CAJ | 학술논문

目的：研究妊娠早中晚期不同年龄孕妇甲状腺功能指标的变化。方法测定温州地区1839名不同孕期的孕妇血清三碘甲状腺原氨酸（FT3）、游离甲状腺激素（FT4）、总三碘甲状腺原氨酸（TT3）、总甲状腺素（TT4）、促甲状腺激素（TSH）、抗甲状腺球蛋白抗体（TGAb）及抗甲状腺过氧化物酶抗体（TPOAb）。结果妊娠早中晚期3组孕妇的FT3、FT4、TT3、TT4、TSH中位数比较，除TT4在妊娠早期与中期差异均无统计学意义（P＞0.05）外，其余各项指标在妊娠早中晚期之间的差异均有统计学意义（P＜0.05）；FT3和FT4的中位数随孕期逐渐降低，TSH中位数随孕期逐渐升高，TT3中位数在孕中期最高（1.47 nmol/L），TT4中位数晚期最低（80.67 nmol/L）。按年龄分组，＞30岁组在妊娠早中晚3期的TSH值均低于≤30岁组（P＜0.05）；妊娠中期的FT4、TT3、TT4和妊娠晚期的FT3值均低于≤30岁组（P＜0.05）。TGAb 和TPOAb 的阳性率妊娠晚期分别为4.74％和1.63％，均低于妊娠早期的阳性率（14.40％和5.56％）和妊娠中期的阳性率（11.20％和3.08％），差异均有统计学意义（P＜0.05）。结论不同孕期孕妇的甲状腺功能指标存在明显差异，不同年龄段孕妇的甲状腺功能指标亦存在差异，应加强孕期甲状腺功能监测，重视正常参考值范围的研究。
목적：연구임신조중만기불동년령잉부갑상선공능지표적변화。방법측정온주지구1839명불동잉기적잉부혈청삼전갑상선원안산（FT3）、유리갑상선격소（FT4）、총삼전갑상선원안산（TT3）、총갑상선소（TT4）、촉갑상선격소（TSH）、항갑상선구단백항체（TGAb）급항갑상선과양화물매항체（TPOAb）。결과임신조중만기3조잉부적FT3、FT4、TT3、TT4、TSH중위수비교，제TT4재임신조기여중기차이균무통계학의의（P＞0.05）외，기여각항지표재임신조중만기지간적차이균유통계학의의（P＜0.05）；FT3화FT4적중위수수잉기축점강저，TSH중위수수잉기축점승고，TT3중위수재잉중기최고（1.47 nmol/L），TT4중위수만기최저（80.67 nmol/L）。안년령분조，＞30세조재임신조중만3기적TSH치균저우≤30세조（P＜0.05）；임신중기적FT4、TT3、TT4화임신만기적FT3치균저우≤30세조（P＜0.05）。TGAb 화TPOAb 적양성솔임신만기분별위4.74％화1.63％，균저우임신조기적양성솔（14.40％화5.56％）화임신중기적양성솔（11.20％화3.08％），차이균유통계학의의（P＜0.05）。결론불동잉기잉부적갑상선공능지표존재명현차이，불동년령단잉부적갑상선공능지표역존재차이，응가강잉기갑상선공능감측，중시정상삼고치범위적연구。
Objective To understand the variation of thyroid hormones in each trimesters of pregnancy in women.Methods A total of 1 839 pregnant women in different trimesters were enrolled and thyroid hormones including FT3,FT4,TT3, TT4,TSH,TGAb and TPOAb were measured.The reference range of hormone in each trimester was calculated.Results There were statistically differences in all thyroid hormones among all trimesters of pregnancy women (P<0.05 )except for TT4 between the early and middle trimesters (P>0.05 ).The median of FT3 and FT4 were gradually reduced as the pregnant trimester grew up while the median of TSH had the adverse tendency.The median of TT3 was highest during the middle trimester (1.47 nmol/L).TT4 median was lowest during the late trimester (80.67 nmol/L).The TSH level of pregnant women over 30 years old was significantly lower than that of below 30 age group during all trimesters(P<0.05 ). There were significant differences in FT4,TT3 and TT4 level among early and middle trimesters among different ages groups(P<0.05 ).The positive rates of TGAb and TPOAb during late trimester (4.74% and 1.63%)were significantly lower than those of early trimester (1 4.40% and 5.56%)and middle trimester (1 4.40% and 5.56%)(P<0.05 ). Conclusion Significant differences of thyroid hormones are found not only in different stages of pregnancy,but also in different ages.Therefore,establishing trimester-specific reference data of thyroid hormones during different pregnency may be important for clinical practice.