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目的建立河南省不同孕期的健康孕妇血清甲状腺激素的正常参考范围,研究其变化规律。方法选取2012年12月至2013年5月在郑州大学第三附属医院就诊的本省健康妊娠期妇女583名和非妊娠妇女187名,采用化学发光法检测血清TSH、TT4、FT4、TT3、FT3水平,建立不同孕期孕妇的甲状腺激素参考值范围。结果 (1)各孕期甲状腺激素水平与非孕期比较有统计学差异(P均<0.01)。(2)孕早期血清TSH水平比非孕期和孕中晚期明显降低(P均<0.01),孕中晚期逐渐回升(P<0.01)。(3)FT4孕期各组比较差异有统计学意义(P<0.01),孕中期及晚期呈下降趋势,显著低于非孕期(P<0.01)。(4)TT4整个孕期明显高于非孕期(P<0.01),孕中期达高峰,孕晚期略下降。(5)FT3和TT3孕早期明显高于非孕期(P<0.01),孕中期较孕早期增高(P<0.01)并持续至孕晚期。结论孕期甲状腺激素水平与非孕期存在明显差异,各孕期之间亦存在明显差异,因此建立孕期甲状腺激素参考值对于妊娠期甲状腺疾病的早期诊断具有临床意义。
Objective To establish the normal reference range of serum thyroid hormone in healthy pregnant women of different pregnant stages in Henan Province and to study its variation law. Methods A total of 583 healthy pregnant women and 187 non-pregnant women were selected from the Third Affiliated Hospital of Zhengzhou University from December 2012 to May 2013. The levels of serum TSH, TT4, FT4, TT3 and FT3 were detected by chemiluminescence method. Establishment of pregnant women in different pregnancy thyroid hormone reference range. Results (1) The levels of thyroid hormone during pregnancy were significantly different from those during non-pregnancy (all P <0.01). (2) Serum TSH levels in the first trimester were significantly lower than those in the non-trimester and the second trimester (P <0.01), and gradually increased in the second trimester (P <0.01). (3) There was significant difference between each group during FT4 pregnancy (P <0.01), and the trend was lower in the second and third trimester than that in non-pregnancy (P <0.01). (4) TT4 was significantly higher in the whole pregnancy than non-pregnancy (P <0.01), peaked in the second trimester, and slightly decreased in the third trimester. (5) FT3 and TT3 in early pregnancy were significantly higher than those in non-pregnant (P <0.01) and increased in early pregnancy (P <0.01) and continued until the third trimester of pregnancy. Conclusions The levels of thyroid hormone during pregnancy are significantly different from those during non-pregnancy and there are also significant differences between pregnancies. Therefore, establishing the reference value of thyroid hormone during pregnancy is of clinical significance for the early diagnosis of thyroid disease during pregnancy.