孕妇尿碘水平在妊娠晚期的临床价值  

Clinical value of urinary iodine level in the third trimester of pregnancy

作　　者：陈春艳[1] 杨小红[1] 郑明康[1] 

机构地区：[1]广东省珠海市妇幼保健院,广东珠海519000

出　　处：《中国医药导报》2014年第22期84-86,共3页China Medical Herald

摘　　要：目的：探讨妊娠晚期不同程度尿碘缺乏对母婴甲状腺功能的影响。方法随机抽取2011年4月1日-2012年3月31日在珠海市妇幼保健院门诊参加围生期保健的孕妇549名筛查尿碘，根据尿碘值分为正常组、轻度缺碘组、中度缺碘组和重度缺碘组，检测血清促甲状腺素（TSH）、游离T3（FT3）、游离T4（FT4）水平，观察孕妇缺碘性甲状腺功能低下（以下简称“甲低”）的发生率，随诊其所生新生儿足跟血TSH水平，了解不同程度尿碘缺乏对新生儿甲状腺功能的影响。结果亚临床型甲低的发生率为3.10%，临床型甲低的发生率为1.09%。正常组、轻度缺碘组、中度缺碘组、重度缺碘组亚临床型甲低发生率逐渐增高，分别为0.35%、3.08%、4.17%、15.00%，各组临床型甲低的发生率也逐渐增高，分别为0、0.77%、2.78%、5.00%，其中，正常组甲低发生率与其他三组、轻度缺碘组甲低发生率与重度缺碘组比较，差异均有统计学意义（均P〈0.05），轻度缺碘组与中度缺碘组、中度缺碘组与重度缺碘组甲低发生率比较，差异无统计学意义（P〉0.05）。尿碘缺乏程度与孕妇甲低的发生率有关联，且呈线性关系，差异有统计学意义（P〈0.05）。新生儿足跟血TSH筛查阳性10例，进一步确诊无新生儿先天性甲低。结论孕妇不同程度尿碘缺乏，使其亚临床型甲低、临床型甲低的发生率增加，增加了新生儿患先天性甲低的风险，因此孕早期应检测尿碘，异常者建议监测甲状腺功能，减少新生儿先天性甲低的发生。Objective To investigate the influence of urine iodine-deficiency with varying degree on thyroid function in the third trimester of pregnancy of pregnant woman and neonate. Methods 549 pregnant women in Outpatient Service, Maternal and Children Health Hospital of Zhuhai City were selected to measure urinary iodine from April 1, 2011 to March 31, 2012. According to urinary iodine, they were divided into 4 groups：normal, mild iodine deficiency, moderate iodine deficiency and severe iodine deficiency groups. The levels of serum free triiodothyronine （FT3）, free thyroxine （FT4） and thyroid-stimulating （TSH） were detected. The incidence of iodine-deficiency hypothyroidism were observed. And their neonates＆#39; heel blood TSH levels were analyzed too, to explore the influence of urine iodine-deficiency with varying degree on neonates’ thyroid function. Results The incidence of hypothyroidism and subclinical hypothyroidism was 1.09% and 3.10%. The incidence of subclinical hypothyroidism and hypothyroidism were gradually increased in normal, mild iodine deficiency, moderate iodine deficiency and severe iodine deficiency groups, the incidence of sub-clinical hypothyroidism were 0.35%, 3.08%, 4.17%, 15.00% respectively, and the incidence of hypothyroidism were 0, 0.77%, 2.78%, 5.00% respectively. There were statistically significant differences in the rates of hypothyroidism be-tween normal group and iodine-deficiency groups （P〈0.05）;mild iodine deficiency group and severe iodine deficiency group （P〈0.05）. There were no statistically significant differences between the mild iodine deficiency group and mod-erate iodine deficiency group, moderate iodine deficiency group and severe iodine deficiency group （P〉0.05）. A linear relationship between the urine iodine-deficiency and hypothyroidism of pregnant woman was found （P〈0.05）. 10 cases of neonates＇ heel blood screening were positive, but there was no congenital hypothyroidism case beyond further diag-nosis. Conclusion The incidence

关 键 词：孕妇 妊娠晚期 尿碘 甲状腺功能低下 

分 类 号：R581.1[医药卫生—内分泌]