2009年吉林省农村地区孕妇和哺乳期妇女碘营养状况与甲状腺功能调查

Investigation of iodine nutritional status and thyroid function among pregnant and lactating women from rural areas of Jinlin province in 2009

目的调查吉林省农村地区孕妇和哺乳期妇女的碘营养水平及甲状腺功能状态。方法2009年选择吉林省磐石市宝山、明城、烟筒山3个乡的农村作为调查地区，抽取当地孕妇和哺乳期妇女作为观察对象，收集血样，直接化学发光免疫分析法检测甲状腺功能[总、游离三碘甲腺原氨酸（TT3、FT3），总、游离甲状腺激素（TT4、FT4）]，放射免疫分析法检测甲状腺球蛋白抗体（TgAb）、甲状腺微粒体抗体（TMAb）、甲状腺球蛋白（Tg）；1个月内连续3次采集观察对象尿样，砷铈催化分光光度法检测尿碘。结果被调查对象中TT3，高于正常的孕妇占14．3％（8／56），而TT4、FT3、FT4低于正常的孕妇分别占3．6％（2／56）、5．4％（3／56）、1．8％（1／56）；TT3高于正常的哺乳期妇女占3．6％（2／56），TT4、FT4低于正常的哺乳期妇女各占1．8％（1／56）。有5％～20％的孕妇和哺乳期妇女TgAb、TMAb升高。孕妇和哺乳期妇女尿碘中位数3次检测结果分别为193．35、170．80、197．30μg／L和193．00、225．85、262．90μg／L。结论现行盐碘水平对孕妇和哺乳期妇女是适宜的，部分孕妇存在甲状腺功能减退倾向，应对孕妇和哺乳期妇女开展常规尿碘及甲状腺功能监测。

Objective To investigate the iodine nutritional level and thyroid function of pregnant and lactating women in rural areas of Jilin province. Methods The investigation sites were selected from rural areas of three towns （Baoshan, Mingcheng and Yantongshan of Panshi county, Jilin province） in 2009. The pregnant and lactating women were selected as subjects in these three towns. The blood samples were collected and ,the thyroid function （including serum TT3, TF4, FT3, FT4） were measured with chemiluminescence, and serum thyroglobulin antibodies（TgAb）, thyromicrosome antibody（TMAb）, and thyroglobulin（Tg） were measured with radioimmunoassay （RIA）. The urine samples were collected three times within one month and were measured for iodine concentration by As-Ce catalytic spectrophotometry method. Results In the pregnant women, serum TT3 was higher than that of healthy pregnant women, accounted for 14.3%（8/56）, while serum TF4, TT3, FT4 were lower than those of healthy pregnant women, accounted for 3.6% （2/56）,5.4% （3/56）, and 1.8% （1/56）, respectively. In the lactating women, serum TF3 was higher than that of healthy lactating women, accounted for 3.6%（2/56）, while serum TT4, FT4 were lower than those of healthy lactating women, accounted for 1.8%（1/56）, respectively. Five per cent to 20% of the pregnant and lactating women had higher TgAb and TMAb. Conclusions Existing salt iodine level is appropriate for pregnant women and lactating women, but there was a tendency towards hypothyroid in some women. Routine monitoring of urinary iodine and thyroid function should be carried out among pregnant and lactating women.