中华内分泌代谢杂志
中華內分泌代謝雜誌
중화내분비대사잡지
CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
2008年
6期
609-612
,共4页
阎玉芹%董作亮%董玲%王锋锐%杨学明%金行一%林来祥%孙毅娜%刘嘉玉%陈祖培
閻玉芹%董作亮%董玲%王鋒銳%楊學明%金行一%林來祥%孫毅娜%劉嘉玉%陳祖培
염옥근%동작량%동령%왕봉예%양학명%금행일%림래상%손의나%류가옥%진조배
妊娠%甲状腺激素%参考值
妊娠%甲狀腺激素%參攷值
임신%갑상선격소%삼고치
Pregnancy%Thyroid hormones%Reference values
目的 建立正常孕妇早、中、晚孕期的甲状腺激素参考值范围,为诊断、治疗、监测(或筛查)孕妇甲状腺疾病以及相关研究提供参考.方法 在碘营养充足地区一次性横断面调查孕妇及非妊娠妇女,通过统一设计的调查表和实验室检测结果严格筛选出505名不同孕期的正常孕妇和153名正常非妊娠妇女(作为对照),建立甲状腺激素参考值范围;甲状腺激素测定采用化学发光免疫测定方法,参考值范围采用中位数(P50)及双侧限值(P2.5和P97.5)表示.结果 进入本研究的所有妇女家庭均食用加碘盐,她们的尿碘中位数均达到了适宜水平,表明这些妇女不存在碘缺乏或碘过量.孕妇的TSH水平在孕早期明显低于非妊娠妇女(P<0.01),孕中期开始回升,但到孕晚期时仍未完全恢复到非妊娠水平;孕妇的FT4和FT3,随妊娠时间逐渐下降,孕中期和孕晚期均明显低于非妊娠妇女(P<0.01);孕妇的TT4和TT3自孕早期开始即明显升高(P<0.01),至孕中期达峰值,大约是非妊娠的1.5倍.结论 孕妇的甲状腺激素水平不同于非妊娠妇女,早、中、晚孕期之间也存在明显差异.因此,建立正常孕妇早、中、晚孕期的甲状腺激素参考值范围具有临床意义.
目的 建立正常孕婦早、中、晚孕期的甲狀腺激素參攷值範圍,為診斷、治療、鑑測(或篩查)孕婦甲狀腺疾病以及相關研究提供參攷.方法 在碘營養充足地區一次性橫斷麵調查孕婦及非妊娠婦女,通過統一設計的調查錶和實驗室檢測結果嚴格篩選齣505名不同孕期的正常孕婦和153名正常非妊娠婦女(作為對照),建立甲狀腺激素參攷值範圍;甲狀腺激素測定採用化學髮光免疫測定方法,參攷值範圍採用中位數(P50)及雙側限值(P2.5和P97.5)錶示.結果 進入本研究的所有婦女傢庭均食用加碘鹽,她們的尿碘中位數均達到瞭適宜水平,錶明這些婦女不存在碘缺乏或碘過量.孕婦的TSH水平在孕早期明顯低于非妊娠婦女(P<0.01),孕中期開始迴升,但到孕晚期時仍未完全恢複到非妊娠水平;孕婦的FT4和FT3,隨妊娠時間逐漸下降,孕中期和孕晚期均明顯低于非妊娠婦女(P<0.01);孕婦的TT4和TT3自孕早期開始即明顯升高(P<0.01),至孕中期達峰值,大約是非妊娠的1.5倍.結論 孕婦的甲狀腺激素水平不同于非妊娠婦女,早、中、晚孕期之間也存在明顯差異.因此,建立正常孕婦早、中、晚孕期的甲狀腺激素參攷值範圍具有臨床意義.
목적 건립정상잉부조、중、만잉기적갑상선격소삼고치범위,위진단、치료、감측(혹사사)잉부갑상선질병이급상관연구제공삼고.방법 재전영양충족지구일차성횡단면조사잉부급비임신부녀,통과통일설계적조사표화실험실검측결과엄격사선출505명불동잉기적정상잉부화153명정상비임신부녀(작위대조),건립갑상선격소삼고치범위;갑상선격소측정채용화학발광면역측정방법,삼고치범위채용중위수(P50)급쌍측한치(P2.5화P97.5)표시.결과 진입본연구적소유부녀가정균식용가전염,저문적뇨전중위수균체도료괄의수평,표명저사부녀불존재전결핍혹전과량.잉부적TSH수평재잉조기명현저우비임신부녀(P<0.01),잉중기개시회승,단도잉만기시잉미완전회복도비임신수평;잉부적FT4화FT3,수임신시간축점하강,잉중기화잉만기균명현저우비임신부녀(P<0.01);잉부적TT4화TT3자잉조기개시즉명현승고(P<0.01),지잉중기체봉치,대약시비임신적1.5배.결론 잉부적갑상선격소수평불동우비임신부녀,조、중、만잉기지간야존재명현차이.인차,건립정상잉부조、중、만잉기적갑상선격소삼고치범위구유림상의의.
Objective To set up the trimester-specific reference ranges of thyroid hormones for normal pregnant women to provide reference criteria for diagnosis, treatment and monitoring or screening of thyroid disease during pregnancy and related research. Methods A cross-sectional survey was conducted in pregnant and non-pregnant women in iodine sufficient areas. A total of 505 normal pregnant women and 153 normal non-pregnant women (as control) were selected for establishing trimester-specific reference ranges of thyroid hormones after rigorous screening through the survey questionnaire and laboratory tests. Thyroid hormones were measured by Bayer automated chemiluminescence immunoassay, and the reference range of each hormone was calculated as median (the 50th percentile value) and two-sided limits (the 2.5th and 97.5th percentile values). Results All women investigated were in iodine sufficient status within optimal urine iodine level. The serum TSH level during the 1st trimester was obviously declined compared with that in the non-pregnant individuals (P < 0.01), and started to rise during the 2nd trimester, but was still not restored to non-pregnant level until the 3rd trimester. Serum FT4 and FT3 levels gradually decreased from the 2nd trimester to the 3rd (P < 0.01), and the TT4 and TT3 levels were markedly elevated since early pregnancy (P < 0.01) and reached peak levels at the 2nd trimester approximately making up to 1.5 times of those in the non-pregnant individuals. Conclusion The thyroid hormone levels during pregnancy differ completely from those of the non-pregnant individuals, and also differ during different gestation periods. Therefore, to establish trimester-specific reference data of thyroid hormones during normal pregnancy may be important for clinical practice.
