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目的研究杭州地区不同孕期女性甲状腺激素水平变化特点,了解甲状腺功能减低症的发病情况。方法选取无相关甲状腺病史的妊娠女性165例,非妊娠健康女性181例,采用化学发光免疫分析法检测血清中的三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及促甲状腺激素(TSH)水平。结果孕早期、孕中期、孕晚期各组与对照组间激素水平(FT3、FT4)比较差异有统计学意义(P<0.05);TT3、TT4激素水平与对照组比较差异无统计学意义(P>0.05)。早孕期组、中孕期组与晚孕期组、对照组间的TSH水平比较差异均有统计学意义(P<0.05)。中孕、晚孕期组的临床甲状腺功能减低症患病率较早孕期组比较差异有统计学意义(P<0.05);亚临床甲状腺功能减低症患病率各孕期组比较,差异无统计学意义(P>0.05)。结论妊娠期女性甲状腺激素水平随孕期不同发生相应改变,检测甲状腺激素水平对筛查和干预甲状腺功能减低症具有重要的优生学价值。
Objective To study the changes of thyroid hormone levels in different pregnant women in Hangzhou and to understand the incidence of hypothyroidism. Methods Totally 165 pregnant women without history of thyroid disease and 181 pregnant women with non-pregnant status were selected. Serum levels of triiodothyronine (TT3), total thyroxine (TT4) and free triiodothyronine were detected by chemiluminescence immunoassay. (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH). Results The levels of hormones (FT3 and FT4) in each group were significantly different from those in the control group (P <0.05) in the first trimester, the second trimester and the third trimester. There was no significant difference in the levels of TT3 and TT4 between the control group and the control group > 0.05). There were significant differences in TSH levels between early pregnancy group, middle pregnancy group, late pregnancy group and control group (P <0.05). The prevalence of clinical hypothyroidism in the third trimester and the second trimester pregnancy was significantly lower than that of the first trimester pregnancy (P <0.05). The prevalence of subclinical hypothyroidism in each pregnancy group was not significantly different (P> 0.05). Conclusions The level of thyroid hormone in pregnant women changes correspondingly with different gestational periods. The detection of thyroid hormone level has important eugenomic value for screening and interventional hypothyroidism.