摘要
目的了解青岛地区妊娠早期(妊娠≤12周)妇女碘营养、甲状腺自身抗体与甲状腺功能减退症(甲减)的关系。方法测定495例妊娠早期妇女空腹尿碘及血清促甲状腺激素(TSH)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)水平。结果妊娠早期妇女碘缺乏占38.59%,尿碘异常率为60.61%。临床甲减、亚临床甲减(亚甲减)和低T4血症的检出率分别为1.82%、4.44%和7.88%。397例甲状腺抗体均阴性的妊娠早期妇女中,尿碘异常个体甲状腺功能异常检出率(15.13%)高于尿碘适量的个体(7.55%),差异有显著性(χ2=5.151,P<0.05);尿碘水平与亚甲减、低T4血症检出率之间均呈"U"字形关系曲线。195例碘适量妊娠早期妇女中,血清TPOAb、TGAb阳性个体总甲状腺功能异常检出率均高于阴性的个体(χ2=21.826、46.578,P<0.05);临床甲减、亚甲减组TPOAb和TGAb阳性率、定量值均分别高于甲状腺功能正常组(χ2=9.432~17.612,Z=-3.209^-1.970,P<0.05),低T4血症组TPOAb阳性率、定量值高于甲状腺功能正常组(χ2=6.624,Z=-4.639,P<0.05)。TPOAb、TGAb定量值与TSH均呈正相关(r=0.164、0.310,P<0.05),仅TPOAb定量值与FT4呈负相关(r=-0.277,P<0.05)。结论青岛地区妊娠早期妇女尿碘波动较大,以轻度碘缺乏检出率较高,碘缺乏和碘过量与甲减相关;碘适量水平下TPOAb和TGAb与甲减相关。
Objective To explore the relation of hypothyroidism with iodine nutrition and thyroid autoantibody in early pregnancy in Qingdao. Methods Fasting urinary iodine,serum TSH,FT4,TPOAb and TGAb were determined in 495 cases of early pregnancy. Results Iodine deficiency in early pregnancy accounted for 38.59%,and the rate of abnormal urinary iodine was of 60.61%.The detection rates of clinical hypothyroidism,subclinical hypothyroidism and hypothyroxinemia were 1.82%,4.44% and 7.88%,respectively.In 397 cases of early pregnancy women with negative thyroid antibody,the detection rate of thyroid dysfunction in individuals with abnormal urinary iodine was higher than those with appropriate urinary iodine levels,being15.13% vs.7.55%（χ2=5.151,P〈0.05）.There was a U shape curve relationship between the detection rate of urinary iodine with subclinical hypothyroidism and hypothyroxinemia.In 195 cases of women whose urinary iodine were in appropriate level,the detection rate of thyroid dysfunction was significantly higher in TPOAb-and TGAb-positive than that in TPOAb-and TGAb-negative ones（χ2=21.826,46.578;P〈0.05）.In clinical hypothyroidism and subclinical hypothyroidism groups,the positive rates of TPOAb and TGAb,and quantitative values were respectively higher than those with normal thyroid function（χ2=9.432-17.612,Z=-3.209--1.970,P〈0.05）.The TPOAb-positive rate and quantitative values were higher in hypothyroxinemia group than that in normal thyroid function group（χ2=6.624,Z=-4.639,P〈0.05）.The quantitative values of TPOAb and TGAb were positively correlated with TSH（r=0.164,0.310;P〈0.05）,and the quantitative value of TPOAb was negatively correlated with FT4（r=-0.277,P〈0.05）. Conclusion Large fluctuations of urinary iodine levels are seen in women with early pregnancy in Qingdao area,a higher detection rate is noted in mild iodine deficiency.Both deficiency and excess of iodine are correlated with thyroid hypofunction.Under an appropriate iodine level,thyroid hypofunction is associated with TPOAb and TGAb.
出处
《青岛大学医学院学报》
CAS
2015年第6期697-700,共4页
Acta Academiae Medicinae Qingdao Universitatis
