沿海产盐区与非产盐区妊娠期妇女碘营养状况及甲状腺功能水平分析

Analysis of iodine-nutrition status and thyroid function of pregnant women in coastal salt-producing areas and coastal non-salt-producing areas in Xiamen City

目的了解福建沿海产盐区与非产盐区妊娠期妇女碘营养状况及其甲状腺功能水平,为防治碘缺乏病提供科学依据。方法选择产盐区翔安区和非产盐区集美区为调查点,每个点随机抽取60名以上妊娠期妇女作为调查对象,采集孕妇的家中盐样、尿样及血样,分别测定盐碘、尿碘及血清甲状腺激素。结果产盐区与非产盐区孕妇合格碘盐食用率分别为81.69%和100.00%;产盐区与非产盐区孕妇尿碘的中位数分别为120.55μg/L和153.35μg/L,尿碘<150μg/L的比例分别为62.2%和46.8%,孕早期尿碘水平>孕中期>孕晚期;产盐区与非产盐区孕妇的甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb),抗甲状腺球蛋白抗体(antithyroid glubulin antibody,TgAb),总三碘甲状腺原氨酸(total-triiodothyronine,TT3),总甲状腺素(total thyroxine,TT4),游离三碘甲状腺原氨酸(free triiodothyronine,FT3),游离甲状腺素(free thyroxine,FT4),促甲状腺激素(thyroid stimulating hormone,TSH),甲状腺球蛋白(tryroglobulin,Tg)中位数均在正常范围,产盐区与非产盐区孕妇的FT3、FT4、TSH之间差异均有统计学意义,产盐区孕妇的FT3、FT4均低于非产盐区,而产盐区孕妇的TSH则高于非产盐区。结论孕妇是易缺碘人群,产盐区孕妇相对非产盐区碘缺乏更为严重。应对孕妇开展常规碘营养和甲状腺功能监测,进一步做好碘营养知识的宣传教育工作,控制碘缺乏病的发生。

Objective To investigate the iodine nutritional status and thyroid function of pregnant women in coastal salt-producing areas and coastal non-salt-producing areas in Xiamen City,and provide the evidence for taking the measurements of iodine deficiency disorder（IDD） control.Methods The Xiang’an salt-producing areas and the Jimei non-salt-producing areas were chosen as research spots,more than sixty pregnant women were selected from each research spots.The household salt,urine sample,and blood samples of pregnant were collected,and the salt-iodine,urine-iodine and blood thyroid hormone levels were assayed respectively.Results The edible qualified iodinated salt rate in salt-producing areas and non-salt-producing areas was 81.69% and 100.00%,respectively.The median of urinary iodine of the pregnant women in salt-producing areas and non-salt-producing areas was 120.55 and 153.35 μg / L respectively,the proportion of urine-iodine level 〈 150 μg / L was 62.2% and 46.8% respectively,trimester 〉 second trimester 〉 third trimester.All the medians of thyroid hormones including thyroid peroxidase antibody（TPOAb）,antithyroid glubulin antibody（TgAb）,total-triiodothyronine（TT 3）,total thyroxine（TT 4）,free triiodothyronine（FT 3）,free thyroxine（FT 4）,thyroid stimulating hormone（TSH）,tryroglobulin（Tg） of pregnant women in both salt-producing areas and non-salt-producing areas were in normal ranges,both the levels of FT 3 and FT 4 of pregnant women in salt-producing areas were lower than that of non-salt-producing areas,however,TSH presented opposite tendency,which all showed significant differences.Conclusions Pregnant women are vulnerable to be in the state of iodine deficiency,the harm of iodine deficiency to pregnant women in salt-producing areas are severer than those in non-salt-producing areas.Routine monitoring of urinary iodine and thyroid function should be carried out among pregnant women,iodine nutrition knowledge should be well propagandized to prevent and control the occurrence of IDD.