武威市妊娠妇女碘营养水平及甲状腺功能状态分析

Analysis on iodine nutritional status and thyroid function in pregnant women

目的了解不同妊娠期妇女碘营养水平及甲状腺功能状态。方法于2009年4月-2010年1月采用横断面调查方法随机抽取甘肃省武威市90名(城市49人,农村41人)妊娠期妇女。采集样本人群空腹晨起血样及任意一次尿样,检测血清促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)、甲状腺球蛋白抗体(TGAb)、甲状腺微粒体抗体(TMAb)及尿碘。结果孕早、中、晚期妇女尿碘中位数分别为231.49、158.25和328.35μg/L,尿碘低于150μg/L的比率分别为39.29%、45.16%、25.81%。孕早期FT3、FT4水平高于孕晚期(P﹤0.05),TSH水平呈增高趋势,组间比较差异无显著性(P>0.05)。不同妊娠期妇女TGAb、TMAb抗体阳性率比较差异无显著性(P>0.05)。孕早、中、晚期妇女甲状腺功能紊乱发生率比较差异有显著性(P<0.05)。结论妊娠妇女碘营养状况良好,部分孕妇存在甲状腺功能减退倾向。

Objective To investigate the iodine nutritional status and thyroid function of pregnant women during different periods of pregnancy, to provide evidence for guiding iodine supplementation for them. Methods A eross-sectional survey was performed in 90 pregnant women in Wuwei City from April 2009 to January 2010. The morning blood samples and random urine samples were collected, and the thyroid-stimulating hormone （ TSH ） , free triiodothyronine （ FT3 ） , free thyroid hormone （ FT4 ） , thyroglobulin antibodies （TGAb）, thyroid mierosomal antibodies （TMAb） in blood samples and iodine in urine samples were detected. Results The medians of urinary iodine were 231.49, 158.25 and 328.35μg/L for women in early, middle and late period of pregnancy, The ratio of urinary iodine below 150tzg/L were 39.29%, 45. 16% and 25.81% respectively. The FT3, FT4 levels in the first trimester were higher than those in the third trimester （P 〈 0.05 ） and TSH level was increased, but no significant difference （P 〉 0. 05）. The positive rate of TGAb and TMAb antibody of pregnant women in different period of time were not significantly different （P 〉 0.05 ）. The incidence of thyroid function disorder was significantly different in different gestation periods. Conclusion Generally, the iodine nutritional status of these pregnant women was appropriate, but there was a tendency towards hypothyroid in some women. Monitoring urinary iodine and thyroid function in pregnant women should be carried out regularly.