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目的评估济南地区妊娠妇女妊娠各期特异性血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及血清促甲状腺激素(TSH)的正常参考范围。方法妊娠妇女370例作为研究组,非妊娠期妇女60例作为对照组,根据美国国家临床生化研究院(NACB)指南的推荐,电化学发光法测定TSH、FT4、FT3、抗甲状腺球蛋白抗体(Tg Ab)、抗甲状腺过氧化物酶抗体(TPOAb)及促甲状腺激素受体抗体(TRAb)血清学水平。结果血清FT3、FT4、TSH在妊娠早期(1~12周末)的参考范围分别为3.33~5.78、3.07~5.52、2.91~5.46 pmol/L,在妊娠中期(13~27周末)的参考范围分别为12.60~18.94、8.74~17.23、8.64~17.21 pmol/L,妊娠晚期(28~40周)的参考范围分别为0.27~4.27、0.53~4.75、0.76~4.59 m IU/L。结论济南地区妊娠妇女的血清甲状腺激素水平具备地域上的特异性,与非妊娠时期差异较大,与ATA建议的妊娠期甲状腺功能指标参考范围结果差别较大。
Objective To evaluate the normal reference range of serum free triiodothyronine (FT3), free thyroxine (FT4) and serum thyrotropin (TSH) in pregnant women at different stages of gestation in Jinan area. Methods 370 pregnant women as the study group and 60 non-pregnant women as the control group. According to the recommendations of the National Institute of Clinical Biochemistry (NACB) guidelines, the chemiluminescence method was used to determine the levels of TSH, FT4, FT3, anti-thyroglobulin antibody Tg Ab), anti-thyroid peroxidase antibody (TPOAb) and thyrotropin receptor antibody (TRAb) serological levels. Results The reference ranges of FT3, FT4 and TSH in early pregnancy (1-12weeks) were 3.33-5.80, 3.07-5.52 and 2.91-5.46 pmol / L, respectively. The reference ranges of serum FT3, FT4 and TSH were 12.60-18.94, 8.74-17.23, 8.64-17.21 pmol / L, and the reference range of late pregnancy (28-40 weeks) were 0.27-4.27,0.53-4.75,0.76-4.99 mIU / L, respectively. Conclusion Serum thyroid hormone levels in pregnant women in Jinan area are geographically specific and vary greatly from those in non-pregnant period. The result is quite different from the recommended reference range of thyroid function index in pregnancy.