中国医药导报
中國醫藥導報
중국의약도보
CHINA MEDICAL HERALD
2014年
22期
84-86
,共3页
孕妇%妊娠晚期%尿碘%甲状腺功能低下
孕婦%妊娠晚期%尿碘%甲狀腺功能低下
잉부%임신만기%뇨전%갑상선공능저하
Pregnant women%The third trimester of pregnancy%Urine iodine%Hypothyroidism
目的：探讨妊娠晚期不同程度尿碘缺乏对母婴甲状腺功能的影响。方法随机抽取2011年4月1日~2012年3月31日在珠海市妇幼保健院门诊参加围生期保健的孕妇549名筛查尿碘，根据尿碘值分为正常组、轻度缺碘组、中度缺碘组和重度缺碘组，检测血清促甲状腺素(TSH)、游离T3(FT3)、游离T4(FT4)水平，观察孕妇缺碘性甲状腺功能低下(以下简称“甲低”)的发生率，随诊其所生新生儿足跟血TSH水平，了解不同程度尿碘缺乏对新生儿甲状腺功能的影响。结果亚临床型甲低的发生率为3.10%，临床型甲低的发生率为1.09%。正常组、轻度缺碘组、中度缺碘组、重度缺碘组亚临床型甲低发生率逐渐增高，分别为0.35%、3.08%、4.17%、15.00%，各组临床型甲低的发生率也逐渐增高，分别为0、0.77%、2.78%、5.00%，其中，正常组甲低发生率与其他三组、轻度缺碘组甲低发生率与重度缺碘组比较，差异均有统计学意义(均P<0.05)，轻度缺碘组与中度缺碘组、中度缺碘组与重度缺碘组甲低发生率比较，差异无统计学意义(P>0.05)。尿碘缺乏程度与孕妇甲低的发生率有关联，且呈线性关系，差异有统计学意义(P<0.05)。新生儿足跟血TSH筛查阳性10例，进一步确诊无新生儿先天性甲低。结论孕妇不同程度尿碘缺乏，使其亚临床型甲低、临床型甲低的发生率增加，增加了新生儿患先天性甲低的风险，因此孕早期应检测尿碘，异常者建议监测甲状腺功能，减少新生儿先天性甲低的发生。
目的：探討妊娠晚期不同程度尿碘缺乏對母嬰甲狀腺功能的影響。方法隨機抽取2011年4月1日~2012年3月31日在珠海市婦幼保健院門診參加圍生期保健的孕婦549名篩查尿碘，根據尿碘值分為正常組、輕度缺碘組、中度缺碘組和重度缺碘組，檢測血清促甲狀腺素(TSH)、遊離T3(FT3)、遊離T4(FT4)水平，觀察孕婦缺碘性甲狀腺功能低下(以下簡稱“甲低”)的髮生率，隨診其所生新生兒足跟血TSH水平，瞭解不同程度尿碘缺乏對新生兒甲狀腺功能的影響。結果亞臨床型甲低的髮生率為3.10%，臨床型甲低的髮生率為1.09%。正常組、輕度缺碘組、中度缺碘組、重度缺碘組亞臨床型甲低髮生率逐漸增高，分彆為0.35%、3.08%、4.17%、15.00%，各組臨床型甲低的髮生率也逐漸增高，分彆為0、0.77%、2.78%、5.00%，其中，正常組甲低髮生率與其他三組、輕度缺碘組甲低髮生率與重度缺碘組比較，差異均有統計學意義(均P<0.05)，輕度缺碘組與中度缺碘組、中度缺碘組與重度缺碘組甲低髮生率比較，差異無統計學意義(P>0.05)。尿碘缺乏程度與孕婦甲低的髮生率有關聯，且呈線性關繫，差異有統計學意義(P<0.05)。新生兒足跟血TSH篩查暘性10例，進一步確診無新生兒先天性甲低。結論孕婦不同程度尿碘缺乏，使其亞臨床型甲低、臨床型甲低的髮生率增加，增加瞭新生兒患先天性甲低的風險，因此孕早期應檢測尿碘，異常者建議鑑測甲狀腺功能，減少新生兒先天性甲低的髮生。
목적：탐토임신만기불동정도뇨전결핍대모영갑상선공능적영향。방법수궤추취2011년4월1일~2012년3월31일재주해시부유보건원문진삼가위생기보건적잉부549명사사뇨전，근거뇨전치분위정상조、경도결전조、중도결전조화중도결전조，검측혈청촉갑상선소(TSH)、유리T3(FT3)、유리T4(FT4)수평，관찰잉부결전성갑상선공능저하(이하간칭“갑저”)적발생솔，수진기소생신생인족근혈TSH수평，료해불동정도뇨전결핍대신생인갑상선공능적영향。결과아림상형갑저적발생솔위3.10%，림상형갑저적발생솔위1.09%。정상조、경도결전조、중도결전조、중도결전조아림상형갑저발생솔축점증고，분별위0.35%、3.08%、4.17%、15.00%，각조림상형갑저적발생솔야축점증고，분별위0、0.77%、2.78%、5.00%，기중，정상조갑저발생솔여기타삼조、경도결전조갑저발생솔여중도결전조비교，차이균유통계학의의(균P<0.05)，경도결전조여중도결전조、중도결전조여중도결전조갑저발생솔비교，차이무통계학의의(P>0.05)。뇨전결핍정도여잉부갑저적발생솔유관련，차정선성관계，차이유통계학의의(P<0.05)。신생인족근혈TSH사사양성10례，진일보학진무신생인선천성갑저。결론잉부불동정도뇨전결핍，사기아림상형갑저、림상형갑저적발생솔증가，증가료신생인환선천성갑저적풍험，인차잉조기응검측뇨전，이상자건의감측갑상선공능，감소신생인선천성갑저적발생。
Objective To investigate the influence of urine iodine-deficiency with varying degree on thyroid function in the third trimester of pregnancy of pregnant woman and neonate. Methods 549 pregnant women in Outpatient Service, Maternal and Children Health Hospital of Zhuhai City were selected to measure urinary iodine from April 1, 2011 to March 31, 2012. According to urinary iodine, they were divided into 4 groups:normal, mild iodine deficiency, moderate iodine deficiency and severe iodine deficiency groups. The levels of serum free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating (TSH) were detected. The incidence of iodine-deficiency hypothyroidism were observed. And their neonates' heel blood TSH levels were analyzed too, to explore the influence of urine iodine-deficiency with varying degree on neonates' thyroid function. Results The incidence of hypothyroidism and subclinical hypothyroidism was 1.09% and 3.10%. The incidence of subclinical hypothyroidism and hypothyroidism were gradually increased in normal, mild iodine deficiency, moderate iodine deficiency and severe iodine deficiency groups, the incidence of sub-clinical hypothyroidism were 0.35%, 3.08%, 4.17%, 15.00% respectively, and the incidence of hypothyroidism were 0, 0.77%, 2.78%, 5.00% respectively. There were statistically significant differences in the rates of hypothyroidism be-tween normal group and iodine-deficiency groups (P<0.05);mild iodine deficiency group and severe iodine deficiency group (P<0.05). There were no statistically significant differences between the mild iodine deficiency group and mod-erate iodine deficiency group, moderate iodine deficiency group and severe iodine deficiency group (P>0.05). A linear relationship between the urine iodine-deficiency and hypothyroidism of pregnant woman was found (P<0.05). 10 cases of neonates' heel blood screening were positive, but there was no congenital hypothyroidism case beyond further diag-nosis. Conclusion The incidence of hypothyroidism and subclinical hypothyroidism increased with urine iodine defi-ciency. Urinary iodine will be measured in early pregnancy. It suggests that pregnant women should monitor the thyroid functions, in order to reduce neonatal hypothyroidism.
