上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

不同孕期及年龄妇女甲状腺功能的分析

卢永霞，李启富，舒小雨，杨 渝，王利华，刘 纯   

  1. 重庆医科大学附属第一医院内分泌科， 重庆 400016
  • 出版日期:2014-02-28 发布日期:2014-03-25
  • 通讯作者: 刘 纯, 电子信箱: liuchun200157@sina.com。
  • 作者简介:卢永霞（1987—）， 女， 硕士生; 电子信箱: 297416118@qq.com。

Analysis of thyroid function in pregnant women of different stages of gestation and ages

LU Yong-xia, LI Qi-fu, SHU Xiao-yu, YANG Yu, WANG Li-hua, LIU Chun   

  1. Department of Endocrinology, the First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
  • Online:2014-02-28 Published:2014-03-25

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摘要：

目的 探讨各妊娠期及各年龄段孕妇甲状腺相关激素的水平，并了解甲状腺功能减低症（甲减）的发病情况。方法 选取2012年12月—2013年4月既往无甲状腺相关病史的妊娠妇女734名，以非孕健康女性108名作为对照。所有孕妇按照年龄分为A组(<28岁)、B组（28~34岁）和C组（35~43岁）；按照孕期分为孕早期组（0~13+6个星期），孕中期组（14~27+6个星期），孕晚期组（28个星期~分娩）。运用电化学发光法检测游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）和促甲状腺素（TSH）的水平。结果 妊娠组各孕期甲状腺相关激素（FT3、FT4和TSH）与对照组相比差异具有统计学意义（P<0.01）。孕中期组和孕晚期组妇女的FT3与FT4水平较孕早期组降低，而TSH水平较孕早期组升高（P<0.05）。孕中期和孕晚期组的临床甲减患病率较孕早期组明显升高，差异有统计学意义（P<0.05）。亚临床甲减患病率各孕期组比较差异无统计学意义（P>0.05）。C年龄组妊娠妇女FT3与FT4水平较A组降低，而TSH水平较A组升高，差异均有统计学意义（P<0.05）。TSH水平随着年龄段的增加而升高，但是各年龄段甲减与亚临床甲减患病率比较差异无统计学意义（P>0.05）。结论 孕妇的妊娠阶段和年龄与甲状腺激素水平密切相关，检测妊娠期甲状腺激素水平对筛查和干预甲减具有重要作用。

关键词: 甲状腺功能减低症, 甲状腺功能, 妊娠年龄, 孕妇

Abstract:

Objective To discuss the levels of thyroid related hormones and incidence of hypothyroidism at different gestational ages and in different stages of gestation. Methods The 734 pregnant women without thyroid related medical history were selected for the study and 108 healthy non-pregnant women were selected as the control group. All these gravidas were divided into different groups by age (group A: <28 years, group B: 28-34 years, and group C: 35-43 years) and by the duration of pregnancy (group T1: 0-13+6 weeks, group T2: 14-27+6 weeks, and group T3: 28 weeks-delivery). The free triiodothyronire (FT3), free thyroxine (FT4), and thyroid stimulating hormore (TSH) levels were measured by chemiluminescent method. Results The differences of thyroid related hormone (FT3, FT4, and TSH) levels of
pregnant women in each stages of gestation and women in the control group were statistically significant (P<0.01). For T2 and T3 groups, the levels of FT3 and FT4 were lower than those of T1 group, while the level of TSH was higher than that of T1 group, and the incidence of hypothyroidism of FT3 and FT4 groups were obviously higher than that of T1 group. All these differences were statistically significant (P<0.05). But the differences of incidence of subclinical hypothyroidism among each stages of gestation were not statistically significant (P>0.05). For group C, the levels of FT3 and FT4 were lower than those of group A, while the level of TSH was higher than that of group A, and the differences were statistically significant (P<0.05). TSH increased with age. But the differences of incidence of hypothyroidism and subclinical hypothyroidism among gestational age groups were not statistically significant (P>0.05). Conclusion The thyroid related hormone levels are closely related to gestational ages and stages of gestation. Detection of gestational thyroid hormone levels plays an important role in screening and intervention of hypothyroidism.

Key words: hypothyroidism, thyroid function, gestational ages, pregnant women