北京市海淀区妊娠早期甲状腺疾病筛查方案探讨

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Abstract Objective To study the screening program of thyroid dysfunction during early pregnancy and develop an specific thyroid-stimulating hormone normal reference value during early pregnancy in Beijing. Methods One thousand four hundred cases of single-birth women were enrolled in this study between October 2011 and October 2012.Their age ranged from 18 to 35 years old and all of them were given a regular prenatal check in in the Armed Police General Hospital. By detecting the levels of thyroid stimulating hormone (TSH), we established two reference values as follows 1) TSH concentrations greater than 2.5 mU/L 2) TSH concentrations less than 0.1mU/L, for the group one we detected free thyroxine (FT₃、FT₄), TGAb and TPOAb, and detected free thyroxine (FT₃、FT₄)、TRAb for the group two .The incidences of thyroid dysfunction were calculated according to ATA treatment guideline.Additionally, 360 single-birth women during early pregnancy, (8-12 weeks) without a history of thyroid disease, family history of thyroid disease, no history of other autoimmune diseases were selected to detect the levels of thyroid stimulating hormone (TSH), TGAb and TPOAb, and those women who were positive for TPOAb and TGAb were excluded. Early pregnancy TSH normal reference value of 95% confidence interval in Beijing, and statistical incidence of hypothyroidism were developed according to this standard. Results (1)The incidence of hypothyroidism in the 1400 cases was 9.0%, of which pregnancy subclinical hypothyroidism and pregnancy clinical hypothyroidism were 7.36% and 1.64%, respectively. In patients with hypothyroidism during pregnancy, the incidence of Hashimoto’s thyroiditis accounted for 46.03%; the incidence of gestational thyrotoxicosis was 3.5%, of which clinical hyperthyroidism and subclinical hyperthyroidism constituted 3.14% and 0.36%, respectively.In gestational thyrotoxicosis, pregnancy with hyperthyroidism syndrome (GHS) accounted for 94%, pregnancy Graves disease accounted for 6%. (2)56 women who were positive for TPOAb and TGAb were excluded in the 360 pregnant women, the 95% normal serum TSH reference value of the remaining 304 pregnant women with negative antibody in early pregnancy was 0.1-3.6 mU/L; according to the standard TSH 0.1-3.6 mU/L .the incidence rate of subclinical hypothyroidism in the 1400 pregnant women was, 3.86%. Conclusions The incidences of hypothyroidism and thyrotoxicosis are high in early pregnancy and mostly subclinical. The main cause of hypothyroidism during pregnancy is Hashimoto’s thyroiditis. Most of thyrotoxicosis in pregnancy is GHS. TSH routine testing of pregnant women in early pregnancy, and further detecting free thyroxine (FT₃、FT₄) and thyroid autoantibodies if TSH is abnormal according to specific TSH reference values of pregnancy is an economical and effective screening method for thyroid disease during pregnancy.

Key words： pregnancy thyroid stimulating hormone reference value pregnancy hypothyroidism subclinical hypothyroidism during pregnancy thyrotoxicosis pregnancy thyrotoxicosis gestational hyperthyroidism syndrome

Received: 14 March 2014

ZTFLH:

R714.147

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	Articles by authors
	XIA Yixin
	ZHENG Ying
	XU Chun
	LIU Hong
	SHEN Liyan

Cite this article:

XIA Yixin,ZHENG Ying,XU Chun等. A screening program for thyroid disease during early pregnancy in Haidian district in Beijing[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2015, 26(1): 26-28.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2015/V26/I1/26

[3]	Stricker R T, Echenard M, Ebehart R, et al.Evaluation of maternal thyroid function during pregnancy:the importance of using gestional age-specific referance intervals[J].Eur J Endocrinol, 2007, 157:509-514.
[1]	DeGeyerC, Steimann S, Muller B, et al.Pattern of thyroid function during early pregnancy in women diagnosed with subclincal hypothyroidism and treated with 1-thyroxin is similar to that in euthyroid controls[J].Thyroid, 2009, 19(1):53-59.
[2]	中华医学会内分泌学分会, 中华医学会围产医学分会.妊娠和产后甲状腺疾病诊治指南[J].中华内分泌代谢杂志, 2012, 28(5):354-371.
[4]	Gilbert R M, Hadlow N C.Assessment of thyroid function during pregnancy:first-trimester(weeks9-13)reference intervals derived from Western Australian women[J].Med J Aust, 2009, 190(4):219-220.
[3]	Stricker R T, Echenard M, Ebehart R, et al.Evaluation of maternal thyroid function during pregnancy:the importance of using gestional age-specific referance intervals[J].Eur J Endocrinol, 2007, 157:509-514.
[5]	Larsen T M.Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum[J].Thyroid, 2011, 21:1081-1125.
[6]	李佳, 滕卫平, 单忠艳.中国汉族碘适量地区妊娠月份特异性TSH和T4的正常参考范围[J].中华内分泌代谢杂志, 2008, 24(6):605-608.
[4]	Gilbert R M, Hadlow N C.Assessment of thyroid function during pregnancy:first-trimester(weeks9-13)reference intervals derived from Western Australian women[J].Med J Aust, 2009, 190(4):219-220.
[5]	Larsen T M.Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum[J].Thyroid, 2011, 21:1081-1125.
[7]	单忠艳.妊娠合并甲状腺功能减退症的进展和争论[J].内科理论与实践, 2010, 5(2):125-129.
[6]	李佳, 滕卫平, 单忠艳.中国汉族碘适量地区妊娠月份特异性TSH和T4的正常参考范围[J].中华内分泌代谢杂志, 2008, 24(6):605-608.
[8]	于晓会, 陈彦彦, 滕卫平, 等.妊娠特异性甲状腺功能参数在评价妊娠中期甲状腺功能中的作用[J].中国实用妇科与产科杂志, 2010, 26(6):459-461.
[7]	单忠艳.妊娠合并甲状腺功能减退症的进展和争论[J].内科理论与实践, 2010, 5(2):125-129.
[8]	于晓会, 陈彦彦, 滕卫平, 等.妊娠特异性甲状腺功能参数在评价妊娠中期甲状腺功能中的作用[J].中国实用妇科与产科杂志, 2010, 26(6):459-461.