四川省达州市孕妇碘营养状况与甲状腺功能的关系  

Relationship between iodine nutrition status and thyroid function in pregnant women in Dazhou City of Sichuan Province

作　　者：刘常燕 肖琳[1] 王宇[1] 靳健美 胡又丹[1] 王文珍 陈朝霞 LIU Chang-yan;XIAO Lin;WANG Yu;JIN Jian-mei;HU You-dan;WANG Wen-zhen;CHEN Zhao-xia(Department of Obstetrics and Gynecology,Dazhou Integrated Traditional Chinese and Western Medicine Hospital,Dazhou Sichuan,635000,China)

机构地区：[1]达州市中西医结合医院妇产科,四川达州635000

出　　处：《职业与健康》2020年第13期1771-1775,1779,共6页Occupation and Health

摘　　要：目的了解四川省达州市孕妇碘营养状况水平与甲状腺功能的关系,并对促甲状腺激素(TSH)及血清游离甲状腺素(FT4)水平影响因素进行分析。方法选择2017年1月—2018年12月在达州市中西医结合医院进行定期产检的孕妇314例进行调查。在妊娠早期、中期、晚期收集血样对TSH、血清游离三碘甲腺原氨酸(FT3)及FT4进行检测,收集尿样对尿碘水平进行检测。对比不同孕期血清甲状腺素水平及尿碘水平,不同尿碘水平孕妇甲状腺素水平,并对TSH及FT4水平的影响因素进行分析。结果不同妊娠期孕妇FT3水平差异无统计学意义(P>0.05),孕中期尿碘及TSH水平均显著低于孕早期与孕晚期(P<0.05),孕早期与孕晚期尿碘及TSH水平差异均无统计学意义(均P>0.05),FT4水平孕早期>孕中期>孕晚期,差异有统计学意义(P<0.05)。不同碘营养水平孕妇FT3水平差异无统计学意义(P>0.05),孕妇FT4水平随碘营养水平的升高呈先下降后升高的趋势,TSH水平则随着碘营养水平的升高呈现先升高后下降的趋势,差异有统计学意义(P<0.05)。不同文化程度、慢性病史、CT/X线检查史、日常腌制品摄入情况的孕妇TSH水平差异有统计学意义(P<0.05),不同居住地、近1年内心理应激事件发生情况、久坐时间、日常交通方式、日常睡眠时间及日常工作时间孕妇FT4水平差异有统计学意义(P<0.05)。居住地为城市、近1年内发生心理应激事件、日常交通方式为乘车/少走动、日常工作时间≥8 h、碘过量和碘缺乏为孕妇TSH水平升高的危险因素,日常睡眠时间≥8 h为保护因素。文化程度大专及以上为孕妇FT4水平下降的保护因素,慢性病史、CT/X线检查史、碘过量和碘缺乏为危险因素。结论四川省达州市孕妇不同妊娠期尿碘、TSH及FT4水平差异有统计学意义,居住地、近1年内心理应激事件发生情况、日常交通方式、日常工作时间及碘营养水平对孕Objective To explore the relationship between iodine nutrition status and thyroid function in pregnant women in Dazhou City of Sichuan Province,analyze the influencing factors of Thyroid stimulating hormone(TSH)and serum free thyroxine(FT4)levels.Methods A total of 314 pregnant women undergoing regular checkups in Dazhou Integrated Traditional Chinese and Western Medicine Hospital from January 2017 to December 2018 were selected for investigation.Blood samples were collected in early,middle,and late pregnancy to test TSH,serum free triiodothyronine(FT3)and FT4.Urine samples were collected to measure urine iodine level.The serum thyroxine levels and urinary iodine level in different pregnancy periods were compared,the thyroxine levels in pregnant women with different urinary iodine levels were analyzed,and the influencing factors of TSH and FT4 levels were explored.Results There was no statistically significant difference in FT3 level among different pregnancy periods(P>0.05).The levels of urine iodine and TSH in the second trimester were significantly lower than those in the first and third trimesters(P<0.05).There was no statistically significant difference in the levels of urine iodine and TSH between the first and third trimesters(all P>0.05).The levels of FT4 were ordered as follows:the first trimester of pregnancy>the second trimester of pregnancy>the third trimester of pregnancy,and the difference was statistically significant(P<0.05).There was no statistically significant difference in FT3 level among pregnant women with different iodine nutrition levels(P>0.05).The FT4 level of pregnant women decreased first and then increased with the increase of iodine nutrition level,while the TSH level increased first and then decreased with the increase of iodine nutrition level,and the difference was statistically significant(P<0.05).There were statistically significant differences in TSH level among pregnant women with different educational levels,chronic diseases history,CT/X-ray examination history,and daily pick

关 键 词：四川 达州 孕妇 碘营养 甲状腺功能 多因素分析 

分 类 号：R153.1[医药卫生—营养与食品卫生学]