新疆维吾尔自治区妊娠期妇女碘营养与甲状腺功能状态相关性研究  

Correlation between iodine nutrition and thyroid function of pregnant women in Xinjiang Uygur Autonomous Region

作　　者：日沙来提·塔依尔 袁一木[2] 马品江[3] 林勤[3] 吴顺华 王琛琛[3] Rishalaiti Tayier;Yuan Yimu;Ma Pinjiang;Lin Qin;Wu Shunhua;Wang Chenchen(The Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China;Xinjiang Production and Construction Corps Hospital,Urumqi 830011,China;Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention,Urumqi 830011,China;Department of Occupational and Environmental Health,School of Public Health,Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第二附属医院,乌鲁木齐830011 [2]新疆生产建设兵团医院,乌鲁木齐830011 [3]新疆维吾尔自治区疾病预防控制中心,乌鲁木齐830011 [4]新疆医科大学公共卫生学院劳动卫生与环境卫生学教研室,乌鲁木齐830011

出　　处：《中华地方病学杂志》2023年第2期134-138,共5页Chinese Journal of Endemiology

基　　金：国家自然科学基金(82260648);新疆维吾尔自治区自然科学基金(2019D01C087)。

摘　　要：目的调查新疆维吾尔自治区(简称新疆)妊娠期妇女碘营养水平和甲状腺功能状态,初步探讨二者关系和影响因素。方法2020年3-6月,采用分层整群抽样法,在新疆南、北疆地区各抽取2个县(市)作为调查点,每个县(市)各抽取约100名孕妇(共412名)作为调查对象,采集随机尿样和血样,检测尿碘和血清甲状腺功能指标[促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、抗甲状腺球蛋白抗体(Tg-Ab)和抗甲状腺过氧化物酶抗体(TPO-Ab)]。结果孕妇尿碘水平[中位数(四分位数间距),M(Q1,Q3)]为228.40(143.15,327.95)μg/L。血清FT3、FT4、TSH水平[M(Q1,Q3)]分别为4.22(3.92,4.61)、13.79(12.63,15.26)pmol/L和1.82(1.26,2.52)mU/L。孕妇总的Tg-Ab、TPO-Ab阳性率分别为5.61%(23/412)和11.95%(49/412)。南、北疆地区Tg-Ab、TPO-Ab阳性率分别为4.78%(10/209)、10.05%(21/209)和6.40%(13/203)、13.79%(28/203),两个地区间比较差异均无统计学意义(χ^(2)=1.31、2.17,均P>0.05)。TPO-Ab阳性是孕妇甲状腺功能异常的影响因素,比值比(OR)[95%置信区间(CI)]为3.22(1.31~7.93)。结论新疆孕妇总体处于碘营养适宜水平,但甲状腺功能状态仍需持续关注。此外,要加强对甲状腺自身抗体阳性孕妇的甲状腺功能监测,预防和控制孕妇甲状腺功能异常的发生。Objective Through the detection of iodine nutrition level and thyroid function of pregnant women in Xinjiang Uygur Autonomous Region(Xinjiang),to preliminary study the pregnant women's iodine nutrition level,thyroid function status and the relationship between the two and influencing factors.Methods From March to June in 2020,stratified cluster random sampling method was adopted.Two counties(cities)in Southern and Northern Xinjiang were selected as survey sites,and about 100 pregnant women(a total of 412)were selected from each county(city)as survey subjects.Random urine samples and blood samples were collected to detect urinary iodine and serum thyroid function indicators[thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4),anti-thyroglobulin antibody(Tg-Ab)and anti-thyroid peroxidase antibody(TPO-Ab)].Results The median and interquartile range[M(Q1,Q3)]of pregnant women's urinary iodine was 228.4(143.15,327.95)μg/L.Serum FT3,FT4 and TSH levels[M(Q1,Q3)]were 4.22(3.92,4.61),13.79(12.63,15.26)pmol/L and 1.82(1.26,2.52)mU/L,respectively.The overall positive rates of Tg-Ab and TPO-Ab were 5.61%(23/412)and 11.95%(49/412),respectively.The positive rates of Tg-Ab and TPO-Ab in Southern and Northern Xinjiang were 4.78%(10/209),10.05%(21/209),6.40%(13/203)and 13.79%(28/203),respectively.The positive rates of Tg-Ab and TPO-Ab in Northern Xinjiang were higher than those in Southern Xinjiang,but the difference was not statistically significant(χ^(2)=1.31,2.17,P>0.05).The positive rate of TPO-Ab in pregnant women was the influencing factor of abnormal thyroid function,and the odds ratio(OR)[95%confidence interval(CI)]was 3.22(1.31-7.93).Conclusions Pregnant women in Xinjiang are generally at an appropriate level of iodine,but the state of thyroid function still needs continuous attention.In addition,it is necessary to strengthen the thyroid function examination of pregnant women with positive thyroid autoantibodies to prevent and control the occurrence of abnormal thyroid function in pregnant wo

关 键 词：孕妇 碘营养 甲状腺功能 甲状腺自身抗体 

分 类 号：R714[医药卫生—妇产科学]