妊娠中、晚期孕妇甲状腺功能的变化及与碘摄入量的关系  

Changes of thyroid function during pregnancy in the second and third trimester and in relation to iodine intake

作　　者：王永红[1] 任景芳[1] 袁丽萍[1] 刘宗梅[1] 

机构地区：[1]山西医科大学第二医院妇产科,太原030001

出　　处：《中华内分泌代谢杂志》2002年第5期352-354,共3页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的　了解缺碘及非缺碘地区妊娠中、晚期孕妇甲状腺功能的变化。方法　应用免疫放射分析技术 ,检测了 90例孕妇 (缺碘地区孕妇 30例 ,非碘缺乏区健康孕妇 6 0例 )妊娠中、晚期和临产后及 30例非碘缺乏区健康非孕妇女血清TSH水平、游离T3 (FT3 )、游离T4(FT4)及总T4(TT4)水平。恒温消解法检测了两组孕妇临产时尿碘水平。结果　 (1)妊娠中、晚期孕妇TSH水平升高 ,游离甲状腺激素水平下降 ,尤以妊娠晚期为著。 (2 )与正常孕妇比较 ,缺碘地区孕妇妊娠中期和临产后TSH水平升高 ,差异均有显著性 (P <0 .0 1) ;缺碘地区孕妇妊娠中、晚期和临产后FT3 、FT4水平显著降低 (P <0 .0 1) ;缺碘地区孕妇临产时尿碘水平显著低于正常孕妇 (P <0 .0 1)。结论　妊娠期孕妇表现为相对的甲状腺功能低下 ,以妊娠晚期为著 ,尤在缺碘地区。Objective To evaluate the changes of thyroid function during pregnancy in the second and third trimester in the regions with or without iodine deficiency. Methods The serum TSH, FT 3, FT 4 and TT 4 levels of 90 pregnant women (30 from iodine deficient area as study group, 60 from iodine sufficient area as control group) and 30 non pregnant women were assayed by high sensitive immunoradiometric assay (IRMA) or radioimmunoassay (RIA), and urine iodine level of pregnant women before delivery was also examined. Results (1) The serum TSH level in pregnant women in the second and third trimester was significantly higher than that of non pregnant women. The serum free thyroid hormone levels of pregnant women were significantly lower than that of non pregnant women, especially in the third trimester. (2) The serum TSH level of pregnant women from iodine deficient area in the second trimester and before delivery was significantly higher than that of pregnant women from iodine sufficient area (P<0.01), while their serum FT 3 and FT 4 levels were significantly lower (P<0.01). The urine iodine level of pregnant women from iodine deficient area before delivery was significantly lower than those of their counterparters (P<0.01). Conclusion The gestation is associated with relative hypothyroxinemia especially in the third trimester and in iodine intake insufficient area.

关 键 词：妊娠 甲状腺 促甲状腺激素 孕妇 免疫放射分析技术 

分 类 号：R714.256[医药卫生—妇产科学]