补碘对孕中晚期低甲状腺素血症孕妇甲状腺功能的影响  

Effects of iodine supplementation on thyroid function of pregnant women with hypothyroxinemia in middle-late pregnancy

作　　者：夏俊[1] 陈茜 晋柏[3] 袁庆新 

机构地区：[1]南京医科大学附属江苏盛泽医院内分泌病科,江苏省215000 [2]南京医科大学第一附属医院内分泌病科 [3]南京医科大学第一附属医院妇产科

出　　处：《江苏医药》2015年第17期2014-2016,共3页Jiangsu Medical Journal

基　　金：吴江市科技计划项目(WS201214)

摘　　要：目的探讨补碘对孕中晚期低甲状腺素血症孕妇甲状腺功能和尿碘浓度(UIC)的影响。方法妊娠24-27+6周低甲状腺素血症孕妇232例,对合并碘缺乏的127例随机给予优甲乐和补碘治疗(A组,78例)或单纯食物补碘治疗(B组,49例),其余105例分别采用优甲乐治疗(C组,55例)或不予治疗(D组,50例)。观察治疗4周后孕妇甲状腺功能和UIC变化。结果入组孕妇中碘缺乏者占54.70%(127/232)。A、B组治疗4周后UIC均升高(P<0.01)。补碘治疗可阻止血清促甲状腺激素(TSH)的上升和游离甲状腺素(FT4)、游离三碘甲状腺素(FT3)的下降。优甲乐和补碘的交互效应可提高FT3水平(P=0.01)。结论孕期易合并碘缺乏;对于低甲状腺素血症孕妇,尤其同时合并碘缺乏者,可通过补碘改善母体的甲状腺功能。Objective To investigate the effects of iodine supplementation on thyroid function and urine iodine concentration（UIC） of pregnant women with hypothyroxinemia. Methods A total of 232 pregnant women in 24-27＋6 pregnant weeks was enrolled, of whom 127 cases were with iodine deficiency and treated with levothyroxine （LT4） and iodine （group A, 78 cases） or with iodine supplementation by iodine-enriched diet （group B, 49 cases）. The rest 105 cases were assigned into group C（treated with LT4,55 cases） and group D（without treatment, 50 cases）. Maternal thyroid function and UIC were examined after four weeks treatment. Results The incidence rate of iodine deficiency was 54. 70 % （127/232） in pregnant women with hypothyroxinemia. The UIC in groups of A and 13 was increased significantly after iodine supplementation （P^0. 01 ）. Iodine supplementation could prevent the increase of thyrotrophin（TSH） and the decreases of free triiodothyronine（FT3 ） and free thyroxine（FT4 ）. The combined use of LT4 and iodine supplementation could significantly improve the level of FT3 in women with hypothyroxinemia （P=0. 01 ）. Conclusion Pregnant women are vulnerable to iodine deficiency. Iodine supplementation can improve maternal thyroid function in pregnant women with hypothyroxinemia,especially in those with iodine deficiency.

关 键 词：妊娠 甲状腺功能 低甲状腺素血症 尿碘 

分 类 号：R581[医药卫生—内分泌]