佛山市妊娠妇女碘营养及甲状腺疾病的初步研究

The initial analysis of iodine nutrition and thyroid function in pregnant women in Foshan

目的了解佛山地区妊娠妇女碘营养状况及甲状腺激素变化的特点,为临床合理补充膳食提供依据。方法收集2013年6月至2014年11月在禅城区中心医院进行门诊产检孕妇血液及尿液标本各442例,采用电化学发光法检测血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)、促甲状腺激素(TSH)水平,采用碘催化砷铈反应原理检测尿碘。结果 442例孕妇尿碘中位数为174μg/L。中度碘缺乏、轻度碘缺乏、碘充足、碘过量分别为4.30%、29.86%、39.59%、26.24%;孕早期、孕中期、孕晚期尿碘水平异常率分别为72.41%、45.89%、62.91%,不孕周期尿碘水平异常与碘适量水平进行两两比较,差异有统计学意义(P<0.05)。碘充足组FT3、TSH结果均低于碘缺乏组、碘过量组,碘充足组与碘缺乏组进行比较,FT4差异有统计学意义(P<0.05),碘充足组与碘过量组进行比较,TSH差异有统计学意义(P<0.05)。结论佛山地区妊娠妇女碘营养水平异常率及甲状腺疾病的患病率较高,应及时对妊娠妇女进行筛查干预,以达到优生优育的目的。

Objective To investigate the status of iodine nutrition and variations of thyroid hormone levels in pregnant women in Foshan and to provide the science theory on the clinical diet supplement rational .Methods The samples were collected from 442 ca‐ses of pregnant women in Chancheng district center hospital from June 2013 to November 2014 .Free triiodothyronine（FT3） ,free thyroxine（FT4） and thyroid stimulating hormone（TSH） were determined by method of electrochemiluminescence .The urinary io‐dine content in pregnant women was measured by using cold digestion method according to iodine catalytic effect of Arsenic‐Ceri‐um .Results The median urinary iodine in 442 cases of pregnant women was 174μg/L .The percentage of midrange iodine deficien‐cy ,mild iodine deficiency ,iodine sufficiency and iodine overdose in 442 cases of pregnant women were respectively 4 .30% ,29 .86% , 39 .59% and 26 .24% .First trimester ,second trimester ,third trimester with abnormal level of urine iodine was respectively 72 .41% ,45 .89% ,62 .91% .The different gestational age with abnormal level of urine iodine and normal level of urine iodine was significant differences（P〈0 .05） .The urine iodine sufficient group of FT3 ,TSH were lower than the urine iodine deficiency groups and the urine iodine excess group ,The FT4 of urine iodine sufficient group compare with iodine deficiency groups was significant differences（P〈0 .05） .TSH in urine iodine sufficient group to compared urine iodine excess group ,with significant differences（P〈0 .05） .Conclusion The abnormal rate of the level of iodine nutrition and the prevalence of thyroid diseases of pregnant women in FoShan are relatively high .The pregnant women should be screening and intervention in time to raise healthier .