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目的:探讨不同孕期和孕妇年龄对机体甲状腺激素水平的影响。方法:选择375例无甲状腺疾病史的孕妇,并以80例健康体检的非妊娠女性作为对照组,比较对照组和不同孕期、不同年龄的孕妇血清总三碘甲状腺原氨酸(TT_3)、总甲状腺素(TT_4)、游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)、促甲状腺激素(TSH)水平,以及抗甲状腺球蛋白抗体(TGAb)、抗甲状腺过氧化物酶抗体(TPOAb)阳性表达情况。结果:早孕期组、中孕期组和晚孕期组孕妇TT_3、TT_4、FT_3、FT_4、TSH水平与对照组比较,差异均有统计学意义(P<0.05),早孕期组、中孕期组和晚孕期组FT_3、FT_4水平依次降低(P<0.05),中孕期组及晚孕期组TSH较早孕期组降低(P<0.05);<28岁组、28~34岁组和≥35岁组孕妇TT_3、TT_4、FT_3及FT_4水平均依次降低,TSH水平依次升高(P<0.05),≥35岁组孕妇FT_3和FT_4水平较<28岁组孕妇降低、TSH水平升高(P<0.05);早孕期组、中孕期组和晚孕期组TPOAb阳性率及TGAb阳性率均依次降低(P<0.05);TPOAb阳性率为10.13%(38/375)。结论:妊娠期甲状腺激素水平与孕周及孕妇年龄密切相关,早孕期监测孕妇甲状腺激素水平对于甲状腺功能异常的检出及母儿健康具有重要意义。
Objective: To investigate the effects of different pregnancy and pregnant women on thyroid hormone levels. Methods: A total of 375 pregnant women with no history of thyroid disease were enrolled in this study. Eighty healthy non-pregnant women were selected as the control group. The levels of total triiodothyronine (TT_3) (TT_4), free triiodothyronine (FT_3), free thyroxine (FT_4), thyrotropin (TSH), and anti-thyroglobulin antibody (TGAb), anti-thyroid peroxidase antibody TPOAb) positive expression. Results: Compared with control group, the levels of TT_3, TT_4, FT_3, FT_4 and TSH in pregnant women in early pregnancy group, middle pregnancy group and late pregnancy group were significantly different (P <0.05) The levels of FT_3 and FT_4 in pregnant women were decreased in turn (P <0.05), while the levels of TSH in pregnant women and pregnant women in the first trimester were lower than those in the first trimester (P <0.05). The pregnant women <28, 28-34, (P <0.05). The levels of FT_3 and FT_4 in pregnant women ≥35 years old were lower than those in pregnant women <28 years old, while the levels of TSH were increased (P <0.05) The positive rate of TPOAb and the positive rate of TGAb in the period group, middle pregnancy group and late pregnancy group were successively decreased (P <0.05). The positive rate of TPOAb was 10.13% (38/375). Conclusions: The level of thyroid hormone in pregnancy is closely related to gestational age and the age of pregnant women. Monitoring the level of thyroid hormone in pregnant women during the first trimester is important for detection of thyroid dysfunction and maternal and child health.