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目的分析合肥地区正常妊娠妇女甲状腺激素水平,初步建立该地区正常孕妇游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)的参考范围。方法选择2015年1月-12月就诊于安徽省第二人民医院的健康孕早期妇女(T1组)440例、孕中期(T2组)372例、孕晚期(T3组)276例及作为对照组的年龄相仿未妊娠妇女(T0组)80例,用贝克曼库尔特DXI800化学发光仪检测以上4组人群FT_3、FT_4、TSH指标。结果以中位数(M)及双侧限值(P_(2.5)和P_(97.5))表示甲状腺激素FT3、FT4、TSH的参考范围。TSH在T1期明显下降,T2期逐渐回升,各期的参考范围分别为1.86(0.11,4.06)m U/L、2.17(0.40,4.98)m U/L、2.48(0.36,5.22)m U/L。FT4在T2期开始下降,各期的参考范围分别为11.86(7.85,16.25)pmol/L、9.85(6.96,12.05)pmol/L、10.92(6.98,11.93)pmol/L。FT3在T1期稍有上升,T2期后逐步下降,各期参考范围分别为4.56(3.59,5.79)pmol/L、4.18(3.35,4.95)pmol/L、4.08(3.24,4.72)pmol/L。结论孕妇的甲状腺激素水平与非妊娠妇女存在明显差异,妊娠各期之间亦存在差异。建立适合该地区各孕期甲状腺功能指标的参考范围有着重要价值。
Objective To analyze the levels of thyroid hormone in normal pregnant women in Hefei and to establish the reference range of free triiodothyronine (FT3), free thyroxine (FT4) and thyrotropin (TSH) in normal pregnant women in this area. Methods 440 healthy pregnant women (T1 group) from January 2015 to December 2015 in the Second People’s Hospital of Anhui Province were enrolled in this study. They were 372 pregnant women (T2 group), 276 pregnant women (T3 group) and pregnant women as the control group Of 80 pregnant women with similar age (T0 group). The Beckman Coulter DXI800 chemiluminescence detector was used to detect FT_3, FT_4 and TSH in the above four groups. Results The reference ranges of thyroid hormones FT3, FT4 and TSH were expressed as median (M) and bilateral limits (P 2.5 and P 97.5). TSH decreased significantly in T1 and gradually increased in T2, with the reference ranges of 1.86 (0.11,4.06) mU / L, 2.17 (0.40,4.98) mU / L, 2.48 (0.36,5.22) mU / L. FT4 began to decline in T2 phase, the reference range of each phase were 11.86 (7.85,16.25) pmol / L, 9.85 (6.96,12.05) pmol / L, 10.92 (6.98,11.93) pmol / L respectively. FT3 increased slightly in T1 and gradually decreased in T2, with the reference ranges of 4.56 (3.59, 5.79) pmol / L, 4.18 (3.35, 4.95) pmol / L and 4.08 (3.24, 4.72) pmol / L respectively. Conclusions The level of thyroid hormone in pregnant women is obviously different from that in non-pregnant women, and there are also differences between different stages of pregnancy. It is of great value to establish a reference range suitable for thyroid function index in each area during pregnancy.