在怀孕期间调查与甲状腺激素测量相关的因素
Miho Fukushita1, Jaeduk Yoshimura Noh1, Natsuko Watanabe1
1Department of Internal Medicine, Ito Hospital, Tokyo, Japan.
European thyroid journal
|August 29, 2025
概括
怀孕时的甲状腺激素水平受到人类胆性腺激素 (HCG),白蛋白和甲状腺素结合型球蛋白 (TBG) 的影响. 这些因素影响免疫检测结果,影响孕妇甲状腺状况的准确评估.
科学领域:
- 内分泌学
- 生殖医学
- 临床化学
背景情况:
- 准确的甲状腺状况评估对于管理怀孕至关重要.
- 怀孕期间甲状腺激素的波动需要仔细解释.
- 甲状腺激素的免疫检测方法可能会受到怀孕特定因素的影响.
研究的目的:
- 研究人类胆性腺激素 (HCG),白蛋白和甲状腺激素结合球蛋白 (TBG) 在怀孕期间对甲状腺激素测量的影响.
- 通过化学发光免疫测试 (CLIA) 和电化学发光免疫测试 (ECLIA) 获得的甲状腺激素测量结果进行比较.
- 为了澄清这些因素的妊娠变化如何影响甲状腺激素测试.
主要方法:
- 在使用CLIA和ECLIA的897名孕妇血清样本中测量了自由甲状腺素 (FT4),自由三甲状腺素 (FT3) 和甲状腺激素 (TSH).
- 在样本子集中使用液态染色体-并联质谱 (LC-MS/MS) 验证的免疫试验结果.
- 使用多变量回归分析来确定甲状腺功能与HCG,白蛋白和TBG等决定因素之间的关联.
主要成果:
- 观察到TSH水平的显著变化,其中一个显著的百分比低于0. 01mIU/ L.
- 甲状腺激素水平在怀孕早期到中期达到峰值,并在怀孕后期下降,低于非怀孕的参考间隔.
- 人体胆激素 (HCG) 是免疫测试甲状腺激素测量的主要决定因素;白蛋白和TBG也影响了结果,特别是在特定的度范围内.
结论:
- 孕期甲状腺激素水平受到HCG的显著影响.
- 甲状腺激素的免疫测量可以根据白蛋白和TBG度而有所不同.
- 孕妇甲状腺功能测试的临床解释需要考虑这些生理波动.
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