摘要
目的 探讨不同孕周、不同碘营养状况下孕妇尿碘水平及孕妇、新生儿甲状腺功能 ,分析孕妇碘营养状况及药物治疗的必要性。方法 于 1997年 7月～ 2 0 0 3年 3月期间 ,收集在我院就诊及分娩的孕产妇尿标本 185 2 8例次 ,按照是否补充“金典”分为A组 (未补碘 )及B组 (补碘 ) ,按照孕周分为 :孕早期 1组 ,孕中期 2组 ,孕晚期 3组 ;另随机抽取 2 4 6例孕产妇 ,并分组 :早孕未补充“金典”者 81例为JA1组 ,孕足月未补充“金典”者 86例为JA3组 ,孕足月补充“金典”者 79例为JB3组 ,对该组孕妇其及分娩的新生儿脐带血进行甲状腺功能的检测。结果 ①本组孕产妇尿碘中位数为 2 31μg L ,尿碘值 <5 0 μg L、 <10 0 μg L、 <2 0 0 μg L的发生率分别为 2 4 %、 13 9%及 4 3 4 % ;②孕早、中、晚期未补充“金典” (及补充“金典”)组尿碘值中位数分别为 :16 2 μg L (377μg L)、 193μg L (2 86 μg L)、 2 6 0 μg L (382 μg L) ,前者尿碘值均低于后者 ,其差异有显著性 (P =0 0 0 0 ) ;随着孕周的增加 ,未补充“金典”组尿碘值依次升高 ,差异有显著性 (P =0 0 0 0 ) ;③三组孕妇甲状腺功能检测值的中位数均在正常范围内 ,除TG一项外 ,FT3、FT4 、TSH、TM等几项差异均有统计学意义(P =0 0 0 0 ) ;④足月?
Objective To investigate the urinary iodine level,thyroid function of pregnant women and the neonatal thyroid function during different periods of pregnancy and iodine nutrient condition.To analyze iodine nutrient condition of pregnant women and necessity of supplemental therapy.Methods A total of 18 528 urinary samples of pregnant women from 1997.7 to 2003.3 in our hospital were collected and measured for iodine concentration.We separated the samples to different groups according to iodine supplement and pregnant trimester;group A without iodine supplement,group B with iodine supplement;the first trimester as group 1,the second trimester as group 2 and the third trimester as group 3.Another 246 pregnant women at the same time were randomly selected,and mother and neonatal thyroid function were measured,including 81 cases of the first trimester pregnant without iodine supplement,86 of term pregnant without iodine supply,and 79 of term pregnant with iodine supplement.Results ① The median urinary iodine of all cases was 231 μg/L.The incidence of urinary iodine<50 μg/L,<100 μg/L,<200 μg/L was 2.4%,13.9% and 43.4%,respectively.② The urinary iodine of non-iodine-supplement group was tending to rise as the pregnant weeks increased(162 μg/L for group 1,193 μg/L for group 2 and 260 μg/L for group 3).③ The urinary iodine level of iodine-supplement group was significantly higher than non-iodine supplement group in the same gestational period(377 μg/L vs.162 μg/L for group 1,286 μg/L vs.193 μg/L for group 2,382 μg/L vs.260 μg/L for group 3).④ The median thyroid function was in the normal range.But FT 3,FT 4,TSH and TM were significantly different between early pregnant women and term pregnant women(P=0.000).No significant difference was observed in term pregnant women regard less of supplemental of iodine. No significant difference of thyroid function in the newborn of term delivery was presented(P>0.05).⑤ TSH value of neonatal cord blood was<5 mU/l in 22.3%,>5 mU/L in 77.7% and>10 mU/L in 38.5%.Conclusions ① Pregnant women in our hospital present iodine-deficient in some degree.② The urinary iodine can reflect iodine level of the pregnant women,so measuring the urinary iodine can guide supplement therapy,especially for the low thyroid function hypothyreosis.③ Urinary iodine is suggested to be measured and be guidance for iodine supplement especially in early pregnant women who vomits severely.
出处
《中国妇产科临床杂志》
2005年第2期93-97,132,共6页
Chinese Journal of Clinical Obstetrics and Gynecology
