中国汉族碘适量地区妊娠月份特异性TSH和T4的正常参考范围
중국한족전괄량지구임신월빈특이성TSH화T4적정상삼고범위
Gestational month-specific reference ranges for TSH and thyroxine in Han nationality women in iodine sufficient area of China
  • 万方数据
    中华内分泌代谢杂志 중화내분비대사잡지
    CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
    2008年 6期 605-608 ,共4页

    李佳%滕卫平%单忠艳%李晨阳%周卫卫%高波%尚涛%周佳任%丁彬%马英%武英%刘群%刘伟%于晓会%陈彦彦%王薇薇%李元宾%范晨玲%王红%郭锐%张红梅

    리가%등위평%단충염%리신양%주위위%고파%상도%주가임%정빈%마영%무영%류군%류위%우효회%진언언%왕미미%리원빈%범신령%왕홍%곽예%장홍매

    妊娠%参考值%促甲状腺素%甲状腺素 妊娠%參攷值%促甲狀腺素%甲狀腺素
    임신%삼고치%촉갑상선소%갑상선소
    Pregnancy%Reference values%Thyrotropin%Thyroxine
    目的 建立中国碘适量地区妊娠月份特异性血清甲状腺激素的正常参考范围.方法 经过严格筛选得到碘适量地区妊娠4～36周(4周≈1个月)妇女1 118名和非妊娠妇女120名,检测血清TSH、TT4、FT4、甲状腺过氧化物酶抗体(TPOAb)以及尿碘水平.结果 妊娠期间,血清TSH在妊娠4周升高,之后开始下降,妊娠12周最低,比非妊娠时降低了35%,随后呈上升趋势,在妊娠晚期则保持稳定,与非妊娠对照组相比,TSH中位数升高了29%;血清TT4在妊娠早期迅速升高,在妊娠16周达到最高值,较非妊娠时升高70%,之后轻微下降,妊娠晚期则保持平稳,较非妊娠时升高50%;在妊娠早期,血清FT4先轻微升高,妊娠4周最高,之后逐渐下降,在妊娠中期仍然呈下降趋势,而在妊娠晚期则没有明显的变化.结论 建立妊娠月份特异性的血清TSH、TT4和FT4正常参考范围对于早期诊断妊娠亚临床甲状腺功能减退症和低T4血症是必要的.
    목적 건립중국전괄량지구임신월빈특이성혈청갑상선격소적정상삼고범위.방법 경과엄격사선득도전괄량지구임신4～36주(4주≈1개월)부녀1 118명화비임신부녀120명,검측혈청TSH、TT4、FT4、갑상선과양화물매항체(TPOAb)이급뇨전수평.결과 임신기간,혈청TSH재임신4주승고,지후개시하강,임신12주최저,비비임신시강저료35%,수후정상승추세,재임신만기칙보지은정,여비임신대조조상비,TSH중위수승고료29%;혈청TT4재임신조기신속승고,재임신16주체도최고치,교비임신시승고70%,지후경미하강,임신만기칙보지평은,교비임신시승고50%;재임신조기,혈청FT4선경미승고,임신4주최고,지후축점하강,재임신중기잉연정하강추세,이재임신만기칙몰유명현적변화.결론 건립임신월빈특이성적혈청TSH、TT4화FT4정상삼고범위대우조기진단임신아림상갑상선공능감퇴증화저T4혈증시필요적.
    Objective To establish the gestational month-specific reference intervals for thyrotropin and thyroxine in Han nationality women in iodine sufficient area of China. Methods In iodine sufficient area of China, 120 non-pregnant women and 1 118 pregnant women at gestational ages from 4 to 36 week (4 weeks≈1 month) were collected according to the strict criteria. Urinary iodine excretion and serum thyrotropin (TSH), total thyroxine (TT4), free thyroxine (FT4), thyroid peroxidase antibody (TPOAb) levels were determined in all subjects. Results During pregnancy, serum TSH increased at week 4, and then began to decrease with the lowest level at week 12, which was 35% lower than the non-pregnant level." After that, serum TSH increased gradually and finally became stable during the third-trimester of pregnancy (T3) when the level was 29% higher than that of non-pregnant controls. Serum TT4 elevated dramatically during the first-trimester with peak at week 16, which increased by 70% compared with the non-pregnant level, then slightly decreased, and became steady with 50% increasing compared with non-pregnant level. Serum FT4 initially increased slightly with peak at week 4, and then decreased gradually until the beginning of T3 without obvious fluctuation during T3. Conclusion The gestational month-specific reference intervals for TSH, TT4 and FT4 are necessary for the early diagnosis of maternal subclinical hypothyroidism and hypothyroxinaemia.
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