北海市孕妇碘营养及甲状腺激素水平调查分析

目的探讨妊娠对孕妇碘营养状况、甲状腺激素水平的影响,为北海市孕妇人群适宜碘营养的指导提供理论依据。方法采用ACS-180化学发光分析仪检测837例孕妇的血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)和人绒毛膜促性腺激素(HCG);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孕妇一次随意尿的尿碘含量。结果 837例孕妇尿碘中位数为224μg.L-1,尿碘≤100μg.L-1的比率为18.52%,<50μg.L-1的比率为5.26%;孕早、中、晚期孕妇尿碘中位数分别为142、147、298μg.L-1,孕早、中期的低尿碘率高于孕晚期(P<0.01)。孕早、中期的FT3、FT4和HCG高于孕晚期(P<0.05),而TSH低于孕晚期(P<0.05)。高尿碘组FT3、FT4和HCG低于低尿碘组(P<0.05),2组TSH比较差别无统计学意义(P>0.05)。结论北海市孕妇人群不存在碘缺乏,但孕早、中期孕妇存在碘摄入不足;孕晚期的甲状腺功能相对孕早、中期而言处于一种轻微甲状腺功能减低的代偿状态;碘营养过剩亦可使孕妇的甲状腺激素水平降低。

Survey on iodine nutrition and thyroid hormones levels of the pregnant in Beihai city

Objective To investigate the influences of pregnance on iodine nutrition and thyroid hormones in the pregnant to provide a theoretical basis for the guidance of suitable iodine nutrition for the pregnant in Beihai.Methods Free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH)and human chorionic gonadotropin(HCG)were measured in 837 patients by ACS-180 automatic chemiluninescence analyzer.The Urinary iodine was measured in a random urine by the use of iodine catalytic reaction mechanism of Arsenic-Cerium,rapid urinary iodine using cold digestion method of quantitative detection.Results The median of urine iodine was 224 μg·L-1,ratio of urine iodine ≤100 μg·L-1 was 18.52%,<50 μg·L-1 was 5.26%;The median of urine iodine in the three trimester was 142,147,298 μg·L-1 respectively,and the ratio of low urine iodine in the early gestation and mid-gestation were higher than that in the late gestation(P<0.01).The levels of FT3,FT4 and HCG in the early gestation and mid-gestation were higher than thoes in the late gestation(P<0.05)and TSH was lower than that in the late gestation(P<0.05).FT3,FT4 and HCG levels in high urine iodine group were significantly lower than thoes in low urine iodine group(P<0.05),but there was no significant differences of TSH between the two groups(P>0.05).Conclusion There is no iodine deficiency among pregnant women in Beihai city,but pregnant early,mid-term pregnant women,there is insufficient iodine intake;Hypothyroidism in a mild compensatory state occur in third trimester of pregnancy compared with early and mid-term;Iodine overnutrition may also reduce the levels of thyroid hormones in pregnant women.