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
2015年
5期
434-437
,共4页
张清松%张丽红%陈敏%樊云井
張清鬆%張麗紅%陳敏%樊雲井
장청송%장려홍%진민%번운정
促甲状腺素%妊娠%孕前优生健康检查%妊娠结局
促甲狀腺素%妊娠%孕前優生健康檢查%妊娠結跼
촉갑상선소%임신%잉전우생건강검사%임신결국
TSH%Pregnancy%Pregestational eugenic and healthy examination%Pregnant outcome
目的 通过分析育龄妇女孕前血清TSH值与妊娠和妊娠结局的关系,探讨血清TSH在孕前优生健康检查中的高危风险值.方法 统计2013年度在国家免费孕前优生健康检查中育龄妇女TSH值分布区间以及血清TSH值与性激素、妊娠率和不良妊娠结局(妊娠后不能生育一个健康婴儿,包括流产、早产、畸形儿等)的关系,得出育龄妇女孕前TSH高危风险值.结果 5 798名育龄妇女孕前血清TSH的平均值为2.36 mIU/L,中位数为2.01 mIU/L,血清TSH值分布为非正态分布,具有长尾性;1年中育龄妇女妊娠率为76.1％,最有利于妊娠的TSH参考区间是0.35 ～ 3.5 mIU/L,其余各区间妊娠率都有不同程度的降低,差异有统计学意义(P＜0.01),TSH＜0.35 mIU/L或＞5.5 mIU/L时,不良妊娠结局显著增高(P＜0.01),logistic回归分析显示,TSH升高或降低,不孕及不良妊娠结局的相对危险度显著增高;与TSH 0.35 ～ 2.5mIU/L组比较,当TSH＞4.5 mIU/L或＜0.35 mIU/L时,FSH、LH、雌二醇的差异有统计学意义(P＜0.01);TSH与性激素LH、雌二醇、孕酮、催乳素有一定相关性(相关系数分别为0.29、-0.28、-0.37、0.36).结论 育龄妇女孕前血清TSH值高危风险值应为＜0.35 mIU/L或＞5.5 mIU/L.
目的 通過分析育齡婦女孕前血清TSH值與妊娠和妊娠結跼的關繫,探討血清TSH在孕前優生健康檢查中的高危風險值.方法 統計2013年度在國傢免費孕前優生健康檢查中育齡婦女TSH值分佈區間以及血清TSH值與性激素、妊娠率和不良妊娠結跼(妊娠後不能生育一箇健康嬰兒,包括流產、早產、畸形兒等)的關繫,得齣育齡婦女孕前TSH高危風險值.結果 5 798名育齡婦女孕前血清TSH的平均值為2.36 mIU/L,中位數為2.01 mIU/L,血清TSH值分佈為非正態分佈,具有長尾性;1年中育齡婦女妊娠率為76.1％,最有利于妊娠的TSH參攷區間是0.35 ～ 3.5 mIU/L,其餘各區間妊娠率都有不同程度的降低,差異有統計學意義(P＜0.01),TSH＜0.35 mIU/L或＞5.5 mIU/L時,不良妊娠結跼顯著增高(P＜0.01),logistic迴歸分析顯示,TSH升高或降低,不孕及不良妊娠結跼的相對危險度顯著增高;與TSH 0.35 ～ 2.5mIU/L組比較,噹TSH＞4.5 mIU/L或＜0.35 mIU/L時,FSH、LH、雌二醇的差異有統計學意義(P＜0.01);TSH與性激素LH、雌二醇、孕酮、催乳素有一定相關性(相關繫數分彆為0.29、-0.28、-0.37、0.36).結論 育齡婦女孕前血清TSH值高危風險值應為＜0.35 mIU/L或＞5.5 mIU/L.
목적 통과분석육령부녀잉전혈청TSH치여임신화임신결국적관계,탐토혈청TSH재잉전우생건강검사중적고위풍험치.방법 통계2013년도재국가면비잉전우생건강검사중육령부녀TSH치분포구간이급혈청TSH치여성격소、임신솔화불량임신결국(임신후불능생육일개건강영인,포괄유산、조산、기형인등)적관계,득출육령부녀잉전TSH고위풍험치.결과 5 798명육령부녀잉전혈청TSH적평균치위2.36 mIU/L,중위수위2.01 mIU/L,혈청TSH치분포위비정태분포,구유장미성;1년중육령부녀임신솔위76.1％,최유리우임신적TSH삼고구간시0.35 ～ 3.5 mIU/L,기여각구간임신솔도유불동정도적강저,차이유통계학의의(P＜0.01),TSH＜0.35 mIU/L혹＞5.5 mIU/L시,불량임신결국현저증고(P＜0.01),logistic회귀분석현시,TSH승고혹강저,불잉급불량임신결국적상대위험도현저증고;여TSH 0.35 ～ 2.5mIU/L조비교,당TSH＞4.5 mIU/L혹＜0.35 mIU/L시,FSH、LH、자이순적차이유통계학의의(P＜0.01);TSH여성격소LH、자이순、잉동、최유소유일정상관성(상관계수분별위0.29、-0.28、-0.37、0.36).결론 육령부녀잉전혈청TSH치고위풍험치응위＜0.35 mIU/L혹＞5.5 mIU/L.
Objective To analyze the relationship of the serum concentration of TSH in pregestational women with pregnancy and pregnant outcome,and to investigate the high risk value of TSH in eugenic and healthy examination before pregnancy.Methods The distribution of TSH in fertile woman and the relationship of serum TSH level with sex hormone levels,rate of pregnancy,and adverse pregnant outcomes (no healthy infants were born,abortion,premature delivery,and malformation) were investigated in national-free pregestational eugenic and healthy examination during 2013.The high risk level of TSH in pregestational women was determined.Results The average level of TSH in 5 798 prepregnant women was 2.36 mIU/L with the median of 2.01 mIU/L,and the serum level of TSH showed abnormal distribution with long tail.The pregnant rate of fertile women within one year was 76.1％.The beneficial range of TSH levels for pregnancy was 0.35-3.5 mIU/L,while the pregnant rate in other ranges of TSH level was decreased with statistically significant difference (P＜0.01).When the concentration of TSH was below 0.35 mIU/L or above 5.5 mIU/L,abnormal pregnant outcomes were significantly increased (P＜0.01).Logistic regression analysis indicated that the relative risks of infertility and abnormal pregnant outcomes were significantly increased.Compared with TSH 0.35-2.5 mIU/L group,there were significantly differences in FSH,LH,and estradiol (E2) in TSH＞4.5 mIU/L or＜0.35 mIU/L group (P＜0.01).TSH was related with LH,E2,progesterone,and prolactin (r=0.29,-0.28,-0.37,0.36).Conclusion The high risk value of serum TSH in prepregnant women should be below 0.35 mIU/L or above 5.5 mIU/L.
