新疆维吾尔自治区口服碘油丸地区孕妇碘营养及甲状腺功能状况  

Iodine nutritional status and thyroid function of pregnant women in the areas of oral lipiodol pills in Xinjiang Uygur Autonomous Region

作　　者：王琛琛 朱艳艳[3] 戴思芸[3] 马品江 日沙来提·塔依尔[4] 张利萍 Wang Chenchen;Zhu Yanyan;Dai Siyun;Ma Pinjiang;Rishalaiti Tayier;Zhang Liping(College of Medical Engineering and Technology of Xinjiang Medical University,Urumqi 830002,China;Institute for Environmental Health and Endemic Disease Control,Center for Disease Control and Prevention of Xinjiang Uyghur Autonomous Region,Urumqi 830002,China;Institute for Endemic Diseases Control,Center for Disease Control and Prevention of Aksu Prefecture,Aksu 843000,China;College of Public Health of Xinjiang Medical University,Urumqi 830002,China)

机构地区：[1]新疆医科大学医学工程技术学院,乌鲁木齐830002 [2]新疆维吾尔自治区疾病预防控制中心环境健康与地方病防治科,乌鲁木齐830002 [3]阿克苏地区疾病预防控制中心地方病科,阿克苏843000 [4]新疆医科大学公共卫生学院,乌鲁木齐830002

出　　处：《中华地方病学杂志》2022年第6期460-465,共6页Chinese Journal of Endemiology

基　　金：国家自然科学基金(72163033);新疆维吾尔自治区自然科学基金(2019D01C087);新疆维吾尔自治区天山创新人才优秀青年项目(2022Q020)。

摘　　要：目的了解新疆维吾尔自治区(新疆)口服碘油丸地区孕妇的碘营养及甲状腺功能情况。方法2019年10月,采用按规模大小成比例的概率抽样(PPS抽样)法,在新疆阿克苏地区(阿克苏)按照东、西、南、北、中划分5个抽样片区,每个片区抽取1个县,每个县按照东、西、南、北、中5个方位各抽取1个乡镇,每个乡镇抽取20名孕妇。通过问卷调查收集孕妇的一般人口学资料,并采集其24 h尿样、家中食用盐盐样和饮用水水样进行碘含量检测,采集血清样本进行甲状腺功能指标检测。结果共调查孕妇555名,孕早、中、晚期孕妇分别为121、234、200名,平均年龄为26岁。其中孕早、中、晚期妇女的尿碘中位数分别为209.53、204.27、225.29μg/L,均为碘适宜;盐碘中位数分别为24.70、26.00、26.20 mg/kg,水碘中位数分别为4.85、3.30、4.85μg/L;不同孕期间尿碘、盐碘、水碘含量比较差异均无统计学意义(H=1.61、4.38、2.63,P均>0.05)。孕妇亚临床甲状腺功能减退(亚甲减)、亚临床甲状腺功能亢进(亚甲亢)和甲状腺功能亢进(甲亢)检出率分别为4.32%(24/555)、0.54%(3/555)、0.36%(2/555);且均以孕中期孕妇最高,分别为7.26%(17/234)、1.28%(3/234)和0.85%(2/234)。孕妇甲状腺功能正常但自身特异性抗体阳性检出率为13.15%(73/555),其中抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白(TgAb)阳性检出率分别为11.35%(63/555)、8.11%(45/555)。排除甲状腺自身特异性抗体阳性的孕妇后,不同孕期孕妇的促甲状腺素(TSH)范围(P2.5~P97.5)均接近或略高于《妊娠和产后甲状腺疾病诊治指南》(第2版)推荐参考值;除孕早期游离甲状腺素(FT4)的P2.5低于参考值外,其他孕期FT4范围均与TSH呈现相同趋势。Spearman相关分析结果显示,孕早期游离三碘甲状腺原氨酸(FT3)与FT4、TPOAb与TgAb、TgAb与FT4均呈正相关(r=0.497、0.504、0.216,P均<0.05),TSH与FT3呈负相关(r=-0.194,P<0.05);孕中、Objective To learn about the iodine nutritional status and thyroid function of pregnant women in the areas of oral lipiodol pills in Xinjiang Uygur Autonomous Region(Xinjiang).Methods In October 2019,using the probability proportionate to size sampling(PPS sampling)method,Aksu Prefecture(Aksu)of Xinjiang was divided into 5 sampling areas according to the directions of east,west,south,north and middle.One county was selected from each area,one township was selected from each county according to the directions of east,west,south,north and middle,and 20 pregnant women were selected from each township.The general demographic data of pregnant women were collected by questionnaires,and 24-hour urine samples,household salt samples and drinking water samples were collected for iodine detection,and serum samples were collected for thyroid function index detection.Results A total of 555 pregnant women were investigated,including 121,234 and 200 women in the early,middle and late pregnancy,with an average age of 26 years.Among them,the median of urinary iodine of women in early,middle and late pregnancy was 209.53,204.27 and 225.29μg/L,respectively,which was all in the appropriate state.The median of salt iodine was 24.70,26.00 and 26.20 mg/kg,respectively,and the median of water iodine was 4.85,3.30 and 4.85μg/L,respectively.There were no significant difference in urinary iodine,salt iodine and water iodine during different pregnancy(H=1.61,4.38,2.63,P>0.05).The prevalence rate of subclinical hypothyroidism,subclinical hyperthyroidism and hyperthyroidism in pregnant women was 4.32%(24/555),0.54%(3/555)and 0.36%(2/555),respectively;and the highest prevalence rate was in the middle pregnancy,which was 7.26%(17/234),1.28%(3/234)and 0.85%(2/234),respectively.The positive rate of autospecific antibody in pregnant women with normal thyroid function was 13.15%(73/555).The positive rate of thyroid peroxidase antibody(TPOAb)and thyroglobulin(TgAb)was 11.35%(63/555),8.11%(45/555),respectively.After excluding the pregnant women wit

关 键 词：碘 营养 孕妇 甲状腺功能 

分 类 号：R153.1[医药卫生—营养与食品卫生学]