervals of thyroid hormones in the first,second and third trimester of pregnan-cy in Sanming city were TSH(0.068,2.943)μU/mL,FT3(4.302,6.888)pmol/L,FT4(8.240,14.719)pmol/L;TSH(0.419,3.274)μU/mL,FT3(4.074,6.629)pmol/L,FT4(6.726,11.980)pmol/L;TSH(0.422,3.570)μU/mL,FT3(3.741,5.850)pmol/L,FT4(6.103,10.347)pmol/L,respectively.Significant differences were found in the reference in-tervals of thyroid hormones during pregnancy among different areas in China.[Conclusions]The levels of TSH,FT3,FT4 during pregnancy are different from those during non-pregnancy,and also significantly differ in different periods of preg-nancy.Reference intervals of thyroid hormones in pregnant women are affected by various factors such as geographic loca-tion,ethnicity and laboratory test method,etc.Therefore,establishing the population-specific reference intervals of thy-roid hormones will benefit for the diagnosis and treatment of thyroid disease in pregnant women from Sanming city.

pregnancythyroid hormonesreference intervalsthyroid diseasepregnancy outcomeevery province and cityanalysis

林穗雯、姚敏蓉、吴芳燕、赵勇、林金梅、刘斌

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中山大学附属第一医院妇产科,广东 广州 510080

广东省妇产疾病临床医学研究中心,广东 广州 510080

三明市第一医院产科,福建 三明 365099

三明市沙县区总医院妇产科,福建 三明 365500

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妊娠 甲状腺激素 参考范围 甲状腺疾病 妊娠结局 各省市 比较

国家重点研发计划

2021YFC2700703

2024

中山大学学报(医学科学版)
中山大学

中山大学学报(医学科学版)

CSTPCD北大核心
影响因子:1.608
ISSN:1672-3554
年,卷(期):2024.45(3)
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