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- 2018
不同孕期特异性甲状腺激素水平探讨
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Abstract:
摘要 目的:探讨各孕期妇女甲状腺激素水平的变化,建立本地区孕期特异性甲状腺激素水平参考值范围.方法:筛选产检并分娩的各孕期正常孕妇共600例,采用化学发光法测定促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3),制定各孕期特异性甲状腺激素水平参考值范围.收集各孕期孕妇3 770例,评估本研究参考值,并与2011年及2017年美国甲状腺医师学会(ATA)指南的诊断标准进行比较.结果:①妊娠早、中、晚各期血清TSH的质量浓度中位数及97.5%参考范围分别为1.06 mIU/L(0.013~3.01 mIU/L),1.31 mIU/L(0.35~4.08 mIU/L),1.51 mIU/L(0.20~4.05 mIU/L),孕早期TSH值显著低于孕中、晚期.②以2017年ATA标准对妊娠中、晚期亚甲减的诊断率与本研究制定的参考值范围相似,但对早孕期亚甲减的诊断,漏诊率高达68.4%.③约69%的孕妇第一次检查甲状腺功能在孕中期,孕早期监测者仅占约14%.结论:①TSH值在早孕期明显低于中晚孕期,不建议使用4.0 mIU/L TSH质量浓度值作为本地区早孕期TSH参考上限.②本地区早孕期筛查率低,应加强宣教,提高早孕期检测率.
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