摘要
目的 调查新疆地区汉族与维吾尔族孕妇促甲状腺激素（TSH）与尿碘水平的关系.方法 收集2014年8月至2017年12月在新疆维吾尔自治区人民医院门诊产前进行甲状腺功能及碘营养状态筛查、资料完整的孕妇1568例,其中汉族组956例（60.9％）,维吾尔族组612例（39.1％）,回顾性分析两组孕妇的TSH及甲状腺过氧化物酶抗体（TPOAb）、尿碘水平.结果 （1）总体情况：所有1568例孕妇的中位尿碘水平为162.6μg/L（第2.5～97.5百分位数：53.4～539.3μg/L）,尿碘水平为碘缺乏、碘适宜、碘超量、碘过量者分别为672例（42.9％）、576例（36.7％）、268例（17.1％）、52例（3.3％）.（2）两组孕妇的尿碘水平：汉族组与维吾尔族组孕妇的中位尿碘水平分别为169.1μg/L（54.6～583.4μg/L）、156.3μg/L（53.1～539.3μg/L）,两组比较,差异有统计学意义（P〈0.05）.汉族组及维吾尔族组孕妇尿碘水平：碘缺乏为40.9％（391/956）、45.9％（281/612）、碘适宜为35.4％（338/956）、38.9％（238/612）、碘超量为20.2％（193/956）、12.3％（75/612）、碘过量为3.6％（34/956）、2.9％（18/612）,两组孕妇尿碘水平的分布比较,差异有统计学意义（P〈0.05）;分别比较两组孕妇不同碘营养状态者的比例,仅碘超量者的比例[分别是20.2％（193/956）、12.3％（75/612）]差异有统计学意义（P〈0.05）.（3）TSH偏高的影响因素分析：分别按民族、不同妊娠期、年龄（〈30岁、≥30岁）、TPOAb水平、抗甲状腺球蛋白抗体水平、碘营养状态分层,比较TSH水平偏高者的比例,维吾尔族孕妇显著高于汉族、妊娠早期明显高于妊娠中、晚期、TPOAb阳性者明显高于阴性者,抗甲状腺球蛋白抗体阳性者明显高于阴性者（P均〈0.05）.（4）尿碘与TSH水平的相关性：所有孕妇的尿碘与TSH水平无相关性（P〉0.05）;汉族组与维吾尔族组孕妇的尿碘与TSH水平均无相关性（P=0.35、0.25）.再按孕周、年龄、抗体水平分层后分析,汉族孕妇中年龄≥30岁者尿碘与TSH水平呈正相关（P〈0.05）,维吾尔族孕妇中处于妊娠晚期者呈负相关（r〈0.05）;进一步控制相应因素,年龄≥30岁汉族孕妇及妊娠晚期维吾尔族孕妇的尿碘与TSH水平也均无相关性（P均〉0.05）.结论 汉族与维吾尔族孕妇的中位尿碘水平及分布均有差异.汉族与维吾尔族孕妇均未发现其尿碘与TSH水平有相关性.
Objective To investigate the relationship between thyrotropin（TSH）and urine iodine in pregnant women of Han and Uygur ethnic groups in People′s Hospital of Xinjiang Uygur Autonomous Region. Methods A total of 1568 pregnant who completed screening of TSH and urine iodine in People′s Hospital of Xinjiang Uygur Autonomous Region hospital from August 2014 to December 2017 were included＆nbsp;in the study, 956 cases were Han and the other 612 were Uygur. Basic clinical data, serum TSH, thyroid peroxidase autoantibody （TPOAb）, and urine iodine levels were retrospectively analyzed. Results （1） General results：The median urine iodine level was 162.6μg/L（53.4-539.3μg/L）, and the distribution of urine iodine classification was iodine deficiency 42.9％（672/1568）, iodine appropriate 36.7％（576/1568）, iodine slightly high 17.1％（268/1568）and iodine excess 3.3％（52/1568）respectively.（2）The median urine iodine levels of Han and Uygur pregnant women were 169.1μg/L（54.6-583.4μg/L）and 156.3μg/L （53.1-539.3μg/L）respectively, and the difference was statistically significant（P〈0.05）.The distribution of urine iodine status in pregnancy between Han and Uygur was significantly different, which were 40.9％（391/956）vs. 45.9％（281/612）in iodine deficiency, 35.4％（338/956）vs. 38.9％（238/612）in iodine appropriate, 20.2％（193/956） vs. 12.3％（75/612） in iodine slightly high and 3.6％（34/956） vs. 2.9％（18/612）in iodine excess.（3）High serum TSH level proportion was significantly higher in Uygur ethnic group, early pregnancy, thyroid peroxidase antibody positive and anti-thyroglobulin antibody positive group when compared with Han, late pregnancy, thyroid peroxidase antibody negative and anti-thyroglobulin antibody negative groups （all P〈0.05）. There were no significant differences in different age groups and iodine nutrition groups（P〉0.05）.（4）There was no correlation between urinary iodine and TSH levels in all pregnant women（P〉0.05）,neither in Han or Uygur group. When further stratified by gestational age, age, and antibody level, there was a positive correlation between urine iodine and serum TSH level in Han pregnant women〉30 years old（P〈0.05）, and there was a negative correlation in the third trimester in Uygur （P〈0.05）. When serum antibody level, gestational week and age were controlled. There was no correlation between urine iodine and serum TSH level in neither group. Conclusions （1）In Han and Uygur pregnant women, the median urine iodine level and the distribution of urine iodine classification between two ethnic groups are significantly different.（2）The correlation between urine iodine and serum TSH is not identified in Han or Uygur pregnant women.
作者
热那姑丽·艾克拜尔
罗蕴之
王新玲
迪丽达尔·依马木
穆叶沙尔·吾拉木
古再
丽努尔·居来提
张玉媛
郭艳英
Renaguli Aikebaier;Luo Yunzhi;Wang Xinling;Dilidaer Yimamu;Muyeshsaer Wulamu;Guzailinuer Julaiti;Zhang Yuyuan;Xin Liang;Guo Yanying(Department of Endocrinology,People＇s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2018年第9期595-601,共7页
Chinese Journal of Obstetrics and Gynecology
基金
新疆维吾尔自治区科技基础条件平台建设项目（PT1601）
新疆维吾尔自治区人民医院院内科研项目（20150216）
关键词
妊娠
促甲状腺激素
碘
维吾尔族
汉族
Pregnancy
Thyrotropin
Iodine
Uygur nationality
Han nationality
