妊娠期尿碘和尿碘肌酐比值分布及甲状腺激素变化的研究  

Distribution of urinary iodine and urinary iodine creatinine ratio and changes of thyroid hormone during pregnancy

作　　者：史梦琪 卜野 纪春磊 田春园 李昕 刘颖 SHI Meng-qi;BU Ye;JI Chun-lei;TIAN Chun-yuan;LI Xin;LIU Ying(Institute of Iodine Deficiency Disorders,Chinese Center for Disease Control and Prevention,Harbin Medical University,Harbin 150081,China;Department of Obstetrics,The Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001,China;Department of Student Affairs,The Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学,中国疾病预防控制中心地方病控制中心,碘缺乏病防治研究所,黑龙江哈尔滨150081 [2]哈尔滨医科大学附属第四医院产科 [3]哈尔滨医科大学附属第四医院学生科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2021年第1期24-28,共5页Journal of Harbin Medical University

基　　金：黑龙江省自然科学基金联合引导项目(LH2020H021)。

摘　　要：目的探索不同孕期妊娠妇女尿碘(UI)和尿碘肌酐比值(UI/UCr)的分布情况,并确定妊娠期甲状腺激素(FT_(3),FT_(4),TSH)的变化规律,为综合评价孕妇碘营养状况及甲状腺功能情况提供参考。方法选择充分补碘地区黑龙江省哈尔滨市部分孕妇1310例,采用横断面调查的方法,调查不同孕期的孕妇(孕早期:0~13周;孕中期:14~27周;孕晚期:28~40周)。通过问卷排除既往有甲状腺疾病史、甲状腺疾病家族史,甲状腺超声检查无甲状腺形态学异常,检测孕妇血清甲功五项、尿碘(UI)及尿肌酐(UCr),纳入符合标准的孕妇样本。结果孕早期尿碘中位数为139.79μg/L,尿碘肌酐比值中位数为136.47μg/g;孕中期尿碘中位数为145.43μg/L,尿碘肌酐比值中位数为146.59μg/g;孕晚期尿碘中位数为135.57μg/L,尿碘肌酐比值中位数为140.50μg/g。孕早期FT_(3)中位数为4.74 pmol/L,孕中期FT_(3)中位数为4.50 pmol/L,孕晚期FT_(3)中位数为4.50 pmol/L;孕早期FT_(4)中位数为15.91 pmol/L,孕中期FT_(4)中位数为14.83 pmol/L,孕晚期为14.56 pmol/L。与孕早期相比,孕中期及孕晚期FT_(3)和FT_(4)水平有差异(P均<0.05)。孕早期TSH中位数为1.24 mIU/L,孕中期为1.36 mIU/L,孕晚期为1.48 mIU/L,孕早期与孕中期相比差异具有统计学意义(P<0.05),孕晚期与孕早期相比,TSH差异具有统计学意义(P<0.05)。结论甲功正常的妊娠妇女,尿碘肌酐水平接近尿碘适宜水平的临界值;妊娠期甲状腺激素呈现特异性变化特征,因此需加强孕妇妊娠期甲状腺功能的监测。Objective To explore the distribution of urinary iodine(UI)and urinary iodine creatinine ratio(UI/UCR)in pregnant women during different pregnancies,and to determine the change of thyroid hormones(FT_(3),FT_(4),TSH)during pregnancy,so as to provide reference for the comprehensive evaluation of iodine nutrition status and thyroid function in pregnant women.Methods A total of 1310 pregnant women in Harbin City,Heilongjiang Province were selected.A cross-sectional survey was used to investigate the pregnant women in different pregnancies(early pregnancy:0~13 weeks;Second trimester:14 to 27 weeks;Third trimester:28 to 40 weeks).They were excluded from the past history of thyroid disease,family history of thyroid disease,thyroid ultrasound examination without thyroid morphological abnormality.Five items of serum thyroid function,urinary iodine(UI)and urinary creatinine(UCR)were detected in pregnant women.Results The median of urinary iodine was 139.79μg/L and the median of urinary iodine creatinine ratio was 136.47μg/g in early pregnancy.In the second trimester,the median of urinary iodine was 145.43μg/L and the median of urinary iodine creatinine ratio was 146.59μg/g.The median urinary iodine was 135.57μg/L and the median urinary iodine creatinine ratio was 140.50μg/g in the third trimester.The median FT_(3)was 4.74 pmol/L in the first trimester,4.50 pmol/L in the second trimester and 4.50 pmol/L in the third trimester.The median FT_(4)was 15.91 pmol/L in the first trimester,14.83 pmol/L in the second trimester and 14.56 pmol/L in the third trimester.The levels of FT_(3)and FT_(4)in the second and third trimesters were different from those in the first trimester(P<0.05).The median TSH in the first trimester was 1.24 mIU/L,the second trimester was 1.36 mIU/L,and the third trimester was 1.48 mIU/L.The difference between the first trimester and the second trimester was statistically significant(P<0.05),and the difference between the third trimester and the first trimester was statistically significant(P<0.05).Conc

关 键 词：孕妇 甲状腺功能 尿碘 尿碘肌酐比值 

分 类 号：R714.147[医药卫生—妇产科学] R581[医药卫生—临床医学]