碘盐浓度调整前后吐鲁番地区妇女甲状腺功能的变化  

Alteration of thyroid function of women in Turpan prefecture before and after concentration adjustment of iodized salt

作　　者：黄佳[1] 段依敏[1] 赵倩 马品江[1] 张玲[1] HUANG Jia;DUAN Yi-min;ZHAO Qian;MA Pin-jiang;ZHANG Ling(The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang 830002, Chin)

机构地区：[1]新疆维吾尔自治区疾病预防控制中心地方病防治科,乌鲁木齐830002

出　　处：《疾病预防控制通报》2018年第3期77-80,共4页Bulletin of Disease Control & Prevention(China)

摘　　要：目的调查分析新疆吐鲁番地区食盐碘含量调整前后妇女的甲状腺功能变化,为合理调整碘盐浓度和碘缺乏病防控策略提供依据。方法分别于碘盐浓度调整前后的2014年和2017年,采取分层整群抽样方法,分2次在吐鲁番地区20～45岁的育龄妇女(分别为316人和300人)中开展问卷调查,采集尿样和血样,测定调查对象的尿碘以及血清促甲状腺素(TSH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、甲状腺球蛋白抗体(TgAb)、抗甲状腺过氧化物酶抗体(TPOAb)7项甲状腺功能指标。结果两次调查共检测育龄妇女尿碘616份,中位数分别为216.3μg/L(316人)和233.3μg/L(300人);TgAb,TPOAb以及TAA阳性率呈现明显的下降趋势,并且TPOAb(χ~2=8.20)和TAA(χ~2=7.14)阳性率差异有统计学意义(均P<0.05);对比两次调查的甲状腺疾病患病率,低甲状腺素血症、甲状腺机能亢进、亚临床甲状腺机能亢进和甲状腺功能减退症的患病率均呈现下降趋势,亚临床甲状腺功能减退症患病率由4.1%上升到7.7%,差异有统计学意义(χ~2=3.53,P<0.05)。结论实施新碘盐浓度标准后,吐鲁番地区妇女尿碘超出适宜量,孕妇碘营养状况适宜,TgAb,TPOAb和TAA阳性率较碘盐浓度调整前均有所下降。Objective To investigate the alteration of thyroid function of the women in Turpan prefecture before and after concentration adjustment of iodized salt, and provide basis for reasonable adjustment of iodized salt concentration and the prevention strategies of iodine deficiency disorders. Methods There were 316 cases selected among fertile women aged20-45 years in 2014（before the concentration adjustment of iodized salt） and 300 cases selected in 2017（after the concentration adjustment of iodized salt） with stratified cluster sampling method in Turpan prefecture. The questionnaire survey was conducted in the all selected women; urine and blood samples were collected to detect urine iodine and seven items of thyroid function, including serum thyroid stimulating hormone（TSH）, free triiodothyronine（T3）, thyroxine（T4）, free triiodothyronine（FT3）, free thyroxine（FT4） and thyroglobulin antibody（A-TG） and thyroid peroxidase antibody（A-TPO）. Results Totally 616 samples of the fertile women were detected for urine iodine in two surveys, with the median of 216.3 μg/L（316 samples） and 233.3μg/L（300 samples）, respectively. The positive rate of thyroglobulin antibody（TgAb）, thyroid peroxidase antibody（TPOAb） and TAA showed obvious downward trend in both surveys, and there were statistical differences（P〈0.05）in positive rates of TPOAb（χ^2=8.20） and TAA（χ^2=7.14）. The comparison between both surveys showed downward trend of the prevalence of hypothyroxinemia, hyperthyroidism, subclinical hyperthyroidism and hypothyroidism; the prevalence of subclinical hypothyroidism increased from 4.1% to 7.7% with statistical difference（χ^2=3.53, P〈0.05）. Conclusions After the implementation of the new standard for iodized salt concentration, the urine iodine exceeds the appropriate content in the fertile women in Turpan prefecture. The iodine nutrition of the pregnant women is suitable, and the positive rates of TgAb,TPOAb and TAA decrease compared with those before

关 键 词：碘盐浓度 妇女 甲状腺功能 

分 类 号：R153.1[医药卫生—营养与食品卫生学]