中华内分泌代谢杂志
中華內分泌代謝雜誌
중화내분비대사잡지
CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
2014年
7期
553-557
,共5页
朱素娟%徐卫民%金行一%霍亮亮
硃素娟%徐衛民%金行一%霍亮亮
주소연%서위민%금행일%곽량량
妊娠早期%碘营养%甲状腺功能
妊娠早期%碘營養%甲狀腺功能
임신조기%전영양%갑상선공능
Early pregnancy%Iodine nutrition%Thyroid function
目的 调查杭州市妊娠早期妇女甲状腺疾病患病情况,进一步探讨妊娠早期妇女开展甲状腺功能筛查的必要性.方法 将至各调查点进行检查的妊娠早期(妊娠0～13周)1 165例妇女作为研究对象,收集其家庭食用盐、空腹晨尿及静脉血,分别采用硫代硫酸钠直接滴定法测定食用盐碘含量,酸消化砷-铈接触法测定尿碘,化学发光法测定血清促甲状腺激素(TSH)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPOAb).结果 杭州市妊娠早期妇女尿碘中位数为135.2μg/L,仅有26.7％的人处于碘适宜水平,城市和农村之间尿碘中位数及频率分布差异无统计学意义(P＞0.05);TPOAb阴性的妊娠早期妇女TSH、FT4异常率分别6.8％ (71/1 039)、8.9％(92/1 039),且农村妊娠早期妇女的TSH、FT4的异常率均高于城市(P=0.035和P=0.001);杭州市妊娠早期妇女临床甲状腺功能减退症(临床甲减)、亚临床甲减及低甲状腺素血症的患病率分别为0.3％(3/1 165)、2.0％(23/1 165)、4.8％(56/1 165),且农村妊娠早期妇女的低甲状腺素血症的患病率明显高于城市(6.1％对3.5％,P=0.040);TPOAb阳性率为9.9％(114/1 153),TPOAb阳性妊娠早期妇女TSH易发生异常,其高于参考值上限的比例(6.1％)明显高于阴性组(1.7％),发生亚临床甲减的危险性是阴性组的3.34倍(95％ CI 1.29～8.65).结论 经济欠发达的农村及TPOAb阳性的妊娠早期妇女更易出现甲状腺功能异常,应重点对这部分人群开展甲状腺功能及碘营养的筛查及监测.
目的 調查杭州市妊娠早期婦女甲狀腺疾病患病情況,進一步探討妊娠早期婦女開展甲狀腺功能篩查的必要性.方法 將至各調查點進行檢查的妊娠早期(妊娠0～13週)1 165例婦女作為研究對象,收集其傢庭食用鹽、空腹晨尿及靜脈血,分彆採用硫代硫痠鈉直接滴定法測定食用鹽碘含量,痠消化砷-鈰接觸法測定尿碘,化學髮光法測定血清促甲狀腺激素(TSH)、遊離甲狀腺素(FT4)、甲狀腺過氧化物酶抗體(TPOAb).結果 杭州市妊娠早期婦女尿碘中位數為135.2μg/L,僅有26.7％的人處于碘適宜水平,城市和農村之間尿碘中位數及頻率分佈差異無統計學意義(P＞0.05);TPOAb陰性的妊娠早期婦女TSH、FT4異常率分彆6.8％ (71/1 039)、8.9％(92/1 039),且農村妊娠早期婦女的TSH、FT4的異常率均高于城市(P=0.035和P=0.001);杭州市妊娠早期婦女臨床甲狀腺功能減退癥(臨床甲減)、亞臨床甲減及低甲狀腺素血癥的患病率分彆為0.3％(3/1 165)、2.0％(23/1 165)、4.8％(56/1 165),且農村妊娠早期婦女的低甲狀腺素血癥的患病率明顯高于城市(6.1％對3.5％,P=0.040);TPOAb暘性率為9.9％(114/1 153),TPOAb暘性妊娠早期婦女TSH易髮生異常,其高于參攷值上限的比例(6.1％)明顯高于陰性組(1.7％),髮生亞臨床甲減的危險性是陰性組的3.34倍(95％ CI 1.29～8.65).結論 經濟欠髮達的農村及TPOAb暘性的妊娠早期婦女更易齣現甲狀腺功能異常,應重點對這部分人群開展甲狀腺功能及碘營養的篩查及鑑測.
목적 조사항주시임신조기부녀갑상선질병환병정황,진일보탐토임신조기부녀개전갑상선공능사사적필요성.방법 장지각조사점진행검사적임신조기(임신0～13주)1 165례부녀작위연구대상,수집기가정식용염、공복신뇨급정맥혈,분별채용류대류산납직접적정법측정식용염전함량,산소화신-시접촉법측정뇨전,화학발광법측정혈청촉갑상선격소(TSH)、유리갑상선소(FT4)、갑상선과양화물매항체(TPOAb).결과 항주시임신조기부녀뇨전중위수위135.2μg/L,부유26.7％적인처우전괄의수평,성시화농촌지간뇨전중위수급빈솔분포차이무통계학의의(P＞0.05);TPOAb음성적임신조기부녀TSH、FT4이상솔분별6.8％ (71/1 039)、8.9％(92/1 039),차농촌임신조기부녀적TSH、FT4적이상솔균고우성시(P=0.035화P=0.001);항주시임신조기부녀림상갑상선공능감퇴증(림상갑감)、아림상갑감급저갑상선소혈증적환병솔분별위0.3％(3/1 165)、2.0％(23/1 165)、4.8％(56/1 165),차농촌임신조기부녀적저갑상선소혈증적환병솔명현고우성시(6.1％대3.5％,P=0.040);TPOAb양성솔위9.9％(114/1 153),TPOAb양성임신조기부녀TSH역발생이상,기고우삼고치상한적비례(6.1％)명현고우음성조(1.7％),발생아림상갑감적위험성시음성조적3.34배(95％ CI 1.29～8.65).결론 경제흠발체적농촌급TPOAb양성적임신조기부녀경역출현갑상선공능이상,응중점대저부분인군개전갑상선공능급전영양적사사급감측.
Objective To investigate the prevalence of thyroid disease in early pregnancy women of Hangzhou,and further to discuss the necessity of screening thyroid function in early pregnant women.Methods From March to October 2013,1 165 cases of women in the center of community health service (or health) for routine prenatal care during early pregnancy were used as research subjects.Household salt,fasting morning urine and serum samples were collected.The salt iodine level was measured by direct titration of sodium thiosulfate.The urinary iodine level was measured by arsenic-cerium contact process method.The levels of serum TSH,FT4,and thyroid peroxidase antibody (TPOAb) were measured by chemiluminescence method.Results The median of urinary iodine of the early pregnancy women was 135.2 μg/L,and only 26.7％ of early pregnancy women' s iodine-nutrition status were optimal.These were no significant difference in median urinary iodine as well as the frequency distribution between urban and suburban(P＞0.05).The abnormal rates of TSH and FT4 in early pregnancy women with negative TPOAb were 6.8％ (71/1 039) and 8.9％ (92/1 039),and the abnormal rates of TSH and FT4 in suburban areas were higher than those in urban areas(P=0.035,P =0.001).The prevalences of hypothyroidism,subclinical hypothyroidism,and hypothyroxinemia in early pregnant women of Hangzhou were 0.3％ (3/1 165),2.0％ (23/1 165),and 4.8％ (56/1 165) respectively,and the prevalence of hypothyroxinemia in suburban areas was significantly higher than that in urban areas (6.1％ vs 3.5％,P =0.040).The positive rate of TPOAb was 9.9％ (114/1 153).The early pregnant women with positive TPOAb have an increased risk of thyroid dysfunction,the ratio of TSH over the reference values was significantly higher than that in the negative group and more prone to subclinical hypothyroidism (OR =3.34,95％ CI 1.29-8.65).Conclusion The early pregnant women in rural areas or with positive TPOAb have an increased risk of abnormal thyroid function,thyroid function and iodine nutrition screening or monitoring should be highlighted.
