【摘要】：目的:探討甘肅蘭州地區(qū)妊娠各期特異性血清甲狀腺激素水平參考值范圍的建立并分析其原因,為臨床診治做好指導(dǎo),避免妊娠期甲狀腺疾病的漏診和誤診,提高母嬰生活質(zhì)量,為優(yōu)生優(yōu)育保駕護(hù)航。方法:根據(jù)美國(guó)國(guó)家臨床生化研究院(the National Academy of Clinical Biochemisty,NACB)推薦的研究方法,妊娠期甲狀腺激素水平醫(yī)學(xué)參考值范圍采用95%可信區(qū)間,并制定本研究納入與排除標(biāo)準(zhǔn)后共收集了來自2015年10月至2016年6月在蘭州大學(xué)第二醫(yī)院婦產(chǎn)科門診產(chǎn)檢的單胎妊娠的健康孕婦562例,其中早孕期(T1)238例,孕中期(T2)192例,孕晚期(T3)132例,作為實(shí)驗(yàn)組,另選取52例非妊娠(T0)健康育齡期婦女作為對(duì)照組。均在其早晨空腹來院產(chǎn)檢時(shí)8:00~12:00留取空腹靜脈血5ml,置于真空黃色帽促凝采血管中,靜置2h,用3500r/min LC-4012低速離心機(jī)對(duì)血樣進(jìn)行離心,離心時(shí)間15分鐘,而后放入Siemens ADVIA Centaur XP全自動(dòng)化學(xué)發(fā)光法免疫儀檢測(cè)游離型的甲狀腺素(free thyroxine,FT4)、游離型的三碘甲腺原氨酸(free triiodothyronine,FT3)以及促甲狀腺激素(thyroid-stimulating hormone,TSH),并對(duì)結(jié)果進(jìn)行統(tǒng)計(jì)分析,建立甘肅蘭州地區(qū)妊娠期甲狀腺激素醫(yī)學(xué)參考值范圍。結(jié)果:甘肅蘭州地區(qū)妊娠各期的TSH醫(yī)學(xué)參考值范圍在妊娠早期、妊娠中期、妊娠晚期分別為0.05~5.58 mIU/L、0.26~4.80 m IU/L、0.21~5.11 m IU/L;FT4醫(yī)學(xué)參考值范圍在妊娠早、中、晚期分別為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,妊娠各期參考范圍有統(tǒng)計(jì)學(xué)意義,孕期與非孕期參考范圍有統(tǒng)計(jì)學(xué)意義,P0.05。結(jié)論:建立甘肅蘭州地區(qū)妊娠期甲狀腺激素參考值范圍十分重要與必要。
[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.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R714

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