福州地区妊娠期妇女甲状腺激素水平分析
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福建医科大学 附属第一医院妇产科,福州 350005

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R335.2; R581.1

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收稿日期: 2016-01-20
基金项目: 福建省卫生厅青年课题(2013-2-43)
作者单位: 福建医科大学 附属第一医院妇产科,福州 350005
作者简介: 冯 燕(1980-),女,主治医师,医学硕士
通讯作者: 胡继芬. Email:missfyan@163.com


The Analysis of Thyroid Hormone Rangesfor Normal Pregnant Women in Fuzhou Area
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Department of Obstetrics and Gynecology, The First Affilliated Hospital of Fujian Medical University, Fuzhou 350005, China

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    摘要:

    目的 建立福州地区妊娠妇女在妊娠不同阶段甲状腺特异性血清检测指标的参考值范围。 方法 回顾性分析2013年7月-2015年5月建卡的既往无甲状腺疾病病史的不同妊娠期妇女共1 658例,其中早期妊娠(≤12周末)271例,中期妊娠(13~27周末)845例,晚期妊娠(28周~妊娠)542例和健康非孕妇女350例,对其血清甲状腺激素[游离三碘甲状腺原氨酸(FT3),游离甲状腺素(FT4),促甲状腺激素(TSH)]进行统计学分析。 结果 血清中FT3、FT4水平随孕期进行而逐渐下降,TSH水平逐渐上升。妊娠期妇女甲状腺疾病总体患病率为12.4%,患病率最高为亚临床甲状腺功能减退症4.95%,其次为低T4甲状腺素血症患病率2.65%,亚临床甲状腺机能亢进症2.17%,临床甲状腺机能减退症2.0%,甲状腺机能亢进0.66%。健康非孕妇女按照试剂标准患病率为6%。 结论 妊娠期甲状腺激素水平随妊娠进展有明显变化,本地区妊娠期甲状腺疾病患病率高于健康非孕妇,不同地区应根据所用试剂及方法,建立本地区甲状腺激素正常参考指标,在妊娠人群中进行常规筛查。

    Abstract:

    Objective To establish the specific reference ranges of thyroid hormone for pregnant women in Fuzhou. Methods We studied retrospectively 1 658 pregnant women, who were seen at our maternity clinic and 350 non-pregnant women. The pregnant women selected did not have thyroid disorder before and were divided into three stages: first trimester(pregnancy≤12 weeks), mid-trimester pregnancy(pregnancy among 13 to 28 weeks), and late pregnancy(pregnancy beyond 28 weeks until delivery). We detected the three serum triiodothyronine(FT3), serum free thyroid(FT4),and thyroid stimulating hormone(TSH)level, then on the measurements we performed statistical analysis. Results The levels of FT3 and FT4 were declining and the level of TSH was increasing gradually. The thyroid morbidity in non-pregnant women was 6%, while the morbidity in pregnant women was 12.4%, which was much higher. The highest morbidity was subclinical hypothyroidism(4.95%), the next was low T4 blood(2.65%), and then were subclinical hyperthyroidism(2.17%), hypothyroidism(2.0%), hyperthyroidism(0.66%). Conclusion The thyroid hormone level in pregnant women changes along with the pregnancy progress. In our area the thyroid morbidity in pregnant is higher than non-pregnant women. Therefore each region should establish its specific reference ranges of thyroid hormone for normal pregnant women according to the reagents used and the detection method for screening the pregnant women.

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冯燕, 胡继芬.福州地区妊娠期妇女甲状腺激素水平分析[J].福建医科大学学报自然版,2016,(3):176-180

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