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目的建立宁波地区正常孕妇孕早期、中期、晚期促甲状腺激素(TSH)、游离甲状腺激素(FT_4)、游离三碘甲状腺原氨酸(FT_3)参考值范围。方法序贯收集2014年1月—2015年12月宁波大学医学院附属医院产科门诊就诊的正常孕妇妊娠早期(T1期,妊娠9~12周)、妊娠中期(T_2期,妊娠16~24周)、妊娠晚期(T_3期,妊娠32~36周)有效血清281例,同时选择158例育龄非孕妇女做正常对照;采用美国贝克曼DX-800检测系统分别检测妊娠不同时期孕妇血清TSH、FT_4、FT_3水平,采用百分位数(P_(2.5)~P_(97.5))制订妊娠不同时期TSH、FT_4、FT_3的正常参考值范围。结果不同妊娠期TSH参考值范围为:T1:0.05~3.97 m IU/L,T_2:0.12~4.28 m IU/L,T_3:0.30~6.01 m IU/L,对照:0.08~3.81 m IU/L;FT_3的参考范围:T1:3.33~5.78 pmol/L,T_2:3.10~5.23 pmol/L,T_3:2.83~4.99 pmol/L,对照:3.90~5.54 pmol/L;FT_4的参考范围:T1:7.25~15.52 pmol/L,T_2:6.88~13.27pmol/L,T_3:5.31~10.79 pmol/L,对照:6.46~14.17 pmol/L;在妊娠不同时期检测结果与育龄非孕对照组结果差异均有统计学意义(FT_3:F=76.431,P<0.01;FT_4:F=116.753,P<0.01;TSH:F=53.670,P<0.01),各孕期之间差异亦有统计学意义。结论孕妇的甲状腺激素水平与非妊娠妇女存在明显差异,且妊娠不同时期女性甲状腺功能指标参考范围不同,建立本地区各孕期的甲状腺激素参考范围临床意义重大。
Objective To establish a reference range of thyroid stimulating hormone (TSH), free thyroid hormone (FT_4) and free triiodothyronine (FT_3) in normal pregnant women in early pregnancy, midterm and late pregnancy in Ningbo. Methods Sequential collection of early pregnancy (T1 period, 9-12 weeks of gestation), mid-gestation (T2 period, 16-24 weeks of gestation) of normal pregnant women attending obstetrics clinic of Affiliated Hospital of Ningbo University Medical College from January 2014 to December 2015, (T_3, 32 ~ 36 weeks of gestation), and 158 normal non-pregnant women of reproductive age were selected as the normal control. The serum levels of TSH, FT_4, FT_3 level, the normal reference range of TSH, FT_4 and FT_3 in different stages of pregnancy was established by using the percentile (P 2 2.5 ~ P 97.5). Results The reference values of TSH in different gestations were T1: 0.05 ~ 3.97 m IU / L, T_2: 0.12 ~ 4.28 m IU / L, T_3: 0.30 ~ 6.01 m IU / The reference range of FT_3: T1: 3.33 ~ 5.78 pmol / L, T_2: 3.10 ~ 5.23 pmol / L, T_3: 2.83 ~ 4.99 pmol / L, control: 3.90 ~ 5.54 pmol / L; FT_4 reference range: 15.52 pmol / L, T_2: 6.88 ~ 13.27 pmol / L, T_3: 5.31 ~ 10.79 pmol / L and control: 6.46 ~ 14.17 pmol / L respectively. There was statistical difference between the results of pregnancy at different stages of pregnancy and non- Significance (FT_3: F = 76.431, P <0.01; FT_4: F = 116.753, P <0.01; TSH: F = 53.670, P <0.01). There was also a statistically significant difference between each pregnancy. Conclusion The level of thyroid hormone in pregnant women is significantly different from that in non-pregnant women. There are different reference ranges of thyroid function indices in different stages of pregnancy. Therefore, it is of great clinical significance to establish the reference range of thyroid hormone in pregnant women in different regions of the country.