兰州地区妊娠期甲状腺激素参考值范围探讨

发布时间：2019-03-25 18:37

【摘要】：目的:探讨甘肃兰州地区妊娠各期特异性血清甲状腺激素水平参考值范围的建立并分析其原因,为临床诊治做好指导,避免妊娠期甲状腺疾病的漏诊和误诊,提高母婴生活质量,为优生优育保驾护航。方法:根据美国国家临床生化研究院(the National Academy of Clinical Biochemisty,NACB)推荐的研究方法,妊娠期甲状腺激素水平医学参考值范围采用95%可信区间,并制定本研究纳入与排除标准后共收集了来自2015年10月至2016年6月在兰州大学第二医院妇产科门诊产检的单胎妊娠的健康孕妇562例,其中早孕期(T1)238例,孕中期(T2)192例,孕晚期(T3)132例,作为实验组,另选取52例非妊娠(T0)健康育龄期妇女作为对照组。均在其早晨空腹来院产检时8:00~12:00留取空腹静脉血5ml,置于真空黄色帽促凝采血管中,静置2h,用3500r/min LC-4012低速离心机对血样进行离心,离心时间15分钟,而后放入Siemens ADVIA Centaur XP全自动化学发光法免疫仪检测游离型的甲状腺素(free thyroxine,FT4)、游离型的三碘甲腺原氨酸(free triiodothyronine,FT3)以及促甲状腺激素(thyroid-stimulating hormone,TSH),并对结果进行统计分析,建立甘肃兰州地区妊娠期甲状腺激素医学参考值范围。结果:甘肃兰州地区妊娠各期的TSH医学参考值范围在妊娠早期、妊娠中期、妊娠晚期分别为0.05~5.58 mIU/L、0.26~4.80 m IU/L、0.21~5.11 m IU/L;FT4医学参考值范围在妊娠早、中、晚期分别为10.73~19.15pmol/L、10.26~18.06pmol/L、9.94~16.35pmol/L。TSH在孕早期最低,FT4最高,妊娠各期参考范围有统计学意义,孕期与非孕期参考范围有统计学意义,P0.05。结论:建立甘肃兰州地区妊娠期甲状腺激素参考值范围十分重要与必要。
[Abstract]:Objective: to explore the establishment of reference range of specific serum thyroid hormone level in Lanzhou area of Gansu Province and analyze its causes so as to guide the clinical diagnosis and treatment of thyroid diseases during pregnancy and avoid missed diagnosis and misdiagnosis of thyroid diseases during pregnancy. Improve the quality of life of the mother and child, for the protection of eugenics and quality of education. Methods: according to the research method recommended by the National Institute of Clinical Biochemistry (the National Academy of Clinical Biochemisty,NACB), 95% confidence interval (CI) was used in the medical reference range of thyroid hormone level during pregnancy. After the inclusion and exclusion standard of this study, 562 healthy pregnant women with single pregnancy were collected from the obstetrics and gynaecology clinic of the second Hospital of Lanzhou University from October 2015 to June 2016, including 238 cases of early pregnancy (T1). 192 cases in the second trimester of pregnancy (T2) and 132 cases in the third trimester (T3) were selected as the experimental group and 52 healthy women of childbearing age without pregnancy (T0) as the control group. In the morning, when they came to the hospital for antenatal examination on an empty stomach, 5 ml of fasting venous blood was collected, placed in a vacuum yellow cap to promote coagulation and collected blood vessels, and placed for 2 hours. The blood samples were centrifuged with 3500r/min LC-4012 low-speed centrifuge for 15 minutes, and the blood samples were centrifuged with a low-speed centrifuge for 15 minutes. The free thyroxine (free thyroxine,FT4), free triiodothyronine (free triiodothyronine,FT3) and thyroid stimulating hormone (thyroid-stimulating hormone,TSH) were detected by Siemens ADVIA Centaur XP automatic chemiluminescence immunoassay. The results were statistically analyzed to establish the medical reference range of thyroid hormone during pregnancy in Lanzhou area of Gansu Province. Results: the reference values of TSH in the first trimester of pregnancy, the second trimester of pregnancy and the third trimester of pregnancy in Lanzhou area of Gansu Province were 0.05 ~ 5.58 mIU/L,0.26~4.80 mIU/L, 0.21 ~ 5.11 mIU/L, respectively. The reference values of FT4 in early, middle and late trimester of pregnancy were 10.73, 19.15, 10.26, 18.06, 9.94 and 16.35 pmol / L respectively, the lowest and the highest in the first trimester of pregnancy, and the highest in FT4. There was statistical significance in the reference range of each stage of pregnancy. The reference range of pregnancy and non-pregnancy was statistically significant, P 0.05. Conclusion: it is very important and necessary to establish the reference range of thyroid hormone during pregnancy in Lanzhou area of Gansu Province.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714

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