甘肃省武威市市区孕妇和乳母碘营养状况及甲状腺功能分析

Analysis of iodine nutritional status and thyroid function of pregnant and lactating women in urban areas ofWuwei City of Gansu Province

目的了解甘肃省武威市市区孕妇、乳母碘营养状况及甲状腺功能状态，为科学补碘提供理论依据。方法2009年采集甘肃省武威市市区孕妇（52人）、乳母（59人）的血液、尿液样本。采用砷铈催化分光光度法测定尿碘含量；直接化学发光免疫分析法检测血清游离三碘甲状腺原氨酸（n）、游离甲状腺激素（FT4）、总三碘甲状腺原氨酸（n）、总甲状腺素（TT4）、促甲状腺激素（TSH）。结果孕妇、乳母尿碘中位数分别为274．68、217．88μg／L，孕妇低于150μg／L，乳母低于100μe,／L的频率分别为9．62％（5／52）、6．78％（4／59）。孕妇血清玛、Tr4水平[（2．48±0．59）、（132．18±33．36）nmol／L]高于乳母[（2．16±0．49）、（108．79±28．36）nmol／L，t值分别为-3．123、-3．971，P均〈0．05]。孕妇和乳母甲状腺功能紊乱发生率分别为17．31％（9／52）、8．47％（5／59），甲状腺功能紊乱均以亚临床甲状腺功能减退居多。结论孕妇、乳母整体碘营养状况良好，部分个体存在甲状腺功能减退倾向，建议对这两类人群开展常规尿碘及甲状腺功能监测。

Objective To find out the iodine nutritional status and thyroid function of pregnant and lactating women in the urban areas of wuwei City of Gansu Province, and to provide a scientific basis for iodine supplementation. Methods Blood and urine samples of pregnant （52 persons） and lactating women （59 persons ） were collected in 2009. Urinary iodine content was measured with arsenic cerium catalytic speetrophotometric. Serum free three triiodothyronine （FT3）, free thyroid hormone （FT4）, triiodo thyronine （TT3）, serum total thyroxine （TT4） and thyroid-stimulating hormone （TSH） were detected with direct chemiluminescence immunoassay. Results The medians urinary iodine of pregnant and lactating women were 274.68, 217.88 μg/L. The rates of low urinary iodine （pregnant women below 150 μg/L, lactating women lower than 100 μg/L） were 9.62%（5/52） and 6.78% （4/59）. Serum TT3, TT4 levels in pregnant women[ （2.48 ± 0.59）, （132.18 ±33.36）nmol/L] were higher than that in the lactating women[ （2.16 ± 0.49 ）, （ 108.79 ± 28.36）nmol/L, t =-3.123, - 3.971, all P 〈 0.05 ]. Thyroid dysfunction incidence rates of pregnant and lactating women were 17.31% （9/52） and 8.47% （5/59）. Thyroid dysfunction was mostly subclinical hypothyroidism. Conclusions Overall iodine nutrition of pregnant and lactating women is in good condition, some individuals have the trend of hypothyroidism. It is necessary to carry out routine monitoring of urinary iodine and thyroid function.