孕妇妊娠中晚期尿碘水平检测及其意义

目的了解北海市妊娠中晚期孕妇人群的碘营养状况,探讨尿碘筛查的时机和科学指导碘摄入的理论依据。方法利用碘催化砷铈反应原理,采用冷消解快速尿碘定量检测方法测定613例孕妇(其中孕中期195例,孕晚期418例)随意尿的碘含量。结果 613例孕妇尿碘中位数是206μg/L,其中尿碘≤100μg/L者占17.78%,尿碘<50μg/L者占4.73%。而孕中、晚期孕妇尿碘中位数分别是149、295μg/L,其中尿碘<150μg/L者所占比例分别为50.26%、26.32%,尿碘≤100μg/L者所占比例分别为24.10%、14.84%,尿碘<50μg/L者所占比例分别为6.15%、4.07%。孕中期尿碘水平低于孕晚期(Z=-8.420,P<0.01),低尿碘率高于孕晚期(χ2=34.00,P<0.01)。高尿碘组孕晚期的尿碘水平高于孕中期(χ2=6.140,P<0.05),低尿碘组和正常尿碘组孕中、晚期的尿碘水平差异无显著性(χ2=0.930~2.097,P>0.05)。结论孕中期前是尿碘筛查、及时纠正碘营养状况的最佳时机,应根据尿碘水平变化评估孕晚期孕妇个体碘的需求,合理调整碘营养。

DETECTION OF URINE IODINE LEVEL AND ITS SIGNIFICANCE OF PREGNANT WOMEN IN THE SECOND AND THIRD TRIMESTER

Objective To investigate the state of iodine nutrition of midtrimester pregnant women(MPW) and late pregnancy women(LPW) in Beihai City and explore the best time for screening urine iodine and theory for the guidance of iodine intake.Methods Based on iodine catalyt reaction principle of Arsenic-Cerium,urine iodine was measured in 613 cases of pregnant women(including 195 MPW and 418 LPW) by rapid urinary iodine cold digestion method of quantitative detection. Results The median urine iodine was 206 μg/L in the subjects,of whom,urine iodine ≤100 μg/L accounted for 17.78%,and those <50 μg/L for4.73%.The median of urine iodine in the MPW and LPW was 149 μg/L and 295 μg/L,in which,urine iodine <150 μg/L accounted for 50.26% and 26.32%;that ≤100 μg/L was 24.10% and 14.84%;that <50 μg/L was 6.15% and 4.07%,respectively.In high unire-iodine group,the iodine level of late-stage MPW was higher than that in intermediate-stage MPW(χ2=6.140,P<0.05);in low urine-iodine and normal iodine groups,the difference of urine iodine between the intermediate stage and late stage of MPW was not significant. Conclusion It is the best opportunity for detecting the urine iodine and correcting the nutritional status of iodine before intermediate stage of pregnancy.A reasonable adjustment of iodine nutrition should be based on individual need of iodine for LPW.