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目的建立早孕期甲状腺功能的参考区间并探讨制定参考区间的必要性。方法对2012年3-12月在首都医科大学附属北京妇产医院产前检查的无甲状腺疾病高危因素的健康初产妇3 180例进行甲状腺功能检查(包括TSH、FT4、FT3、TT4、TT3),分析各项检测值的参考区间,并与试剂盒给出的参考区间进行比较分析。结果 TSH的参考区间为:0.05~5.05?IU/ml;0.76~2.08 ng/dl、2.11~3.43 pg/ml、6.56~14.74?g/dl和88.81~220.95 ng/dl.根据试剂盒参考区间诊断的临床甲减、亚临床甲减及低T4血症的诊断率明显高于本文的参考区间的诊断率;高龄孕妇(≥35岁)早孕期FT4水平低于<35岁孕妇(P<0.05)。结论妊娠期甲状腺功能与非孕期有较大差异,不应直接采用试剂盒给出的诊断标准,应结合妊娠结局建立妊娠期的正常参考范围。
Objective To establish a reference interval of thyroid function in early pregnancy and to explore the necessity of establishing a reference interval. Methods A total of 3180 healthy primipara patients without thyroid disease during prenatal period from March to December 2012 in Beijing Maternity Hospital of Capital Medical University underwent thyroid function tests (including TSH, FT4, FT3, TT4 and TT3) The reference interval of each detection value is analyzed and compared with the reference interval given by the kit. Results The reference interval for TSH was 0.05 to 5.05 IU / ml, 0.76 to 2.08 ng / dl, 2.11 to 3.43 pg / ml, 6.56 to 14.74 μg / dl and 88.81 to 220.95 ng / dl, respectively. According to the reference interval of the kit The clinical hypothyroidism, subclinical hypothyroidism and low T4 blood disease diagnosis rate was significantly higher than the reference range of this diagnosis; elderly pregnant women (≥ 35 years old) early pregnancy FT4 levels were lower than <35 years old pregnant women (P <0.05) . Conclusion There is a big difference between thyroid function and non-pregnancy during pregnancy. The diagnostic criteria given by the kit should not be adopted directly. The normal reference range of pregnancy should be established according to the pregnancy outcome.