妊娠早期孕妇尿碘水平与甲状腺功能的相关性研究

Correlation between urine iodine and thyroid function in early pregnant women

摘要:

目的 研究孕早期母体碘营养状况对甲状腺功能的影响。方法 选取199 例孕早期妇女作为研究对象，采用生化比色法测定尿碘，电化学发光法检测促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）及游离甲状腺素（FT4），研究母体碘营养状况与甲状腺功能的关系。结果 ①尿碘缺乏组、尿碘适量组、尿碘超足量组及尿碘过量组的构成比依次为59.3%、21.1%、9.5% 及10.1% ；②不同尿碘营养水平组甲状腺功能减退症（甲减）、亚临床甲减、甲状腺功能亢进症（甲亢）及亚临床甲亢的患病率比较，差异无统计学意义（P >0.05）；碘过量组低甲状腺素血症（低T4 血症）的患病率较高，差异有统计学意义（χ2=11.593，P =0.009）；③碘营养水平>500 μg/L 时，尿碘水平与TSH 呈正相关；④碘适量组FT3 水平高于碘过量组，差异有统计学意义（P <0.05），碘缺乏组、碘超足量组及碘过量组间差异无统计学意义（P >0.05）；不同碘营养水平组FT4 比较，差异无统计学意义（F =2.454，P =0.064）；碘过量组TSH 水平高于碘缺乏组、碘适量组及碘超足量组，差异有统计学意义（P <0.05）。碘缺乏组、碘适量组与碘超足量组间比较，差异无统计学意义（P >0.05）。结论 大部分孕早期妇女存在碘缺乏，应适量补碘，但应避免碘过量及碘缺乏。

Abstract:

Objective To study the urine iodine level and thyroid function in early pregnant women. Methods A total of 199 early pregnant women were selected. Urine iodine was tested by biochemical colorimetric determination; thyroid stimulating hormone (TSH), three free iodine thyroid former glycine (FT3) and free thyroxine (FT4) were detected by electrochemical luminescence. Results Constituent ratio of deficient urinary iodine group,appropriate urinary iodine group, excess urinary iodine group and overdose urinary iodine group was 59.3%, 21.1%,9.5% and 10.1%, respectively. The prevalence of thyroidism, subclinical thyroidism, hyperthyroidism and subclinical hyperthyroidism in different urinary iodide levels were not statistically significant (P > 0.05). Prevalence rate of low thyroid hormone level (low T4 concentration) in iodine excess group was higher, and the difference was statistically significant (χ2 = 11.593, P = 0.009). When the iodine nutrition level was higher than 500 ug/L, urine iodine was positively correlated with serum TSH. The level of FT3 in appropriate urinary iodine group was higher than that in excess urinary iodine group, the difference was statistically significant (P < 0.05). There were no statistically significant differences among deficient urinary iodine group, excess urinary iodine group and overdose urinary iodine group (P > 0.05). There was no statistically significant difference in different groups for FT4 level (F = 2.454,P = 0.064); TSH level in excess urinary iodine group was higher than that of deficient urinary iodine group,appropriate urinary iodine group and excess urinary iodine group, respectively, the difference was statistically significant (P < 0.05). There were no statistically significant differences among deficient urinary iodine group,appropriate urinary iodine group and excess urinary iodine group (P > 0.05). Conclusions Iodine deficiency can be found in vast majority of women in early pregnancy, so appropriate iodine intake should be advocated.The prevalence of abnormal thyroid function is significantly higher in deficient urinary iodine group than that in appropriate urinary iodine group, indicating that women should avoid excessive or deficient iodine in early pregnancy.