CAJ | 학술논문

目的：探讨建立潮汕地区妇女妊娠3期血清甲状腺功能指标：促甲状腺激素(TSH)、游离甲状腺素(FT4)的参考范围。方法以在该院接受产前检查的863例孕妇为研究对象,通过实验室检测血清 TSH、FT4、抗甲状腺球蛋白抗体(TgAb)、抗甲状腺过氧化物酶抗体(TPOAb)水平,应用美国临床生化研究院(NACB)推荐的方法,初步测出潮汕地区妇女妊娠3期血清TSH、FT4的范围。结果妊娠各期血清 TSH、FT4水平不同,妊娠3期血清 TSH 范围分别为：0.13~3.93 mIU/L、0.42~3.85 mlU/L、0.40~5.68 mIU/L,基本与中国指南推荐参考范围相近,与美国甲状腺学会(ATA)指南推荐值差异较大；血清 FT4范围分别为：12.00~23.34 pmol/L、6.27~12.65 pmol/L、9.80~18.20 pmol/L。结论孕妇血清 TSH、FT4水平随孕期的进展呈动态变化,具有妊娠特异性,本地区健康妊娠妇女血清甲状腺功能范围与非妊娠人群参考值、不同地区的妊娠妇女参考值在甲状腺功能的评估上会有较大的差异性,针对潮汕地区人群生活饮食、碘摄入、经济文化等不同于其他地区,应建立本地区妊娠期特异的甲状腺功能指标参考范围。
목적：탐토건립조산지구부녀임신3기혈청갑상선공능지표：촉갑상선격소(TSH)、유리갑상선소(FT4)적삼고범위。방법이재해원접수산전검사적863례잉부위연구대상,통과실험실검측혈청 TSH、FT4、항갑상선구단백항체(TgAb)、항갑상선과양화물매항체(TPOAb)수평,응용미국림상생화연구원(NACB)추천적방법,초보측출조산지구부녀임신3기혈청TSH、FT4적범위。결과임신각기혈청 TSH、FT4수평불동,임신3기혈청 TSH 범위분별위：0.13~3.93 mIU/L、0.42~3.85 mlU/L、0.40~5.68 mIU/L,기본여중국지남추천삼고범위상근,여미국갑상선학회(ATA)지남추천치차이교대；혈청 FT4범위분별위：12.00~23.34 pmol/L、6.27~12.65 pmol/L、9.80~18.20 pmol/L。결론잉부혈청 TSH、FT4수평수잉기적진전정동태변화,구유임신특이성,본지구건강임신부녀혈청갑상선공능범위여비임신인군삼고치、불동지구적임신부녀삼고치재갑상선공능적평고상회유교대적차이성,침대조산지구인군생활음식、전섭입、경제문화등불동우기타지구,응건립본지구임신기특이적갑상선공능지표삼고범위。
Objective To investigate and establish thyroid function reference range during 3 pregnant stages in Chaoshan area:thyrotropin (TSH),free thyroxin (FT4).Methods 863 healthy pregnant women visited antenatal clinic in the Second Affiliated Hospital were included in this study.By detecting serum levels of TSH,FT4,thyroglobulin antibody (TgAb),and thyroid peroxi-dase antibody (TPOAb)in these women,the euthyroid reference ranges of serum TSH and FT4 in different pregnant stages were established based on the standards of the United States National Institute of Clinical Biochemical (NACB)guidelines.Results The ranges of serum TSH in the first,second and third trimester of pregnancy were 0.13-3.93 mIU/L,0.14-4.55mlU/L,and 0.42-3.85 mIU/L,respectively.The ranges of serum FT4 levels in these 3 stages were 12.00-23.34 pmol/L,6.27-12.65pmol/ L, and 9.80-18.20 pmol/L,respectively.The range of serum TSH levels in our study were similar with the reference range recom-mended by the guidelines in China,but were different compared with the American Thyroid Association (ATA)guidelines.Conclu-sion TSH,FT4 levels show dynamic changes during different stages of pregnancy.The thyroid function ranges of healthy pregnant women in Chaoshan area are quite different compared with non-pregnant population and pregnant women in distinct area.Due to the differences of diet,iodine intake,economy and culture in Chaoshan area,regional thyroid function reference ranges specific for differ-ent stages of pregnant women should be established.