目的 探讨高水碘地区甲状腺抗体阴性妇女妊娠各期甲状腺功能的变化特征.方法 在高水碘地区选天津市静海县妇幼保健院(饮水水碘>200μg/L)和在适碘地区选天津市和平区妇幼保健院(饮水水碘<10μg/L,碘盐普及率>90%,居民尿碘中位数>100μg/L)作为调查地点.在妇幼保健院门诊,选取妊娠资料完整的妊娠早、中、晚期孕妇各50名,采集血样,用化学发光法检测甲状腺功能.同时收集日间随意一次尿样、家中饮用水样和食用盐样,尿碘测定采用砷铈催化分光光度法,水碘测定采用快速定量检测试剂盒,盐碘测定采用硫代硫酸钠滴定法.结果 ①甲状腺抗体阴性孕妇中,高水碘地区孕早期妇女血清TT_4、TT_3、FT_4明显低于适碘地区(111.97 nmol/L vs 140.46 nmol/L,Z=3.56,P<0.01;1.86 nmol/L vs 2.26 nmol/L,Z=2.35,P<0.05;14.13 pmol/L vs 16.32 pmol/L,Z=5.14,P<0.01);孕中期妇女血清FT_4、FT_3明显低于适碘地区(11.98 pmol/L vs 14.30 pmol/L,Z=5.75,P<0.01;4.04 pmol/L vs 4.32 pmol/L,Z=2.76,P<0.01);孕晚期妇女血清,TT_3、TSH明显高于适碘地区(2.88 nmol/L vs 2.70 nmol/L,Z=-2.27,P<0.05;2.37 mU/L vs 1.75mU/L,Z=-2.70,P<0.01).②高水碘地区孕妇家中饮水碘和孕妇尿碘明显高于适碘地区(205.57μg/L vs8.22μg/L,Z=-14.71,P<0.01;305.91μg/L vs 191.86μg/L,Z=-4.01,P<0.01),家中盐碘明显低于适碘地区(26.5 mg/kg vs 31.7 mg/kg,Z=5.68,P<0.01).③健康且没有甲状腺病史的被调查孕妇中,妊娠各期甲状腺抗体阳性率在高水碘和适碘地区之间比较差异无统计学意义(孕早期:10.20%vs 10.64%;孕中期:14.00%vs9.52%;孕晚期:4.00%vs 7.69%,P均>0.05).结论 高水碘地区甲状腺抗体阴性孕妇妊娠各期甲状腺功能不同于适碘地区,对高水碘地区孕妇应加强孕期(特别是孕早、中期)甲状腺功能监测.
目的 探討高水碘地區甲狀腺抗體陰性婦女妊娠各期甲狀腺功能的變化特徵.方法 在高水碘地區選天津市靜海縣婦幼保健院(飲水水碘>200μg/L)和在適碘地區選天津市和平區婦幼保健院(飲水水碘<10μg/L,碘鹽普及率>90%,居民尿碘中位數>100μg/L)作為調查地點.在婦幼保健院門診,選取妊娠資料完整的妊娠早、中、晚期孕婦各50名,採集血樣,用化學髮光法檢測甲狀腺功能.同時收集日間隨意一次尿樣、傢中飲用水樣和食用鹽樣,尿碘測定採用砷鈰催化分光光度法,水碘測定採用快速定量檢測試劑盒,鹽碘測定採用硫代硫痠鈉滴定法.結果 ①甲狀腺抗體陰性孕婦中,高水碘地區孕早期婦女血清TT_4、TT_3、FT_4明顯低于適碘地區(111.97 nmol/L vs 140.46 nmol/L,Z=3.56,P<0.01;1.86 nmol/L vs 2.26 nmol/L,Z=2.35,P<0.05;14.13 pmol/L vs 16.32 pmol/L,Z=5.14,P<0.01);孕中期婦女血清FT_4、FT_3明顯低于適碘地區(11.98 pmol/L vs 14.30 pmol/L,Z=5.75,P<0.01;4.04 pmol/L vs 4.32 pmol/L,Z=2.76,P<0.01);孕晚期婦女血清,TT_3、TSH明顯高于適碘地區(2.88 nmol/L vs 2.70 nmol/L,Z=-2.27,P<0.05;2.37 mU/L vs 1.75mU/L,Z=-2.70,P<0.01).②高水碘地區孕婦傢中飲水碘和孕婦尿碘明顯高于適碘地區(205.57μg/L vs8.22μg/L,Z=-14.71,P<0.01;305.91μg/L vs 191.86μg/L,Z=-4.01,P<0.01),傢中鹽碘明顯低于適碘地區(26.5 mg/kg vs 31.7 mg/kg,Z=5.68,P<0.01).③健康且沒有甲狀腺病史的被調查孕婦中,妊娠各期甲狀腺抗體暘性率在高水碘和適碘地區之間比較差異無統計學意義(孕早期:10.20%vs 10.64%;孕中期:14.00%vs9.52%;孕晚期:4.00%vs 7.69%,P均>0.05).結論 高水碘地區甲狀腺抗體陰性孕婦妊娠各期甲狀腺功能不同于適碘地區,對高水碘地區孕婦應加彊孕期(特彆是孕早、中期)甲狀腺功能鑑測.
목적 탐토고수전지구갑상선항체음성부녀임신각기갑상선공능적변화특정.방법 재고수전지구선천진시정해현부유보건원(음수수전>200μg/L)화재괄전지구선천진시화평구부유보건원(음수수전<10μg/L,전염보급솔>90%,거민뇨전중위수>100μg/L)작위조사지점.재부유보건원문진,선취임신자료완정적임신조、중、만기잉부각50명,채집혈양,용화학발광법검측갑상선공능.동시수집일간수의일차뇨양、가중음용수양화식용염양,뇨전측정채용신시최화분광광도법,수전측정채용쾌속정량검측시제합,염전측정채용류대류산납적정법.결과 ①갑상선항체음성잉부중,고수전지구잉조기부녀혈청TT_4、TT_3、FT_4명현저우괄전지구(111.97 nmol/L vs 140.46 nmol/L,Z=3.56,P<0.01;1.86 nmol/L vs 2.26 nmol/L,Z=2.35,P<0.05;14.13 pmol/L vs 16.32 pmol/L,Z=5.14,P<0.01);잉중기부녀혈청FT_4、FT_3명현저우괄전지구(11.98 pmol/L vs 14.30 pmol/L,Z=5.75,P<0.01;4.04 pmol/L vs 4.32 pmol/L,Z=2.76,P<0.01);잉만기부녀혈청,TT_3、TSH명현고우괄전지구(2.88 nmol/L vs 2.70 nmol/L,Z=-2.27,P<0.05;2.37 mU/L vs 1.75mU/L,Z=-2.70,P<0.01).②고수전지구잉부가중음수전화잉부뇨전명현고우괄전지구(205.57μg/L vs8.22μg/L,Z=-14.71,P<0.01;305.91μg/L vs 191.86μg/L,Z=-4.01,P<0.01),가중염전명현저우괄전지구(26.5 mg/kg vs 31.7 mg/kg,Z=5.68,P<0.01).③건강차몰유갑상선병사적피조사잉부중,임신각기갑상선항체양성솔재고수전화괄전지구지간비교차이무통계학의의(잉조기:10.20%vs 10.64%;잉중기:14.00%vs9.52%;잉만기:4.00%vs 7.69%,P균>0.05).결론 고수전지구갑상선항체음성잉부임신각기갑상선공능불동우괄전지구,대고수전지구잉부응가강잉기(특별시잉조、중기)갑상선공능감측.
Objective To investigate the characteristics of maternal thyroid function of pregnant women with negative thyroid antibody in high water iodine area. Methods The investigation sites were selected,which were the Hospital for Women and Children of Jinghai county in the high water iodine area(drinking iodine > 200 μg/L) and the Hospital for Women and Children of Heping district in Tianjin in the adaptive iodine area (drinking iodine < 10μg/L,popularization rate of iodized salt > 90％,residents urinary iodine > 200μg/L). In the maternal and child hospitals,50 pregnant women of each stage from obstetric clinics in first,second,third term of pregnancy
were selected,the blood samples were collected and the thyroid function were measured with chemiluminescence. Water,salt and diurnal optional urine samples were measured for iodine concentration. Iodine levels of urine,water,salt were determined respectively by As-Ce catalysis spoctrophotometry method,quantitative determining kit which use time-recorded determination by catalytic effect on the As-Ce reaction and sodium hyposulfite titration method. Results ①In pregnant women with negative thyroid antibody,serum TT_4,TT_3,FT_4 in first term of pregnaney and TT_4,TT_3 in second term of pregnancy were significantly lower in high water iodine area than low water iodine area(111.97 nmol/L vs 140.46 nmoL/L,Z = 3.56,P < 0.01 ; 1.86 nmol/L vs 2.26 nmol/L,Z = 2.35,
P < 0.05; 14.13 pmol/L vs 16.32 pmol/L,Z = 5.14,P < 0.01,and 11.98 pmol/L vs 14.30 pmol/L,Z = 5.75,P < 0.01 ; 4.04 pmol/L vs 4.32 pmol/L,Z = 2.76,P < 0.01),while TT_3 and TSH in third term of pregnancy were significantly higher(2.88 nmoL/L vs 2.70 nmol/L,Z=-2.27,P< 0.05; 2.37 mU/L vs 1.75 mU/L,Z =-2.70,
P < 0.01).②Concentration of water iodine and urine iodine were higher(205.57μg/L vs 8.26 μg/L,Z =-14.71,P < 0.01 ; 305.91 g/L vs 191.86 g/L,Z =-5.30,P < 0.01),while salt iodine was lower(26.5 mg/kg vs 31.7 mg/kg,Z =-5.86,P < 0.01) in high water iodine area. ③Among 290 selected healthy pregnant women without
medical history of thyroid diseases,there was no significant difference in positive rate of thyroid antibody in each
term of pregnancy between high water iodine area and low water iodine area(10.20％ vs 10.64％ ; 14％ vs 9.52％ ; 4％ vs 7.69％ ; all P > 0.05). Conclusions The thyroid function of pregnant women with negative thyroid antibody in high water iodine area is different from pregnant women in low water iodine area with universal salt iodization. Enhanced monitoring on thyroid function of pregnant women in high water iodine area should be
performed,especially in first and second trimester.
