韶关市碘适量地区孕妇甲状腺功能及自身抗体的研究  

Study of thyroid function in pregnant women and autoantibodies in an appropriate amount of iodine region of Shaoguan City

作　　者：夏侯为民 王晓燕[2] 吴凌霄 谷小俭 杨通[3] 谭明凤 XIAHOU Wei -min WANG Xiao -yan WU Ling -xiao GU Xiao -jian YANG Tong TAN Ming -feng(Lechang City Center for Disease Control and Prevention, Guangdong 512200, China)

机构地区：[1]乐昌市疾病预防控制中心,广东512200 [2]浙江中医药大学基础医学院流行病学与卫生统计学教研室 [3]广东省疾病预防控制中心

出　　处：《医学动物防制》2016年第10期1067-1070,共4页Journal of Medical Pest Control

基　　金：韶关市卫生计生局科研计划项目(Y16146)

摘　　要：目的评价韶关市适碘地区不同孕期孕妇甲状腺功能和自身抗体水平,并分析其变化规律,为孕妇科学补碘提供理论依据。方法查找韶关乐昌市2015年碘盐监测资料。在较大医疗机构妇产科门诊采用横断面方法随机抽取331名常住健康孕妇,其中孕早期（0-13周）、孕中期（14-27周）、孕晚期（28-40周）分别为68、126、137名。采集孕妇尿样测定尿碘,采集静脉血测定甲状腺素（TSH）、血清游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）、甲状腺球蛋白抗体（TGAb）、甲状腺过氧化物酶抗体（TPOAb）。结果孕早、中、晚期孕妇尿碘中位数分别为185.6μg/L、174.2μg/L、152.7μg/L,全部达到WHO推荐标准,随妊娠的进展尿碘水平逐渐下降（χ2=5.991,P=0.05）;孕早、中、晚期孕妇FT3水平差异无统计学意义（P〉0.05）;孕早、中、晚期FT4水平差异有统计学意义（P〈0.05）;孕早、中、晚期TSH水平差异无统计学意义（P〉0.05）。TSH水平随着妊娠的进展呈上升趋势,差异有统计学意义（P〈0.001）;FT3水平随妊娠的进展呈下降的趋势,差异有统计学意义（P〈0.005）;FT4水平随妊娠的进展呈下降的趋势,差异有统计学意义（P〈0.001）,各孕期呈＂U＂型曲线;各孕期TGAb阳性率差异无统计学意义（P〉0.05）;各孕期TPOAb阳性率差异无统计学意义（P〉0.05）;甲状腺功能正常率为88.52%;甲状腺TSH、FT3、FT4异常人数和TPOAb、TGAb阳性人数在各尿碘水平差异无统计学意义（P〉0.05）;农村与城镇孕妇尿碘中位数差异无统计学意义（P〉0.05）。结论随妊娠进展孕妇碘营养不足增加,高FT4血症主要分布在孕晚期,建议定期检测甲状腺功能和自身抗体水平,相关机构开展甲状腺功能和自身抗体水平监测。Objective Evaluation of different thyroid function of pregnant women and autoantibodies Shaognan normal iodine ar- eas, and to analyze the changes in the law to provide a theoretical basis for scientific iodine for pregnant women. Methods Find Shaoguan Lechang City in 2015 iodized salt monitoring data. In larger medical institutions, maternity clinics randomly selected cross - sectional method 331 healthy pregnant women resident in which trimester（0 to 13 weeks）, the second trimester（ 14 to 27 weeks）, the third trimester（28 to 40 weeks）were 68, 126, 137 name. Collecting urine of pregnant women urine iodine, blood samples were collected hormone（ TSH）, serum free thyroxine（ FT4）, three free triiodothyronine（ FT3 ）, thyroglobulin antibody （TGAb） , thyroid peroxidase antibody（TPOAb）. Results Pregnant early, middle and late pregnant women, the median urinary iodine was 185.6 μg/L, 174. 2μg,/L, 152. 7 μg/L, all meet the WHO recommendations, progress urinary iodine levels de- creased with pregnancy （χ2 = 5. 991, P = 0. 05 ） ; pregnant early, middle and late pregnant women FT3 level was no significant difference（P 〉0. 05）; pregnant early, middle and late FT4 level difference was statistically significant（ P 〈 0. 05 ）; pregnant early, middle and late TSH level no significant difference（ P 〉 0. 05 ）. As the pregnancy progresses TSH levels rise, the differ- ence was statistically significant（ P 〈 0. 001 ） ; progress FT3 levels with pregnancy showed a downward trend, the difference was statistically significant（ P 〈 0. 005 ） ; progress with the FT4 pregnancy a downward trend, and the difference was statistically significant（ P 〈 0. 001 ）, each pregnancy was ＂U＂ shaped curve; each pregnancy TGAb positive rate was no significant difference （P 〉0. 05） ; the positive rate of each pregnancy TPOAb no statistical difference significance（ P 〉 0.05 ） ; normal thyroid func-tion was 88. 52% ; thyroid TSH, FT3, FT4 abnormal numbers and TPOAb, TGA

关 键 词：甲状腺功能 碘适量地区 妊娠 碘营养 

分 类 号：R153.1[医药卫生—营养与食品卫生学] R581[医药卫生—公共卫生与预防医学]