武汉某医院不同孕期孕妇甲状腺激素水平比较研究

A Comparative Study of Thyroid Hormone Levels in Pregnant Women of Different Pregnancy in a Hospital in Wuhan

摘要: 目的：探究不同孕期孕妇甲状腺激素水平的相关性。方法：纳入2020年1月~2023年12月武汉市汉南区人民医院行产检孕妇219例，另取50例非妊娠健康女性设为对照组。依据孕期分为3组，其中孕早期组(孕周 ≤ 13周) 91例，孕中期组(孕周 > 13且≤27周) 56例、孕晚期组(孕周 > 27周) 72例，比较三组产妇甲功三项[游离甲状腺素(FT4)、游离三碘甲状原氨酸(FT3)、促甲状腺激素(TSH)]。记录三组患者甲状腺过氧化物酶抗体(TPOAB)、抗甲状腺球蛋白抗体(TGAb)阳性率。结果：三组孕妇较对照组TSH、FT3、FT4均有显著下降(P < 0.05)；孕早期组TSH水平低于孕中期组、孕晚期组，且孕晚期组TSH水平高于孕中期组(P < 0.05)；孕中期组、孕晚期组较孕早期组FT4、FT3水平显著下降(P < 0.05)；且孕晚期组较孕中期组FT4、FT3水平显著下降。孕早期组TPOAB阳性率高于孕中期组、孕晚期组(P < 0.05)，孕中期与孕晚期比较无统计学差异(P > 0.05)。结论：不同孕期孕妇的甲状腺功能指标存在明显差异，应关注不同孕期产妇甲功五项指标，并予以相应观察或干预。

Abstract: Objective: To explore the correlation between different pregnancy and thyroid hormone levels. Methods: A total of 219 pregnant women who underwent prenatal examination in Hannan District People’s Hospital of Wuhan from January 2020 to December 2023 were included, and 50 non-pregnant healthy women were selected as the control group. According to pregnancy, they were divided into three groups, including 91 cases in the early pregnancy group (gestational age ≤ 13 weeks), 56 cases in the middle pregnancy group (gestational age > 13 and ≤27 weeks), and 72 cases in the late pregnancy group (gestational age > 27 weeks). Three items of thyroid function [free thyroxine (FT4), free triiodothyronine (FT3), thyroid stimulating hormone (TSH)] were compared among the three groups. The positive rates of thyroid peroxidase antibody (TPOAB) and antithyroglobulin antibody (TGAb) in the three groups were recorded. Results: TSH, FT3 and FT4 in the three groups of pregnant women were significantly lower than those in the control group (P < 0.05). The TSH level in the first trimester group was lower than that in the second trimester group and the third trimester group, and the TSH level in the third trimester group was higher than that in the second trimester group (P < 0.05). The levels of FT4 and FT3 in the second trimester group and the third trimester group were significantly lower than those in the first trimester group (P < 0.05). The levels of FT4 and FT3 in the third trimester group were significantly lower than those in the second trimester group. The positive rate of TPOAB in the first trimester group was higher than that in the second trimester group and the third trimester group (P < 0.05). There was no significant difference between the second trimester and the third trimester (P > 0.05). Conclusion: There are significant differences in thyroid function indexes of pregnant women in different pregnancy periods. Attention should be paid to the five indexes of thyroid function of pregnant women in different pregnancy periods, and corresponding observation or intervention should be given.