妊娠期碘营养状况及其与甲状腺功能关系研究  

Study on the iodine nutritional status and its relationship with thyroid function in pregnant women

作　　者：张培[1] 王蕴慧[2] 陈慧[2] 丁红[2] 陈欣[2] 谭剑平[2] 

机构地区：[1]中山大学附属第三医院妇产科,广东广州510630 [2]中山大学孙逸仙纪念医院妇产科,广东广州510120

出　　处：《中国实用妇科与产科杂志》2016年第1期94-98,共5页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：广东省科技计划(2011B031800119)

摘　　要：目的探讨广州地区孕妇碘营养状况及其与甲状腺功能的关系。方法选择2012年3月至2014年2月在中山大学孙逸仙纪念医院产检的孕妇815为研究对象,进行甲状腺功能、抗甲状腺过氧化物酶抗体(TPO-Ab)和尿碘的检测,结果异常者定期复查,密切监测母胎情况,追踪至妊娠终止。结果 815例无甲状腺疾病史孕妇尿碘中位数(median urinary iodine,MUI)为197.0μg/L;其中碘缺乏者39.6%(323/815);碘适宜者20.9%(170/815);碘超足量者27.4%(223/815);碘过量者12.1%(99/815)。早中晚孕期MUI分别为208、182.5、174.5μg/L。不同碘营养状况下甲状腺功能、甲状腺疾病的患病率及TPO-Ab阳性率的差异无统计学意义,均P>0.05。结论孕妇碘营养状态为碘适宜,但个体间差异较大。不同碘营养状况下甲状腺疾病的患病率无明显差异,即轻度碘缺乏或碘过量不增加甲状腺疾病的患病率。随着孕周的增加,尿碘值逐渐下降,但都在碘适宜的范围内。Objective To evaluate the iodine nutritional status of pregnant women in Guangzhou and discuss the rela- tionship between iodine nutritional status and thyroid function. Methods Pregnant women who take antenatal care at Sun Yat-sen Memorial Hospital, St/n Yat-sen University were chosen as the research objects between March 2012 and February 2014. They received thyroid function testing （TT4, FT4, TSH, TPOAb） and urinary iodine testing during preg- nancy. If the result was abnormal, then they needed to be reviewed periodically.Results There were 815 pregnant wom- en without thyroid anamuesis, the median urinary iodine （MUI） being 197p, g/L. According to the urinary iodine value, women were divided into four groups iodine deficient, iodine sufficient, iodine over sufficient and iodine excessive groups, and the percentage of the four groups were 39.6% （323/815）, 20.9% （170/815）, 27.4% （223/815） and 12.1% （99/ 815）, respectively. In accordance with the testing time, women were divided into three groups： the first trimester （T1）, the second trimester （T2） and the third trimester （T3） groups. The MUI in T1 , T2, and T3 was 208ug/L, 182.5p, g/L, and 174.5ug/L, respectively. The differences of thyroid function （TT4, FT4, TSH） and TPO-Ab positive rates among the four groups were not statistically significant.Conclusion Pregnant women in our study are iodine sufficient, but the urine io- dine distribution is individually different. There is no significant difference on the prevalence of thyroid diseases among different iodine nutritional status. With the increase of gestational age, urinary iodine value declines gradually but still in the scope of iodine sufficient status.

关 键 词：碘营养状况 甲状腺疾病 妊娠期 

分 类 号：R714.147[医药卫生—妇产科学]