舟山海岛孕妇妊娠期碘营养状况与甲状腺功能调查分析  

An investigation of iodine nutrition status and thyroid function during pregnancy in Zhoushan islands,Zhejiang Province

作　　者：张彩 耿晓冬 包佳艳 丁梦贞 ZHANG Cai;GENG Xiaodong;BAO Jiayan;DING Mengzhen(Dinghai Center for Disease Control and Prevention,Zhoushan,Zhejiang 316000,China;不详)

机构地区：[1]舟山市定海区疾病预防控制中心,浙江316000 [2]舟山市妇女儿童医院

出　　处：《中国地方病防治》2024年第5期369-372,共4页Chinese Journal of Control of Endemic Diseases

基　　金：浙江省医药卫生科技计划项目(2024KY520);舟山市科技局公益类项目课题(2023C31028)。

摘　　要：目的调查和评估舟山海岛孕妇不同妊娠期碘营养状况与甲状腺功能,为孕妇碘营养干预提供科学理论依据。方法选取2022年7月至2023年11月在舟山市妇女儿童医院就诊符合纳入标准的孕妇作为调查对象,根据孕妇膳食情况将其分为4组,采集孕期3次血样和尿样,比较各组碘营养状况和甲状腺功能。结果共纳入203例孕妇,碘盐食用率为40.39%,补碘率为77.83%;妊娠各期的尿碘中位数分别为114.76、96.90、91.99μg/L,孕早期和孕晚期各组尿碘水平差异有统计学意义;妊娠各期尿碘肌酐比值(UIC/UCr)分别为126.21、108.72、147.54μg/g,孕晚期各组差异有统计学意义;促甲状腺激素(TSH)值中位数随着妊娠期逐渐升高,妊娠晚期1组和3组之间TSH高于4 mU/L的比例差异有统计学意义;妊娠各期TgAb阳性率分别为6.90%、3.45%、2.46%,妊娠期各组间阳性率差异无统计学意义;妊娠各期TPOAb阳性率分别为8.37%、4.93%、5.91%,妊娠早期4组的TPOAb阳性率高于1组,差异有统计学意义。结论舟山海岛孕妇不同妊娠期均处于碘营养缺乏状态,需要增加碘摄入量。Objective To investigate and evaluate the iodine nutritional status and thyroid function of pregnant women in Zhoushan Islands during different pregnancy periods,so as to provide a scientific basis for rational iodine supplement in pregnant women.Methods The pregnant women willing to take perinatal health care examination in Zhoushan Maternal and Child Health Care Hospital were randomly selected from July 2022 to November 2023.Based on the principle of informed consent,three urine and blood samples were collected.According to the dietary situation of pregnant women,they were divided into four groups.The levels of iodine nutrition and thyroid function were compared among the groups.Results A total of 203 pregnant women were investigated.The rate of iodized salt intake was 40.39%,and the rate of iodine supplementation was 77.83%.The median urinary iodine were 114.76,96.90 and 91.99μg/L,respectively,the difference of median urinary iodine was statistically significant between the groups in the early and late pregnancy;UIC/UCr was 126.21,108.72 and 147.54μg/L,and the difference was statistically significant in the late pregnancy;the median TSH gradually increased during pregnancy,and the proportion of TSH higher than 4 mU/L between the 1 group and the 3 group in the late pregnancy was significantly different;the positive rates of TgAb were 6.90%,3.45%and 2.46%,respectively,and there was no significant difference among the groups during pregnancy;the positive rates of TPOAb were 8.37%4.93%and 5.91%,respectively,the positive rate of TPOAb in 4 group in the early trimester was higher than that in 1 group,and the difference was significant.Conclusion Pregnant women in Zhoushan Islands are in a state of iodine deficiency and need to increase their iodine intake during pregnancy.

关 键 词：海岛 孕妇 碘 甲状腺功能 

分 类 号：R581[医药卫生—内分泌] R591.1[医药卫生—内科学]