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目的了解三亚碘适量地区妊娠期妇女甲状腺功能的变化情况并讨论其正常值范围。方法选取接受常规孕前检查的健康妊娠期妇女132例,根据妊娠时间的不同将其分为妊娠早期组46例、妊娠中期组46例,妊娠晚期组40例,同时,选取进行一般常规健康检查的健康非妊娠期妇女132例作为对照组。记录上述所有妇女甲状腺功能相关化验指标,分析其变化过程并计算95%正常参考值范围。结果妊娠早期、中期、晚期妇女的甲状腺功能相关指标与对照组妇女相比较均明显降低(P<0.05)。妊娠早期血清游离三碘甲状腺原氨酸(FT3)正常参考值范围:3.32~5.71 pmol/L。游离甲状腺素(FT4)正常参考值范围:12.58~19.01 pmol/L,促甲状腺激素(TSH)正常参考值范围:0.31~4.13 m IU/L。妊娠中期:FT3为3.11~5.36 pmol/L,FT4为8.51~17.38 pmol/L,TSH为0.58~4.69 m IU/L;妊娠晚期:FT3为2.89~5.41 pmol/L,FT4为8.46~17.18 pmol/L,TSH为0.79~4.65 m IU/L。以上述参考范围进行诊断,甲状腺功能减退率0.40%,亚临床甲状腺功能减退率3.40%,单纯性低T4阳性率3.10%,TPOAb阳性患病率7.90%。结论三亚碘适量地区妊娠期妇女甲状腺水平较非妊娠妇女有所降低,当地内分泌科医生应利用本地区妊娠期妇女甲状腺功能指标正常参考范围诊治孕妇甲状腺疾病以提高治疗水平。
Objective To understand the changes of thyroid function in gestational women in Sijia and its normal range. Methods A total of 132 healthy pregnant women undergoing preconception examination were selected and divided into 46 cases of early pregnancy group, 46 cases of middle pregnancy group and 40 cases of late pregnancy group according to the different gestational time. At the same time, 132 healthy non-pregnant women as control group. Record all thyroid function-related laboratory tests, analyze the changes and calculate the 95% normal reference range. Results The indexes of thyroid function in early, middle and late pregnant women were significantly lower than those in the control group (P <0.05). Early trimester serum free triiodothyronine (FT3) normal reference range: 3.32 ~ 5.71 pmol / L. Free FT4 normal reference range: 12.58 ~ 19.01 pmol / L, thyroid stimulating hormone (TSH) normal reference range: 0.31 ~ 4.13 m IU / L. The third trimester pregnancy: FT3 was 3.11-5.36 pmol / L, FT4 was 8.51-17.38 pmol / L and TSH was 0.58-4.69 mIU / L. The third trimester pregnancy: FT3 was 2.89-5.41 pmol / L and FT4 was 8.46-17.18 pmol / L, TSH is 0.79 ~ 4.65 m IU / L. The above reference range of diagnosis, hypothyroidism rate 0.40%, subclinical hypothyroidism rate 3.40%, simple low T4 positive rate of 3.10%, TPOAb positive rate of 7.90%. Conclusion Thyroid levels in gestational women in Sijia are lower than those in non-pregnant women in Sijia, and local endocrinologists should use the normal reference range of thyroid function indexes in pregnant women in the region to diagnose and treat thyroid diseases in pregnant women so as to improve the treatment level.