妊娠早期碘营养状况与甲状腺功能关系的流行病学调查  

An epidemiological study of the relationship between iodine intake levels and thyroid function during early pregnancy

作　　者：史晓光[1,2] 滕晓春[2,3] 单忠艳[2,3] 于晓会[2,3] 李佳[2] 陈彦彦[2] 滕卫平[2,3] 

机构地区：[1]中国医科大学附属第一医院急诊科,沈阳110001 [2]中国医科大学附属第一医院内分泌研究所,沈阳110001 [3]中国医科大学附属第一医院内分泌科,沈阳110001

出　　处：《中国实用内科杂志》2009年第6期520-522,共3页Chinese Journal of Practical Internal Medicine

基　　金：国家"十五"科技攻关计划项目(2004BA720A);卫生行业科研专项项目(200802008);辽宁省重点实验室专项资金计划项目(辽科发[2005]36号-39);辽宁省科学技术计划项目(2007225010)

摘　　要：目的探讨妊娠早期碘营养状况与甲状腺功能的关系。方法随机选取2005—2007年碘充足的沈阳地区10所医院妇产门诊妊娠8周以内孕妇1154例,测定空腹尿碘、空腹血清促甲状腺素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、游离甲状腺素(FT4)。结果在碘充足地区仍有42.63%的孕妇存在碘缺乏。妊娠早期碘缺乏、碘适量、碘超足量、碘过量孕妇的亚临床甲减患病率分别为11.79%、8.60%、11.24%、18.75%,碘营养状况与患病率呈"U"字形关系曲线。碘超足量和碘过量的孕妇血清FT4水平均显著高于碘适量组。碘营养状况对TPOAb无影响。结论孕早期碘缺乏可以导致母体亚临床甲减患病率增加,碘超足量和碘过量可以导致母体亚临床甲减患病率和低T4血症的增加。Objective To investigate the relationship between iodine intake levels and thyroid function during early pregnancy. Methods From 2005 to 2007 1154 women at 8th gestational weeks in 10 diffierent hospitals in Shenyang were randomly selected. Fasting urinary iodine and fasting serum thyrotropin, free thyroxine, thyroid peroxidase antibody were detected. Results In the iodine adequate area,there were 42. 63% of pregnant women who were still exposed in iodine deficiency. The prevalence of subclinical hypothyroidism was 11.79% ,8. 60%, 11.24% and 18.75% in iodine deficient, iodine adequate,iodine more than adequate and iodine excessive group, respectively, with a U-shaped curve between iodine intake levels and the prevalence. The level of serum FT4 was higher in iodine more than adequate and iodine excessive group than that in iodine adequate one. There was no effect of iodine intake levels on serum thyroid peroxidase anti- bodie. Conclusion Iodine deficiency during early pregnancy may result in an increase of the prevalence of maternal subclinical hypothyroidism. Iodine more than adequacy and iodine excess may result in an increase of the prevalence of maternal subclinical hypothyroidism, as well as a decrease of maternal free thyroxine levels.

关 键 词：碘 妊娠 甲状腺功能减退症 亚临床甲减 低甲状腺素血症 

分 类 号：R5[医药卫生—内科学]