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
2014年
12期
1047-1052
,共6页
李晨嫣%单忠艳%毛金媛%王薇薇%解晓晨%周卫卫%李晨阳%徐斌%毕丽华
李晨嫣%單忠豔%毛金媛%王薇薇%解曉晨%週衛衛%李晨暘%徐斌%畢麗華
리신언%단충염%모금원%왕미미%해효신%주위위%리신양%서빈%필려화
促甲状腺素%参考范围%妊娠%人绒毛膜促性腺激素%甲状腺素
促甲狀腺素%參攷範圍%妊娠%人絨毛膜促性腺激素%甲狀腺素
촉갑상선소%삼고범위%임신%인융모막촉성선격소%갑상선소
TSH%Reference range%Pregnancy%Human chorionic gonadotropin%Thyroxine
目的 为中国妊娠妇女妊娠早期亚临床甲状腺功能减退症(亚临床甲减)的诊断建立合理的TSH参考范围.方法 筛查4 800名妊娠4～12周妇女及2 000名非妊娠妇女甲状腺功能,对其中535名妊娠妇女进行妊娠中期及妊娠晚期随访.结果 血清TSH浓度中位数从妊娠7周开始出现显著降低.妊娠4～6周TSH的中位数显著高于7～12周[2.15(0.56～5.31)mIU/L对1.47(0.10～4.34) mIU/lL,P＜0.01],但与非妊娠妇女相比无明显差异[2.07(0.69～ 5.64) mIU/L,P=0.784].FT4中位数在妊娠早期无明显改变.以TSH＞2.5 mIU/L作为亚临床甲减的诊断标准,4 800名妊娠妇女的亚临床甲减患病率为27.8％,若采用本实验室所得的TSH参考范围(0.14～4.87 mIU/L),该患病率仅为4％.在妊娠早期血清TSH＞2.5 mIU/L的118名妇女中,妊娠20周、30周时分别只有30.0％、20.3％的妊娠妇女TSH水平高于3.0 mIU/L.结论 非妊娠妇女的TSH参考范围适用于妊娠4～6周妇女亚临床甲减的诊断.中国妊娠妇女妊娠早期的TSddH水平上限显著高于2.5 mIU/L.
目的 為中國妊娠婦女妊娠早期亞臨床甲狀腺功能減退癥(亞臨床甲減)的診斷建立閤理的TSH參攷範圍.方法 篩查4 800名妊娠4～12週婦女及2 000名非妊娠婦女甲狀腺功能,對其中535名妊娠婦女進行妊娠中期及妊娠晚期隨訪.結果 血清TSH濃度中位數從妊娠7週開始齣現顯著降低.妊娠4～6週TSH的中位數顯著高于7～12週[2.15(0.56～5.31)mIU/L對1.47(0.10～4.34) mIU/lL,P＜0.01],但與非妊娠婦女相比無明顯差異[2.07(0.69～ 5.64) mIU/L,P=0.784].FT4中位數在妊娠早期無明顯改變.以TSH＞2.5 mIU/L作為亞臨床甲減的診斷標準,4 800名妊娠婦女的亞臨床甲減患病率為27.8％,若採用本實驗室所得的TSH參攷範圍(0.14～4.87 mIU/L),該患病率僅為4％.在妊娠早期血清TSH＞2.5 mIU/L的118名婦女中,妊娠20週、30週時分彆隻有30.0％、20.3％的妊娠婦女TSH水平高于3.0 mIU/L.結論 非妊娠婦女的TSH參攷範圍適用于妊娠4～6週婦女亞臨床甲減的診斷.中國妊娠婦女妊娠早期的TSddH水平上限顯著高于2.5 mIU/L.
목적 위중국임신부녀임신조기아림상갑상선공능감퇴증(아림상갑감)적진단건립합리적TSH삼고범위.방법 사사4 800명임신4～12주부녀급2 000명비임신부녀갑상선공능,대기중535명임신부녀진행임신중기급임신만기수방.결과 혈청TSH농도중위수종임신7주개시출현현저강저.임신4～6주TSH적중위수현저고우7～12주[2.15(0.56～5.31)mIU/L대1.47(0.10～4.34) mIU/lL,P＜0.01],단여비임신부녀상비무명현차이[2.07(0.69～ 5.64) mIU/L,P=0.784].FT4중위수재임신조기무명현개변.이TSH＞2.5 mIU/L작위아림상갑감적진단표준,4 800명임신부녀적아림상갑감환병솔위27.8％,약채용본실험실소득적TSH삼고범위(0.14～4.87 mIU/L),해환병솔부위4％.재임신조기혈청TSH＞2.5 mIU/L적118명부녀중,임신20주、30주시분별지유30.0％、20.3％적임신부녀TSH수평고우3.0 mIU/L.결론 비임신부녀적TSH삼고범위괄용우임신4～6주부녀아림상갑감적진단.중국임신부녀임신조기적TSddH수평상한현저고우2.5 mIU/L.
Objective To establish a rational reference range of serum TSH for diagnosis of subclinical hypothyroidism in the first trimester of pregnant women in China.Methods A total of 4 800 pregnant women in the first trimester and 2 000 women who planned to become pregnant were screened.535 pregnant women were evaluated in follow-up visits at the second and third trimesters.Results Median concentrations of serum TSH decreased significantly after the 7th week of gestation.The median of TSH during 4-6 weeks was significantly higher than that during7-12 weeks [2.15 (0.56-5.31) mIU/L vs 1.47 (0.10-4.34) mIU/L,P＜0.01],however,there was no significant difference compared with non-pregnant women [2.07 (0.69-5.64) mIU/L,P =0.784).The median of FT4 was not significantly altered in the first trimester.The prevalence of subclinical hypothyroidism in the 4 800 pregnant women was 27.8％ with the diagnostic criterion of TSH＞2.5 mIU/L and 4.0％ by utilizing the reference range derived in our laboratory(0.14-4.87 mIU/L).Additionally,out of 118 pregnant women who had serum TSH＞ 2.5 mIU/L in the first trimester,only 30.0％ and 20.3％ of them at the 20th and 30th week of gestation had TSH＞ 3.0 mIU/L.Conclusions The reference range for non-pregnant women can be used for the assessment of pregnant women during 4-6 weeks of gestation.The upper limit of serum TSH in the first trimester was much higher than 2.5 mIU/L in Chinese pregnant women.
