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目的:建立和评估乌鲁木齐市妊娠妇女妊娠各期特异性血清FT3、FT4,血清TSH的正常参考范围。方法:筛选于本院门诊产检的妊娠妇女663例作为标准人群,电化学发光法测定FT3、FT4,血清TSH、抗甲状腺球蛋白抗体(Tg Ab)、抗甲状腺过氧化物酶抗体(TPOAb),制定妊娠各期甲状腺激素水平各项指标参考范围。收集妊娠各期孕妇2252例,验证参考范围对诊断妊娠期甲状腺疾病的符合性。结果:血清FT3在妊娠早期、妊娠中期、妊娠晚期的参考值范围分别为:3.43~9.94pmol/L,3.53~5.74pmol/L,2.39~5.19pmol/L;血清FT4在妊娠早期、妊娠中期、妊娠!期的参考值范围分别为:9.94~20.21pmol/L,9.69~17.77pmol/L,7.28~15.99pmol/L;血清TSH在妊娠早期、妊娠中期、妊娠晚期的参考值范围分别为:0.06~4.80ml U/L,0.29~5.84ml U/L,0.48~4.56ml U/L。按ATA标准妊娠期总的甲减、亚临床甲减、低T4综合征、甲亢的患病率分别4.9%、32.6%、4.8%和0.7%,按本研究制定的特异性参考范围患病率为0.2%、4.7%、2.3%和1.4%。结论:乌鲁木齐市妊娠妇女的血清甲状腺激素水平具备地域上的特异性,与非妊娠时期差异较大;本研究制定的参考值范围对于诊断妊娠期甲状腺疾病的患病率与国内其他报道基本一致,但与ATA指南的参考值范围诊断的患病率差别较大。
Objective: To establish and evaluate the normal reference range of specific serum FT3, FT4 and serum TSH in pregnancy in Urumqi. Methods: A total of 663 pregnant women were selected as outpatients in this outpatient clinic. The levels of FT3, FT4, serum TSH, anti-thyroglobulin antibody (TPAb), anti-thyroid peroxidase antibody (TPOAb) Development of various stages of pregnancy thyroid hormone levels of reference indicators. Collect 2252 pregnant women of various stages of pregnancy to verify the reference range for the diagnosis of thyroid disease during pregnancy compliance. Results: The reference values of serum FT3 in early pregnancy, second trimester and third trimester of pregnancy were 3.43-9.94pmol / L, 3.53-5.74pmol / L and 2.39-5.19pmol / L, respectively. Serum FT4 was detected in early gestation, second trimester, The range of reference value for pregnancy was 9.94-20.21pmol / L, 9.69-17.77pmol / L and 7.28-15.99pmol / L, respectively. The reference value of serum TSH in early pregnancy, middle pregnancy and late pregnancy were 0.06 ~ 4.80 ml U / L, 0.29 ~ 5.84 ml U / L, 0.48 ~ 4.56 ml U / L. According to the ATA standard, the prevalences of total hypothyroidism, subclinical hypothyroidism, hypo-T4 syndrome and hyperthyroidism were 4.9%, 32.6%, 4.8% and 0.7% respectively. The prevalence of specific reference range 0.2%, 4.7%, 2.3% and 1.4%. Conclusion: Serum thyroid hormone levels in pregnant women in Urumqi are geographically specific and vary significantly from those in non-pregnant period. The range of reference values established in this study is basically consistent with other reports in China for the diagnosis of thyroid disease in pregnancy, However, the prevalence of the diagnosis varies with the reference range of the ATA guidelines.