摘要
目的通过对汀苏省高碘和适碘地区孕早期孕妇甲状腺疾病患病率的调查，初步建立不同水碘含量地区妊娠早期甲状腺疾病的流行病学数据库，为甲状腺疾病的有效防治提供依据。方法选择徐州丰县和睢宁作为高碘和适碘地区，在两地抽取早孕妇女共439例，均为确认孕3月以内的当地常住妇女。设计并填写调查问卷，记录姓名、年龄、既往史、联系方式等一般资料，留取空腹静脉全血，现场离心血标本，分装血清，冰盒保存运输，实验室-86℃冰箱冷冻待检，以电化学发光法测定游离气碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、总甲状腺素（TT4）、促甲状腺激素（TSH）及甲状腺过氧化物酶抗体（TPOAb）。调查问卷内容及检验结果全部录入Epidata数据库，筛除既往甲状腺疾病、。肾脏疾病、心脏疾病、妊高症等对象后，对符合条件的396例对象之数据进行统计学分析。结果396例调查孕妇中，有197例（49．7％）患甲状腺疾病，甲状腺功能亢进、亚临床甲亢、甲状腺功能减退、亚临床甲减、低T4血症和甲状腺自身免疫状态的患病率分别为0．5％、6．3％、3．3％、29．3％、9．3％和1．0％。其中，高碘地区孕妇的亚临床甲减患病率明渺高于适碘地区，分别为32．4％和19．6％，其余类型甲状腺功能异常如甲减、甲亢、亚临床甲亢、低T4血症及甲状腺白身免疫状态的患病，率均无差别。结论江苏高碘与适碘地区孕妇甲状腺疾病谱以哑临床甲减、岖临床甲亢和低T。血症为主，高碘地区孕妇的亚临床甲减患病率高可能与碘摄人过量有关．
Objective To study the prevalence of thyroid disease in pregnant women living in both excess and sufficient water iodine area of in Jiangsu Province, and to establish an epidemiological database of thyroid disorders among pregnant women in different water iodine area in Jiangsu Province in order to guide our clinical practise. Methods Fengxian and Suining of Xuzhou were selected as excess and sufficient water iodine region. All the 439 pregnant women within the first trimester were enrolled in our study. The name, age, and previous history were recorded on questionnaire. The samples of fasting blood were obtained. Serum parameters such as free triiodothyronine （ FT3 ）, free thyroxine （ FT4 ）, total thyroxine （ TT4 ）, thyrotropic stimulating hormone （ TSH ）, and thyroid peroxidase （TPOAb） were measured by electrochemilmninescence assay. The data of the eligible 396 subjects were stored and analyzed by Epidata after excluding subjects with previous thyroid dysfuncion, renal disease, heart disease, and pregnancy-induced hypertension syndrome. Results Among the 396 subjects, 197 women （49.7%） had thyroid disorders. The prevalence of hyperthyroidism, subclinical hyperthyroidism, hypothyroidism, subclinical hypothyroidism, hypothyroxinaemia, and thyroid autoimmunity were 0.5% , 6.3% , 3.3% , 29.3% , 9.3%, and 1.0% , respectively. The prevalence of subclinical hypothyroidism was significantly higher in excess water iodine region （ 32.4% ） than that in sufficient water iodine area （ 19.6% ）, while the prevalence of other types of thyroid diseases such as subclinical hyperthyroidism, hyperthyroidism, hypothyroidism, hypothyroxinaemla, and TPOAb- positive cases in either excess or sufficient water iodine regions was not different. Conclusions Subclinical hyperthyridism, hypothyroxinaemia, and subclinical hypothyroidism are the main thyroid disorders in pregnant women in both excess and sufficient water iodine area. The prevalence of subclinical hypothyroidism increases obviously in excess water iodine region, indicating the relationship between thyroid disease and high iodine intake.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2012年第6期475-479,共5页
Chinese Journal of Endocrinology and Metabolism
关键词
妊娠
甲状腺疾病
发病率
高碘地区
适碘地区
Pregnancy
Thyroid diseases
Prevalence
Excess iodine region
Sufficient iodine region
