妊娠期甲状腺生理及特异性参考值范围建立的现状

妊娠期甲状腺激素水平随人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)、甲状腺结合球蛋白(thyroid binding globulin,TBG)以及碘代谢的改变而发生一系列合成、循环、代谢等变化并建立新的平衡,使得孕期的甲状腺素水平不同于非孕期。一旦平衡无法建立或打破,会导致多种甲状腺功能异常并继发一系列母儿并发症,严重威胁母婴健康。因此国内外指南均建议各地区建立妊娠各期甲状腺激素特异性参考值范围。由于种族、碘状态、研究方法等方面的差异,各国各地区相继建立的参考值范围均存在一定差异。

Thyroid physiology and situation of establishment of specific reference range in pregnancy

During pregnancy, thyroid hormones undergo significant changes including production, circulation and metabolism, coming to a new balance with the vary of human chorionic gonadotropin(hCG), thyroid binding globulin(TBG) and iodine metabolism, which makes the thyroid hormones different from those of non-pregnant women. Once the balance cannot be established or broken, it can lead to a variaty of thyroid diseases which result in lots of adverse obstetric and fetal outcomes threated to maternal and child health. Consinderring that, the domestic and foreign guidelines all recommend that regions should establish trimester-specific thyroid function reference intervals. Due to the differences in race, iodine status, research methods, etc., the reference intervals have been established differently in various countries and regions.