摘要
目的 调查清远地区汉族育龄女性妊娠前半周期临床甲状腺功能减退症(简称甲减)、亚临床甲状腺功能减退症(简称亚甲减)、单纯低甲状腺素血症(简称低FT4血症)的患病率、漏诊率,为妊娠期甲状腺疾病的诊治提供指导。方法 选择2018年1—12月妊娠前半期在本院门诊就诊的育龄女性2561例,对其临床资料进行分析,对其中未确诊甲状腺疾病病例2519例,以妊娠期特异性甲状腺功能正常范围(指南推荐、本单位特异参考值)和非妊娠人群三种标准,对其甲状腺功能分别进行甲减、亚甲减、低FT4血症3种疾病筛查。结果 应用三个诊断标准均发现有漏诊病例,其中应用指南推荐(Roche)参考值标准发现:甲减漏诊6例,漏诊率(16.22%),占筛查人群(0.24%);亚甲减漏诊31例,漏诊率(100%),占筛查人群(1.23%);低FT4血症漏诊25例,漏诊率(100%),占筛查人群(0.99%)。经筛查得出妊娠前半周期筛查总患病率:甲减37例(1.44%)、亚甲减31例(1.21%)、低FT4血症25例(0.98%)。结论 加强妊娠期甲状腺功能减退症患者的孕期管理及规范诊治,特别关注合并高危因素患者,可减少漏诊率及改善妊娠结局。
Objective To investigate the prevalence and missed diagnosis rate of clinical hypothyroidism,sub-clinical hypothyroidism(SCH),hypothyroxinemia(low FT4)in the first half of pregnancy among women of childbearing age in the Han ethnic group of Qingyuan city,to guide the diagnosis and treatment of thyroid diseases during pregnancy.Methods The 2561 women of childbearing age in the first half of pregnancy who visit a doctor in outpatient department of our hospital from January to December 2018 were selected in this study,and their clinical data were analyzed.The disease of hypothyroidism,SCH and low FT4 were screened among the 2519 undiagnosed cases by using the three kinds of criteria of the normal pregnancy-specific thyroid function scope(recommendations of the guideline,reference range)and non-pregnant population.Results The missed diagnosis was found in the process of screening by the three criteria respectively.In the screening with the reference range from recommendations of the guideline(Roche),6 cases with hypothyroidism,31 cases with SCH and 25 cases with low FT4 were missed diagnosed.The missed diagnosis rate were 16.22%,100%and 100%,respectively.And these cases account for 0.24%,1.23%and 0.99%of the screened population,respectively.The screening findings showed that total prevalence in the first half of pregnancy was 37 cases with hypothyroidism(1.44%),31 cases with SCH(1.21%),and 25 cases(0.98%)with low FT4.Conclusions The missed diagnosis can be reduced and the pregnancy outcome could be improved by strengthening the management and standard diagnosis of the patients with hypothyroidism during pregnancy and paying more attention to patients with high-risk factors.
作者
成志
温穗文
齐玲
付宏望
陈玉铃
孙晶
蔡莉花
Cheng Zhi;Wen Huiwen;Qi Ling;Fu Hongwang;Chen Yuling;Sun Jing;Cai Lihua(Qingyuan people's hospital,the sixth affiliated hospital of Guangzhou Medical University,Qingyuan,Guangdong,511500,China)
出处
《齐齐哈尔医学院学报》
2022年第9期874-877,共4页
Journal of Qiqihar Medical University
基金
清远市科技计划项目(2018B069)。
