缺碘地区妊娠妇女甲状腺功能检测的临床分析

Clinical Analysis of Thyroid Function Test in Pregnant Women in Iodine Deficiency Area

目的探讨缺碘地区孕妇妊娠各期的甲状腺功能检测,为妊娠期甲状腺功能筛查提供重要依据。方法收集在本市三所医院产科进行常规产前检查的妊娠妇女1 800例。按照是否具有高危因素分为高危孕妇900例(A组),正常孕妇900例(B组)。对正常孕妇进行尿碘检测,评价本地区妊娠妇女碘营养状况。对高危孕妇与正常孕妇甲状腺过氧化物酶抗体(TPOAb)阳性与阴性甲状腺疾病患病率进行比较,进行TPOAb与促甲状腺激素(TSH)的相关性分析。结果佳木斯地区属轻度碘缺乏地区,妊娠期妇女血清TSH水平与TPOAb水平呈正相关,提示TPOAb的阳性者TSH升高比率大,TSH越高越可能存在自身免疫性甲状腺疾病。结论缺碘地区对妊娠期妇女进行甲状腺功能筛查十分必要,尽早发现和治疗,对于预防和减少产科并发症,保证胎儿的正常发育具有重要意义。

Objective To investigate the thyroid function of pregnant women in each stage of detection in iodine deficiency area,provide an important basis for the screening of thyroid function in pregnancy. Methods 1 800 cases of pregnant women were collected from three hospitals in our city. According to whether had the risk factors were divided into high-risk pregnant women in 900 cases（group A）,900 cases of normal pregnant women（group B）. Urinary iodine was detected in normal pregnant women and evaluate the iodine nutritional status of pregnant women. The prevalence of thyroid peroxidase antibody（TPOAb）in high-risk pregnant women and normal pregnant women were compared,and the correlation between TPOAb and thyroid stimulating hormone（TSH）was analyzed. Results The Jiamusi area belonged to mild iodine deficiency area,as for pregnant women,there was correlation between serum TSH level and TPOAb level,suggesting that TPOAb positive increased the ratio of TSH. The higher the more likely exsited autoimmune thyroid disease. Conclusion Pregnant women in iodine deficiency areas of thyroid function screening is necessary. Early detection and treatment,for prevention and reduction of obstetric complications,to ensure the normal development of the fetus is of great significance.