探讨孕妇不同孕期尿碘含量对新生儿甲状腺功能的影响  

Influence of urinary iodine content to neonate's thyroid function of pregnant women in different gestational age

作　　者：陈秀兰[1] 李莲[2] 袁学华[1] 

机构地区：[1]湖北省十堰市妇幼保健院检验科,湖北十堰442000 [2]湖北医药学院附属人民医院检验部,湖北十堰442000

出　　处：《中国医药导报》2012年第27期95-97,102,共4页China Medical Herald

基　　金：湖北省十堰市科学技术研究与开发项目(2010STT06)

摘　　要：目的探讨孕妇在不同怀孕阶段的尿碘含量和新生儿先天性甲减之间的相关性,为制订孕妇尿碘筛查的最佳时机和科学补碘提供理论依据。方法采用过氧乙酸四甲基联苯胺氧化显色法检测妊娠妇女尿碘水平;采用荧光酶免法检测干滤纸血片中促甲状腺激素(TSH)浓度;用化学发光法测定甲状腺功能。结果孕0～12、13～20、21～28、29～35、36～41周及产后3～6 d孕妇尿碘的中位数分别为178、165、136、129、196、232μg/L;妊娠21～28、29～35周孕妇尿碘水平偏低;孕21～28周尿碘低下组孕妇TSH水平[(5.66±2.92)mU/L]明显高于尿碘正常组[(3.51±0.61)mU/L](P<0.01);孕29～35周尿碘低下组孕妇TSH水平[(5.57±1.67)mU/L]高于尿碘正常组[(3.96±0.75)mU/L](P<0.05);尿碘低下组孕妇所生的新生儿干血片TSH水平[(11.8±10.5)mU/L]明显高于尿碘正常组孕妇所生的新生儿TSH水平[(3.89±1.13)mU/L](P<0.01);妊娠21～35周孕妇尿碘、TSH水平和新生儿TSH水平呈显著相关性。结论检测妊娠中、晚期孕妇的尿碘水平可评估其胎儿的碘营养状况。Objective To analyze the correlation of urinary iodine content and congenital hypothyroidism in different pregnant women during pregnancy,thus provide a theoretical basis for the choice of best time to screen maternal urinary iodine.Methods Pregnant women urinary iodine levels were tested by peractic acid tetramethylbenzidine oxidation chromomeric assay.The concentrations of thyroid stimulating hormone（TSH） in dried blood film were determined by fluorescence enzyme immunoassay,and thyroid function was evaluated using chemiluminescence.Results Median of urinary iodine was 178 μg/L,165 μg/L,136 μg/L,129 μg/L,196 μg/L,232 μg/L in women during 0-12 weeks,13-20 weeks,21-28 weeks,29-35 weeks,36-41 weeks pregnant and 3-6 days after postpartum;and pregnant women urinary iodine levels were lower during 21-28 weeks and 29-35 weeks of pregnancy.TSH levels [（5.66±2.92）mU/L] in 21-28 weeks pregnant women with lower urinary iodine were significantly higher than that of urinary iodine normal group [（3.51±0.61）mU/L]（P 0.01）;TSH levels [（5.57±1.67）mU/L] in 29-35 weeks pregnant women with lower urinary iodine were significantly higher than that of urinary iodine normal group [（3.96±0.75）mU/L]（P 0.05）.TSH levels [（11.8±10.5）mU/L] level of dried blood spot in newborn of pregnant women with lower urinary iodine were significantly higher than that of pregnant women with normal urinary iodine group [（3.89±1.13）mU/L]（P 0.01）.There was a significant correlation between Urinary iodine,TSH levels of 21-35 weeks of pregnancy maternal and neonatal TSH levels.Conclusion Iodine nutritional status of the fetus could be evaluated by urinary iodine levels of pregnant women in middle and late gestation.

关 键 词：妊娠 尿碘 促甲状腺激素 新生儿 甲状腺功能低下 

分 类 号：R581.1[医药卫生—内分泌]