济南地区正常妊娠妇女各期甲状腺功能指标的参考值范围评估

doi:10.6040/j.issn.1671-7554.0.2015.053

摘要/Abstract

摘要： 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(TgAb)、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 mIU/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。

关键词: 促甲状腺激素, 甲状腺素, 妊娠, 参考范围

Abstract: Objective To establish the refernce ranges for specific serum FT3, FT4 and TSH in different stages of the pregnant women of Jinan City, China. Methods A total of 370 pregnancy women were chosen as the study group, and 60 non-pregnancy women were chosen as the control group. According to the guidelines of United States National Institute of Clinical Biochemical(NACB), the serum levels of TSH, FT4, FT3, thyroglobulin antibody(TgAb), thyroid peroxidase antibody(TPOAb), thyrotrophin receptor antibody(TRAb)were detected by electrochemiluminescence method. Results The reference ranges of the serum levels of FT3, FT4 and TSH during the early, medium, and late periods were 3.33-5.78, 3.07-5.52, 2.91-5.46 pmol/L; 12.60-18.94, 8.74-17.23, 8.64-17.21 pmol/L; and 0.27- 4.27, 0.53- 4.75, 0.76- 4.59 mIU/L. Conclusion The reference ranges of the serum levels of FT3, FT4 and TSH at the different gestation stages in Jinan City have a large difference between the pregnant women of the other areas, and also have a large difference of the reference ranges of the pregnant women recommended by ATA.

Key words: Thyroid stimulating hormone, Thyroxine, Reference range, Pregnancy

中图分类号:

R714.5

申妍,左常婷. 济南地区正常妊娠妇女各期甲状腺功能指标的参考值范围评估[J]. 山东大学学报（医学版）, 2016, 54(5): 34-38.

SHEN Yan, ZUO Changting. Estimation of reference range for thyroid functional parameter in pregnant women of Jinan City, China[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(5): 34-38.

参考文献

[1] Granfors M, Akerud H, Skogo J, et al. Targeted thyroid testing during pregnancy in clinical practice[J]. Obstet Gynecol, 2014, 124(1): 10-15.
[2] Pappa T, Ferrara AM, Refetoff S, et al. Inherited defects of thyroxine-binding proteins[J]. Best Pract Res Clin Endocrinol Metab, 2015, 29(5): 735-747.
[3] Donnay S, Arena J, Lucas A, et al. Iodine supplementation during pregnancy and lactation. Position statement of the working group on disorders related to iodine deficiency and thyroid dysfunction of the Spanish Society of Endocrinology and Nutrition[J]. Endocrinol Nutr, 2014, 61(1): 27-34.
[4] Tortosa F. Subclinical thyroid dysfunction in pregnancy[J]. Endocrinol Nutr, 2011, 58(6): 255-257.
[5] Forbes S. Pregnancy sickness and parent-offspring conflict over thyroid function[J]. Theor Biol, 2014, 21; 355: 61-67.
[6] Wang S, Teng WP, Li JX, et al. Effects of maternal subclinical hypothyroidism on obstetrical outcomes during early pregnancy[J]. Endocrinol Invest, 2012, 35(3): 322-325.
[7] Mannisto T, Vaarasmaki M, Pouta A, et al. Thyroid dysfunction and autoantibodies during pregnancy as predictive factors of pregnancy complications and maternal morbidity in later life[J]. Clin Endocrinol Metab, 2010, 95(3): 1084-1094.
[8] Surks MI, Boucai L. Age- and race-based serum thyrotropin reference limits[J]. Clin Endocrinol Metab, 2010, 95(2): 496-502.
[9] Yue B, Rockwood AL, Sandrock T, et al. Free thyroid hormones in serum by direct equilibrium dialysis and online solid-phase extraction-liquid chromatography/tandem mass spectrometry[J]. Clin Chem, 2008, 54(4): 642-651.
[10] Benhadi N, Wiersinga WM, Reitsma JB, et al. Higher maternal TSH levels in pregnancy are associated with increased risk for miscarriage, fetal or neonatal death[J]. Eur J Endocrinol, 2009, 160(6): 985-991.
[11] Wang S, Teng WP, Li JX, et al. Effects of maternal subclinical hypothyroidism on obstetrical outcomes during early pregnancy[J]. Endocrinol Invest, 2012, 35(3): 322-325.
[12] Luetic AT, Miskovic B. Is hyperthyroidism underestimated in pregnancy and misdiagnosed as hyperemesis gravidarum?[J]. Med Hypotheses, 2010, 75(4): 383-386.
[13] Laurberg P, Bournaud C, Karmisholt J, et al. Management of Graves’ hyperthyroidism in pregnancy: focus on both maternal and foetal thyroid function, and caution against surgical thyroidectomy in pregnancy[J]. Endocrinol, 2009, 160(1): 1-8.
[14] Moleti M, Lo Presti VP, Campolo MC, et al. Iodine prophylaxis using iodized salt and risk of maternal thyroid failure in conditions of mild iodine deficiency[J]. Clin Endocrinol Metab, 2008, 93(7): 2616-2621.
[15] Lambert-Messerlian G, McClain M, Haddow JE, et al. First- and second-trimester thyroid hormone reference data in pregnant women: a FaSTER(First- and second-trimester evaluation of risk for aneuploidy)research consortium study[J]. Obstet Gynecol, 2008, 199(1): 62.e1-62.e6.
[16] Gong Y, Hoffiman BR. Free thyroxine reference interval in each trimester of pregnancy determined with the Roche Modular E-170 electrochemiluminescent immunoassay[J]. Clin Biochem, 2008, 41(10-11): 902-906.
[17] 李佳, 滕卫平, 单忠艳, 等. 中国汉族碘适量地区妊娠月份特异性TSH和T4的正常参考范围[J]. 中华内分泌代谢杂志,2008, 24(6): 605-608. LI Jia, TENG Weiping, SHAN Zhongyan, et al. Gestational month-specific reference ranges for TSH and thyroxine in Han nationality women in iodine sufficient area of China[J]. Chinese Journal of Endocrinology And Metabolism, 2008 24(6): 605-608.
[18] 罗军,韩密,宋梦帆,等.两种免疫试剂检测妊娠期甲状腺功能结果的比较[J].中华围产医学杂志, 2012, 15(7): 404-410. LUO Jun, HAN Mi, SONG Mengfan, et al. Comparison of thyroid function tests results determined by two kinds of immunoassay in uncomplicated pregnant women[J]. Chinese Journal of Perinatal Medicine, 2012, 15(7): 404-410.
[19] 薛海波,李元宾,滕卫平,等. 妊娠早期母亲亚临床甲状腺功能减退症对其后代脑发育影响的前瞻性研究[J]. 中华内分泌代谢杂志,2010, 26(11): 135-137. XUE Haibo, LI Yuanbin, TENG Weiping, et al. Impact of maternal subclinical hypothyroidism during the first trimester on brain development of the offspring: a prospective study[J]. Chinese Journal of Endocrinology And Metabolism, 2010, 26(11): 135-137.
[20] Yu QY, Dong ZL, Dong L, et al. Trimester- and method-specific reference intervals for thyroid tests in pregnant chinese women: methodology, euthyroid definition and iodine status can influence the setting of reference intervals[J]. Clin Endocrinol(Oxf), 2011, 74(2): 262-269.
[21] Boucai L, Surks MI. Reference limits of serum TSH and free T4 are significantly influenced by race and age in an urban outpatient medical practice[J]. Clin Endocrinol(Oxf), 2009, 70(5): 788-793.
[22] Moradi S, Gohari MR, Aghili R. Thyroid function in pregnant women: iodine deficiency after iodine enrichment program[J]. Gynecol Endocrinol, 2013, 29(6): 596-599.
[23] 金行一,朱素娟,徐卫民,等.碘适量地区城市妊娠妇女亚临床甲状腺功能异常情况的研究[J]. 中国预防医学杂志, 2010,1(11):2-3. JIN Xingyi, ZHU Sujuan, XU Weimin, et al. Study on subclinical abnormalities of thyroid function in pregnant women in iodine sufficient areas[J]. Chinese Preventive Medicine, 2010, 1(11):2-3.

相关文章 15

[1]	孙言,孙文荣,耿琛琛,王慧慧,展新风. 术前超声诊断卵巢妊娠1例[J]. 山东大学学报（医学版）, 2017, 55(5): 131-132.
[2]	李梅. 高龄女性的卵子和胚胎质量[J]. 山东大学学报（医学版）, 2017, 55(1): 16-21.
[3]	李昀,仲万霞,姚宁,胡双纲,刘洪卯. 女性年龄对胚胎植入前遗传学诊断及筛查结局的影响[J]. 山东大学学报（医学版）, 2017, 55(1): 60-62.
[4]	邓晓惠,徐亚瑄. 高龄女性生育力评估及辅助生育[J]. 山东大学学报（医学版）, 2017, 55(1): 5-10.
[5]	杨冬梓,麦卓瑶. 高龄多囊卵巢综合征患者的卵巢储备特点及其助孕结局[J]. 山东大学学报（医学版）, 2017, 55(1): 26-32.
[6]	张琳,李敬,王泽,张江涛,马增香,石玉华. 多囊卵巢综合征患者促甲状腺激素对血糖、血脂的影响[J]. 山东大学学报（医学版）, 2017, 55(1): 80-84.
[7]	陶国伟,王晓玲,石琳琳,丁婷婷. 产前超声在不同孕期胎盘植入中的诊断价值[J]. 山东大学学报（医学版）, 2016, 54(9): 10-13.
[8]	刘冉,陶国伟,甄军晖,罗霞,千日成. ER、PR在妊娠期子宫肌瘤组织中的表达及意义[J]. 山东大学学报（医学版）, 2016, 54(5): 45-49.
[9]	董延磊, 朱琳. 腹腔镜下不同手术方式治疗输卵管妊娠后的妊娠状态[J]. 山东大学学报（医学版）, 2015, 53(7): 65-67.
[10]	初海鹏, 谭秀梅, 卢战凯. 阴道超声和血绒毛膜促性腺激素联合检测在异位妊娠诊断中的应用[J]. 山东大学学报（医学版）, 2014, 52(Z1): 138-139.
[11]	凌惠琴, 周艳萍. 中药方剂联合熊去氧胆酸治疗妊娠期肝内胆汁淤积症临床观察[J]. 山东大学学报（医学版）, 2014, 52(S2): 55-56.
[12]	陈更越, 张静, 丁树艳, 马莉莉, 王伟, 田园. HO-1及MIF在子痫前期患者胎盘及脐组织的表达[J]. 山东大学学报（医学版）, 2014, 52(S2): 1-2.
[13]	高世华, 张雪梅, 杨学. 甲氨喋呤联合中药治疗异位妊娠的临床观察[J]. 山东大学学报（医学版）, 2014, 52(S1): 33-34.
[14]	周晓莉, 黄惠娟, 吕玉霞. 腹腔镜手术治疗妊娠期卵巢囊肿90例疗效观察[J]. 山东大学学报（医学版）, 2014, 52(S1): 134-134.
[15]	王琦1,2，于春晓3，高聆1，赵家军3，曹铭锋3. 1-7554.0.2013.611促甲状腺激素调节肝脏AMPKα Thr 172而非Ser 173的磷酸化[J]. 山东大学学报（医学版）, 2014, 52(6): 22-27.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed