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目的分析正常孕妇妊娠期甲状腺功能的变化。方法选取2012年1月至2014年12月在香河县人民医院产科就诊的正常孕妇妊娠早期400例为A组、妊娠中期440例为B组,妊娠晚期370例为C组,同期选取非妊娠妇女410例为对照组。采用化学发光免疫法检测4组妇女的甲状腺激素和甲状腺自身抗体。分析妊娠期甲状腺功能的变化特点,测定正常孕妇妊娠期血清促甲状腺激素(TSH)、游离甲状腺素(FT_4)和游离三碘甲状腺原氨酸(FT_3)的参考范围,探讨妊娠期甲状腺功能异常的患病率。结果 A组、B组、C组TSH和FT_4水平显著低于对照组[(1.18±0.45)mU/L、(1.63±0.32)mU/L、(2.35±0.59)mU/L比(3.03±0.84)mU/L;(15.6±1.6)pmol/L、(15.0±1.3)pmol/L、(12.6±1.1)pmol/L比(17.3±1.6)pmol/L],差异有统计学意义(P<0.05)。A组FT_3水平与对照组比较差异无统计学意义[(4.92±0.41)pmol/L比(4.97±0.43)pmol/L](P>0.05)。B组、C组FT_3水平显著低于对照组[(4.71±0.35)pmol/L、(3.85±0.24)pmol/L比(4.97±0.43)pmol/L](P<0.05)。正常妊娠期妇女妊娠早、中、晚期血清TSH的参考值分别为0.03~3.73 mU/L、0.10~3.85 mU/L、0.35~4.76 mU/L,血清FT_4的参考值分别为11.24~20.13 pmol/L、10.06~17.57 pmol/L、9.45~15.26 pmol/L,血清FT_3的参考值分别为3.62~6.01 pmol/L、3.44~5.87 pmol/L、2.85~5.04 pmol/L。妊娠期甲状腺功能异常总患病率为6.78%(82/1210),显著高于对照组2.93%(12/410),差异有统计学意义(P<0.05)。A组、B组、C组发病率显著高于对照组[8.25%(33/400)、6.14%(27/440)、5.95%(22/370)比2.93%(12/410)],差异有统计学意义(P<0.05)。结论妊娠期孕妇甲状腺相关激素受到内分泌变化的影响,与非妊娠期妇女存在较大的差异。
Objective To analyze the changes of thyroid function in normal pregnant women during pregnancy. Methods From January 2012 to December 2014, 400 pregnant women in the first trimester of pregnancy in the obstetrics department of Xianghe People’s Hospital were enrolled as Group A, the third trimester of pregnancy was Group B, the third trimester of pregnancy was Group C, the third trimester of pregnancy was Group C, 410 cases as control group. Thyroid hormones and thyroid autoantibodies were detected by chemiluminescence immunoassay in 4 groups of women. To analyze the changes of thyroid function during pregnancy and to determine the reference range of thyroid stimulating hormone (TSH), free thyroxine (FT_4) and free triiodothyronine (FT_3) during pregnancy in normal pregnant women, and to explore the relationship between thyroid dysfunction during pregnancy Prevalence. Results The levels of TSH and FT_4 in group A, group B and group C were significantly lower than those in control group (1.18 ± 0.45 mU / L, 1.63 ± 0.32 mU / L, 2.35 ± 0.59 mU / L, 3.03 ± 0.84 ), mU / L; (15.6 ± 1.6) pmol / L, (15.0 ± 1.3) pmol / L and (12.6 ± 1.1) pmol / L vs (17.3 ± 1.6) pmol / L, respectively) 0.05). The level of FT_3 in group A was not significantly different from that in control group [(4.92 ± 0.41) pmol / L vs (4.97 ± 0.43) pmol / L] (P> 0.05). The level of FT_3 in group B and C was significantly lower than that in control group [(4.71 ± 0.35) pmol / L, (3.85 ± 0.24) pmol / L vs (4.97 ± 0.43) pmol / L] The reference values of serum TSH in normal pregnant women were 0.03 ~ 3.73 mU / L, 0.10 ~ 3.85 mU / L, 0.35 ~ 4.76 mU / L and the serum FT_4 reference values were 11.24 ~ 20.13 pmol / L, 10.06 ~ 17.57 pmol / L and 9.45 ~ 15.26 pmol / L respectively. The reference values of serum FT_3 were 3.62 ~ 6.01 pmol / L, 3.44 ~ 5.87 pmol / L and 2.85 ~ 5.04 pmol / L, respectively. The total prevalence of abnormal thyroid function during pregnancy was 6.78% (82/1210), significantly higher than that of the control group (2.93%, 12/410). The difference was statistically significant (P <0.05). The incidence rates of group A, group B and group C were significantly higher than that of the control group [8.25% (33/400), 6.14% (27/440), 5.95% (22/370) vs. 2.93% (12/410) There was statistical significance (P <0.05). Conclusion The thyroid-related hormones in pregnant women during pregnancy are affected by endocrine changes, and there is a big difference with non-pregnant women.