妊娠早期妇女甲状腺功能指标分析

摘要

目的:了解妊娠早期妇女甲状腺功能指标变化情况.方法:选择2016年8月1日-2017年7月31日在航天中心医院就诊的妊娠早期妇女1460例为妊娠组,另选择健康体检的非妊娠妇女472例为对照组,采用化学发光法检测血清甲状腺功能指标,比较分析两组差异.结果:妊娠早期妇女三碘甲状腺原氨酸(TT3)、甲状腺素(TT4)水平显著高于对照组,游离三碘甲状腺原氨酸(FT3)、促甲状腺素(TSH)、甲状腺过氧化物酶抗体(Anti-TPO)水平显著低于对照组(P＜0.05).妊娠组甲状腺功能异常率占31.7％,且大多是亚临床甲减(13.1％)及单纯甲状腺过氧化物酶抗体阳性(13.2％);而对照组除单纯甲状腺自身抗体阳性异常率(22.7％)比妊娠组高(13.2％)外,其他甲状腺功能异常率均低于妊娠组.结论:孕早期妇女甲状腺功能指标与非孕期妇女相比存在明显差异,大多为亚临床甲减及单纯甲状腺过氧化物酶抗体阳性.妊娠早期检测血清甲状腺功能指标有助于及时发现甲状腺功能异常并采取干预措施.%Objective:To investigate the chang of thyroid function index of early pregnant women.Methods:1460 early pregnant women presented to aerospace center hospital from August 2016 to July 2017 were enrolled in study group,and 472 non-pregnant women were included in control group at the same time.Serum levels of total triiodothyronine (TT3),total tetraiodothyronine(TT4),free triiodo-thyronine (FT3),free tetraiodothyronine (FT4),hyroid stimulating hormone(TSH) and thyroid peroxidade antibody (anti-TPO) of all included women were detected by chemiluminescence method,and were compared between the two groups.Results:Compared with women in control group,ser um levels of TT3,TT4,FT3,TSH and anti-TPO of pregnant women in study group were statistical significant different(P＜0.05),serum levels of TT3 and TT4 were higher,while serum levels of FT3,TSH and anti-TPO were lower.Thyroid dysfunction rate of pregnant women in study group was 31.7％,and most of them were subclinical hypothyroidism (13.1％) and pure anti-TPO positive (13.2％).The rate of pure anti-TPO positive of women in control group was 22.7％,which was significant higher than that of women in study group.And the levels of other thyroid function index of women in control group were lower than those of women in study group.Conclusion:The serum levels of thyroid hormone of early pregnant women are different from those of non-pregnant women,and most of early pregnant women have subclinical hypothyroidism and pure anti-TPO positive.Therefore,serum thyroid hormone levels detected early for pregnant women can help diagnosing thyroid dysfunction and giving intervention in time.