山东省青岛地区妊娠早期妇女碘营养状况与甲状腺功能减退症的相关性分析

A study of the relationship between iodine intake levels and hypothyroidism of pregnant women in Qingdao

目的：检测山东省青岛地区妊娠早期（妊娠＜12周）妇女尿碘水平，探讨其与甲状腺功能减退症的关系，为指导妊娠早期妇女补碘提供依据。方法选取山东省青岛地区妊娠12周以内的妊娠早期妇女326例作为研究对象，测定空腹尿碘及血清促甲状腺素（TSH）、游离甲状腺素（FT4）及甲状腺过氧化物酶抗体（TPOAb）水平。结果妊娠早期妇女尿碘中位数（MUI）176．57μg／L；碘缺乏、碘足量、碘超足量和碘过量分别38．65％、41．10％、15．95％、4．30％；碘异常率58．9％（192／326）。碘缺乏组、碘过量与碘足量组的甲状腺功能减退症患病率相比较，差异有统计学意义（χ2＝4．308、P ＜0．05；χ2＝4．826、P ＜0．05），而碘缺乏组、碘足量组、碘超足量组、碘过量组的 TPOAb 阳性率分别为10．32％、9．70％、11．53％、7．14％，碘缺乏组、碘超足量组、碘过量组与碘足量组分别相比较，差异均无统计学意义（均 P ＞0．05）。结论青岛地区妊娠早期妇女群体不存在碘缺乏，但个体碘缺乏仍存在。碘缺乏、碘过量是妊娠早期甲状腺功能减退症的危险因素，建议妊娠早期筛行尿碘检测。

Objective To investigate the urinary iodine level and the thyroid function of early pregnant women in Qingdao,to explore the relationship between the iodine nutritional status and hypothyroidism.Methods 326 early pregnant women （〈12 gestational weeks）were collected.The urinary iodine concentration and serum thyroid stimulating hormone （TSH）,free thyroxine （FT4 ）,thyroid peroxidase antibody （TPOAb）were detected. Results The median of urine iodine of pregnant women was 176.57μg/L,and the ratios of iodine deficient,iodine adequate,iodine more than adequate and iodine excessive groups were 3 8.65%,41.10%,15.95% and 4.30%.The total ratio of innormal urine iodine was 58.9%（192 /326）.The differences between the ratios of the iodine deficient group,iodine excessive group and iodine adequate group both had statistically significant（χ2 =4.308,P 〈0.05;χ2 =4.826,P 〈0.05 ）.There was no effect of iodine intake levels on serum thyroid peroxidase antibody.Conclusion There is no iodine deficiency among early pregnant women in Qingdao,but still individuals expose iodine deficiency.Iodine deficiency and iodine excessive are the risk factors of hypothyroidism during early pregnancy women,so we commend to detect the urinary iodine level.