CAJ | 학술논문

目的了解高碘地区孕妇碘营养状况及其对新生儿甲状腺功能的影响.方法以2010年4-6月河北省海兴县某医院的210名待产孕妇为调查对象,收集孕妇随机尿样及其所产新生儿脐带血,分别测定孕妇尿碘浓度及新生儿血清中游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)及敏感促甲状腺激素( sTSH)水平.对孕妇碘营养状况和新生儿甲状腺功能进行评价并分析二者之间的关系.结果 210名孕妇年龄为(27.69±4.73)岁,其尿碘水平的中位数(四分位数间距)为1240.70(1292.68)μg/L.其中,碘过量者(尿碘≥500 μg/L)占84.3％ (177/210),碘超足量者(尿碘250～499 μg/L)占13.8％ (29/210),碘充足者(尿碘150 ～249 μg/L)占0.5％(1/210),碘不足者(尿碘＜150μg/L)占1.4％ (3/210).新生儿血清中FT3、FT4水平分别为(2.93±0.59)、(15.03±1.92) pmol/L,血清sTSH水平的中位数(四分位数间距)为7.33(5.59) mU/L.新生儿血清sTSH水平＞5 mU/L者占78.1％ (164/210).孕妇尿碘水平与新生儿血清FT3、sTSH水平无相关性(P＞0.05),但与FT4水平呈正相关(P＜0.01),碘不足孕妇所产新生儿血清FT水平[(12.99±1.10) pmol/L]低于碘过量组[(15.16±1.83) pmol/L] (P ＜0.05).结论高碘地区大部分孕妇碘营养过量,但仍有少数孕妇存在碘缺乏；该地区新生儿血清sTSH水平较高,应加强对其发生甲状腺功能减退、亚临床甲状腺功能减退的风险进行监测.
목적 료해고전지구잉부전영양상황급기대신생인갑상선공능적영향.방법 이2010년4-6월하북성해흥현모의원적210명대산잉부위조사대상,수집잉부수궤뇨양급기소산신생인제대혈,분별측정잉부뇨전농도급신생인혈청중유리삼전갑선원안산(FT3)、유리갑상선소(FT4)급민감촉갑상선격소( sTSH)수평.대잉부전영양상황화신생인갑상선공능진행평개병분석이자지간적관계.결과 210명잉부년령위(27.69±4.73)세,기뇨전수평적중위수(사분위수간거)위1240.70(1292.68)μg/L.기중,전과량자(뇨전≥500 μg/L)점84.3％ (177/210),전초족량자(뇨전250～499 μg/L)점13.8％ (29/210),전충족자(뇨전150 ～249 μg/L)점0.5％(1/210),전불족자(뇨전＜150μg/L)점1.4％ (3/210).신생인혈청중FT3、FT4수평분별위(2.93±0.59)、(15.03±1.92) pmol/L,혈청sTSH수평적중위수(사분위수간거)위7.33(5.59) mU/L.신생인혈청sTSH수평＞5 mU/L자점78.1％ (164/210).잉부뇨전수평여신생인혈청FT3、sTSH수평무상관성(P＞0.05),단여FT4수평정정상관(P＜0.01),전불족잉부소산신생인혈청FT수평[(12.99±1.10) pmol/L]저우전과량조[(15.16±1.83) pmol/L] (P ＜0.05).결론 고전지구대부분잉부전영양과량,단잉유소수잉부존재전결핍；해지구신생인혈청sTSH수평교고,응가강대기발생갑상선공능감퇴、아림상갑상선공능감퇴적풍험진행감측.
Objective To reveal the iodine status of pregnant women and its impact on thyroid function of neonates in high iodine area.Methods A total of 210 pregnant women were chosen from a hospital in Haixing county,Hebei province.Pregnant women's random urinary and neonates' cord blood were collected.The urinary iodine concentration ( UIC ) was examined by arsenic-cerium catalytic spectrophotometry.The levels of free triiodothyronine (FT3 ),free thyroxine (FT4) and sensitive thyroid-stimulating hormone (sTSH) in serum were measured by chemiluminescence.Results The age of 210 pregnant women was (27.69 ± 4.73 )years old,whose urinary iodine median (inter-quartile range ) was 1240.70( 1292.68) μg/L.84.3％ (177/210) of the pregnant women had excessive iodine intake( UIC ≥500 μg/L),13.8％ ( 29/210) had more than adequate iodine intake ( UIC within 250 - 499 μg/L),0.5％(1/210) had adequate iodine intake( UIC within 150 - 249 μg/L) and 1.4％ (3/210) had insufficient iodine intake( UIC ＜ 150 μg/L).The average serum level of FT3,FT4 in neonates were (2.93 ± 0.59),(15.03 ± 1.92)pmol/L,respectively.The median (inter-quartile range) of serum sTSH in neonates were 7.33(5.59)mU/L 78.1％ (164/210) of the neonates' serum TSH were beyond 5 mU/L There were no correlation between pregnant women's urinary iodine level and neonates' serum FT3 and sTSH level (P ＞0.05),but there was a positive correlation between pregnant women's urinary iodine level and neonates' serum FT4 level ( P ＜ 0.01 ).Serum FT4 level of the neonates with whose mothers had insufficient iodine intake ( ( 12.99 ± 1.10) pmol/L) were statistically lower than those with their mothers had excessive iodine intake( (15.16 ± 1.83) pmol/L) (P＜0.05).Conclusion Most of the pregnant women in high iodine area were excessive for iodine nutrition,but still a few pregnant women had insufficient iodine nutrition.The level of neonates' serum sTSH were relatively high and monitoring of risk of hypothyroidism and subclinical hypothyroidism should be strengthened.