青岛地区妊娠期妇女碘营养状况与甲状腺功能减退症的相关性研究  

THE RELATIONSHIP BETWEEN THE IODINE NUTRITIONAL STATUS AND HYPOTHYROIDISM OF PREGNENT WOMEN IN QINGDAO

作　　者：刘灿灿[1] 王秀秀[2] 周燕[1] 王颜刚[1] 赵文娟[1] 

机构地区：[1]青岛大学附属医院内分泌科,山东省青岛市266003 [2]青岛大学医学院第二附属医院内分泌科

出　　处：《中国煤炭工业医学杂志》2015年第6期993-997,共5页Chinese Journal of Coal Industry Medicine

摘　　要：目的研究青岛地区妊娠期妇女碘营养状况及其与甲状腺功能减退症的相关性。方法随机选取妊娠妇女663例,检测空腹尿碘、血清TSH、FT4、甲状腺过氧化物酶抗体（TPOAb）。结果妊娠期妇女尿碘在2.50~3 366.00μg/L,尿碘中位数（MUI）为161.59μg/L,碘缺乏、碘足量、碘超足量、碘过量的比例分别为44.95%、34.09%、15.69%、5.28%;妊娠T2、T3期尿碘水平以及轻度碘缺乏的比例均明显高于T1期,差异有统计学意义（均P〈0.05）;妊娠T2、T3期碘足量的比例低于T1期妇女,差异也有统计学意义（均P〈0.05）;妊娠期临床甲减、亚临床甲减、低T4血症的患病率分别为0.60%、3.77%、6.49%,妊娠各期之间的患病率差异均无统计学意义（均P〉0.05）;妊娠期TPOAb总阳性率为9.80%,碘缺乏组中亚临床甲减患者TPOAb的阳性率明显高于甲功正常组（P〈0.01）,且TPOAb阳性组亚临床甲减的患病率明显高于TPOAb阴性组（P〈0.01）。结论青岛地区妊娠期妇女群体不存在碘缺乏,但有44.95%的妊娠妇女个体存在碘缺乏,随着妊娠期的延长,碘缺乏呈加重趋势;TPOAb阳性与妊娠妇女发生亚临床甲减相关。Objective To investigate the urinary iodine level and the thyroid function of pregnant women in Qingdao, and to explore the relationship between the iodine nutritional status and hypothyroidism. Methods A total of 663 pregnant women who in obstetric clinical of author＇s hospital for routine prenatal care were collected from December 2012 to December 2014, the urinary iodine concentration and thyroid function were measured. Results The level of those pregnant women＇s urine iodine concentration was between 2.50 ~3 366.00μg/L, the median of urine iodine was 161.59μg/L. The ratios of iodine deficient, iodine ade- quate, iodine more than adequate and iodine excessive groups were 44. 95%, 34.09%, 15.69%, 5.28% respectively. The ratios of iodine deficient of T2, T3 period were higher than T1 period（P〈0.05;P〈0. 01）, and the urine iodine level of T2, T3 period were lower than T1 period（P〈0.05;P〈0.01）. The prevalence of overt hypothyroidism, subclinical hypothyroidism and hypothyroxinemia were 0. 60%, 3. 77%, 6.49% respectively, but there was no difference in the prevalences（P〉0.05}. The positive rate of TPOAb in the 663 pregnant women was 9.8%, the positive rate in the iodine deficient group of subclinical hypothyroidism was significantly higher than those with euthyroidism （P〈0.01}, and the prevalence of subclinical hypothyroidism in the TPOAb positive group was significantly higher than the TPOAb negative group（P〈0.01}. Conclusion There is no iodine deficiency among pregnant women groups in Qingdao, but still 44.95% individuals expose in iodine insufficient. The ratio of iodine insufficient will increase with the extension of pregnancy. Positive TPOAb is one of risk factors of subclinical hypothyroidism during pregnancy.

关 键 词：妊娠 碘营养 甲状腺功能减退症 甲状腺过氧化物酶抗体 

分 类 号：R582.2[医药卫生—内分泌]