健康人群甲状腺自身抗体与甲状腺功能的关系

The relationship between thyroid autoantibodies and thyroid function in different populations

探讨我国8～10岁学龄儿童、成人、孕妇和哺乳期妇女的甲状腺自身抗体与甲状腺功能关系，为甲状腺疾病的预防监测提供参考。在6个碘盐供应较好的省份一次性横断面调查了健康8～10岁学龄儿童、成人、孕妇和哺乳期妇女各693、698、325、332名；采用全自动化学发光免疫分析法检测血清TSH、FT4、FT3，放射免疫法检测甲状腺自身抗体。抗体检测结果显示，女性甲状腺自身抗体阳性率明显高于男性，表现为学龄儿童：5.6%对2.0%，成人：22.8%对3.2%；但孕妇和哺乳期妇女抗体阳性率（8.9％，8.7％）明显低于普通成年女性（22.8%）。抗体阳性者甲状腺功能异常率高于抗体阴性者，均以亚临床甲状腺功能减退为主。另外，发现哺乳期妇女抗体阴性者，其甲状腺功能异常率也较高，但以低FT4为主。甲状腺功能异常与甲状腺自身抗体阳性有关，应加强甲状腺自身抗体阳性者的随访和监测，以利于甲状腺疾病的预防和临床早期诊治。应尽快建立哺乳期妇女甲状腺功能正常参考值范围。

To explore the relationship between thyroid autoantibodies and thyroid function in school children aged 8-10 years, adults, pregnant women, and lactating women in China, in order to provide reference for the prevention and monitoring of thyroid disease. Healthy 8-10 years old school children（693 cases）, adults（698 cases）, pregnant women（325 cases）, and lactating women（332 cases） from six iodine sufficient areas were enrolled. Serum TSH, FT4, and FT3 were determined by chemiluminescent immunoassay, while antithyroid antibody by radioimmunoassay. The positive rate of thyroid autoantibodies in females was significantly higher than that in the male（5.6% vs 2.0% in school children, and 22.8% vs 3.2% in adults）; while positive rate of autoantibodies in pregnant and lactating women（8.9%, 8.7%） were significantly lower than that in the other healthy adult women（22.8%）. The incidence of abnormal thyroid function in antibody-positive people was higher than that in negative ones in all groups, and abnormal thyroid function showed mainly as subclinical hypothyroidism. In addition, lactating women with negative autoantibodies presented a higher incidence of abnormal thyroid function, mainly as low FT4. The abnormal thyroid function is related with the positive thyroid autoantibodies, indicating that it is essential to follow-up these people with positive antibodies in order to facilitate prevention, early diagnosis, and treatment of thyroid disease. Reference data for thyroid hormones in lactating women should be established as soon as possible.