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目的研究妊娠早期妇女碘营养及甲状腺功能,为指导孕期妇女补碘提供依据。方法选取2013年6月至2014年1月在南方医科大学附属小榄医院产科门诊行常规产前检查的1 851例妊娠早期妇女作为研究对象,收集尿液和采集空腹静脉血,采用砷铈催化分光光度法测定尿标本中碘含量,利用化学发光法测定促甲状腺激素(TSH)、游离甲状腺素(FT4)和过氧化物酶抗体(TPOAb)。结果 1 851例妊娠早期孕妇尿碘中位数为129μg/L,其中60.72%的孕妇处于碘缺乏状态,28.09%的孕妇处于碘适量,2.32%的孕妇碘过量。本组孕妇甲状腺异常总患病率为29.39%,其中低甲状腺素血症、甲减、亚临床甲减、甲亢、亚临床甲亢、甲状腺TPOAb阳性的患病率分别为24.37%、0.70%、0.81%、0.92%、2.59%、11.02%。尿碘水平异常与碘足量水平的甲状腺功能异常总患病率分别为30.73%和25.96%,差异有统计学意义(χ2=4.095,P=0.043),而二者的甲状腺功能异常个体患病率差异无统计学意义(P>0.05)。尿碘水平异常与尿碘足量水平孕妇的TPOAb阳性率分别为10.74%和11.73%,差异无统计学意义(P>0.05)。结论妊娠早期妇女60%以上存在碘摄入不足,尿碘水平异常孕妇的甲状腺功能异常的总患病率明显高于碘足量水平孕妇。
Objective To study iodine nutrition and thyroid function in the first trimester of pregnancy and to provide basis for guiding iodine supplement in pregnant women. Methods From January 2013 to January 2014, 1851 pregnant women of the first trimester routinely receiving prenatal care at the obstetric outpatient department of Siu Lam Hospital Affiliated to Southern Medical University from June 2013 to January 2014 were enrolled in this study. Urine and fasting venous blood were collected and arsenic and cerium The content of iodine in urine samples was determined by spectrophotometry. The thyroid stimulating hormone (TSH), free thyroxine (FT4) and peroxidase antibody (TPOAb) were determined by chemiluminescence. Results The median of urinary iodine in 1 851 pregnant women with early pregnancy was 129 μg / L, of which 60.72% pregnant women were in iodine deficiency state, 28.09% pregnant women were in adequate iodine, and 2.32% pregnant women were pregnant with iodine excess. The total prevalence of thyroid abnormalities in pregnant women was 29.39%. The prevalence rates of hypothyroxinemia, hypothyroidism, subclinical hypothyroidism, hyperthyroidism, subclinical hyperthyroidism and thyroid TPOAb were 24.37%, 0.70%, 0.81 %, 0.92%, 2.59%, 11.02%. The total prevalence of abnormal thyroid function in patients with abnormal levels of urinary iodine and iodine intake was 30.73% and 25.96%, respectively (χ2 = 4.095, P = 0.043), while both thyroid dysfunction The difference was not statistically significant (P> 0.05). The positive rates of TPOAb in pregnant women with abnormal levels of urinary iodine and urinary iodine were 10.74% and 11.73%, respectively, with no significant difference (P> 0.05). Conclusion The prevalence of thyroid dysfunction in more than 60% of pregnant women in the first trimester is lower than that in the pregnant women with abnormal urinary iodine levels.