摘要
目的探讨碘摄入量对产后甲状腺炎(PPT)的发生、发展以及甲状腺自身抗体的影响.方法 610例产妇进入队列研究,488例(80%)达到随访6个月以上.进入队列的孕产妇均在分娩前、产后3个月和6个月时留取空腹血清,测定血清TSH、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)、FT4、FT3、甲状腺球蛋白(Tg)和TSH受体抗体(TRAb).每次采血的同时留取空腹尿,以多次尿碘的均值作为判定该孕产妇个体碘营养水平的依据.同时进行体格检查和甲状腺B超检查.PPT产妇继续接受产后9个月和12个月的随访.结果 488例产妇的尿碘中位数为201 μg/L.临床和亚临床PPT患者的尿碘中位数显著高于非PPT者(232 μg/L vs 200 μg/L,P＜0.05),根据尿碘水平将产妇分为低碘组(尿碘＜100 μg/L)、适碘组(尿碘100～300 μg/L)和高碘组(尿碘＞300 μg/L),高碘组PPT(包括临床和亚临床PPT)患病率为18.02%,显著高于适碘组(10.56%,P＜0.05).产后6个月TPOAb阳性者尿碘水平显著高于TPOAb阴性者(尿碘240 μg/L vs 198 μg/L,P＜0.05).结论孕产妇尿碘＞300 μg/L可能导致PPT发病率增加.产后6个月时TPOAb阳性者尿碘水平高于TPOAb阴性者.
Objective To explore the effects of iodine intake on the pathogenesis of postpartum thyroiditis (PPT) and thyroid autoantibodies in China. Methods A total of 610 pregnant women were involved in the cohort study. Among them 488 (80%) were followed up for more than 6 months after delivery. Fasting sera were collected from these women just before delivery and 3 and 6 months after delivery for analyses of TSH, FT_3, FT_4, thyroglobulin (Tg), thyroid peroxidase antibody (TPOAb), TgAb and TSH receptor antibody (TRAb). Urinary iodine (UI) concentrations were concomitantly tested, iodine nutrition of these subjects was evaluated by the average value of multiple UI measurments, and physical examination and B type echograph were simultaneously performed. Women diagnosed as PPT were further observed 9 and 12 months after delivery. Results The UI median (MUI) in 488 pregnant women was 201 μg/L. The MUI in patients with overt PPT and subclinical PPT was higher than that in normal pregnant women (232 μg/L vs 200 μg/L, P<0.05). According to UI, all the pregnant women were divided into 3 groups: low-iodine group (LI, UI<100 μg/L), sufficient-iodine group (SI, UI 100-300 μg/L) and high-iodine group (HI, UI>300 μg/L). The prevalence of PPT in HI was 18.02%, being significantly higher than those of SI (10.56%, P<0.05). Six months after delivery, UI of TPOAb-positive women was higher than that of TPOAb-negative women (240 μg/L vs 198 μg/L, P<0.05). Conclusion In pregnant women, UI>300 μg/L may contribute to an increased prevalence of PPT. Six after delivery, UI of TPOAb-positive women is higher than that of TPOAb-negative women.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2005年第2期103-105,共3页
Chinese Journal of Endocrinology and Metabolism
基金
国家自然科学基金 ( 30240013
30370680 )
辽宁省科技计划项目基金(2003225005)
辽宁省教育厅课题基金(202013158)
