摘要
目的了解盐碘含量下调后孕妇的甲状腺功能和疾病状况,为科学防治碘缺乏病提供依据。方法收集2014-2015年大理州医院不同孕期产检孕妇的甲状腺功能检测结果,包括甲状腺功能(TSH、TT4、TT3、FT4、FT3)及抗体(TPOAb、TgAb),对其中360人采用B超测量甲状腺容积、结节。分析孕妇甲状腺功能异常、甲状腺抗体阳性、甲状腺结节、甲状腺肿大的检出情况。结果共调查1 110例孕妇,不同孕期的TSH(χ2=31.811,P<0.05),TT4、TT3、FT4、 FT3(F=15.447、34.589、159.097、70.19,P均<0.05)差异有统计学意义。孕妇甲状腺功能总异常率为10.81%(120/1110),孕早、中、晚期分别为11.35%(63/555)、9.85%(33/335)、10.90%(24/220),差异无统计学意义(χ2=0.491,P>0.05),其中甲减、甲亢、亚甲减、亚甲亢、低FT4血症检出率分别为0.99%、0.99%、4.41%、1.26%、3.15%。TPOAb阳性率8.11%(90/1110),孕早、中、晚期分别为8.47%(47/555)、8.36%(28/335)、6.82%(15/220),差异无统计学意义(χ2=0.616,P>0.05);TgAb阳性率8.65%(96/1 110),孕早、中、晚期分别为10.63%(59/555)、7.46%(25/335)、5.45%(12/220),差异有统计学意义(χ2=6.197,P<0.05)。甲状腺结节检出率为14.17%(51/360),孕早、中、晚期分别为14.41%(17/118)、11.38%(14/123)、16.81%(20/119),差异无统计学意义(χ2=1.472,P>0.05)。甲状腺肿大率1.67%(6/360),孕早、中、晚期分别为1.69%(2/118)、1.68%(2/123)、1.63%(2/119),差异无统计学意义(χ2=0.002,P>0.05)。结论盐碘含量下调后,大理市孕妇甲状腺功能良好,甲状腺结节、甲状腺肿大等检出率较低。需深入开展孕妇碘营养与甲状腺疾病的关系研究,为精准、科学补碘提供依据。
Objective To understand the thyroid function and disease status of pregnant women after the reduction of salt iodine content,and to provide a basis for scientific prevention of iodine deficiency disorders.Methods The results of thyroid function test of different pregnancy periods women during the routine examination were collected in Dali Prefecture Hospital from 2014 to 2015,including thyroid function(TSH,TT4,TT3,FT4,FT3) and antibodies(TPOAb,TgAb),360 of the pregnant women were tested thyroid volume and nodules by B-ultrasound.The detection rate of abnormal thyroid function,positive antibody,thyroid nodules and goiter in pregnant women was analyzed.Results A total of 1 110 pregnant women were investigated.The differences of TSH(χ2 =31.811,P<0.05),TT4,TT3,FT4,FT3(F=15.447,34.589,159.097,70.19,P<0.05) of different pregnancy periods women were statistically significant.The total abnormal rate of thyroid function was 10.81%(120/1 110),and 11.35%(63/555),9.85%(33/335),10.90%(24/220) in early,middle,and late pregnancy,respectively,and the difference was not statistically significant(χ2 =0.491,P>0.05).Among them,the detection rates of hypothyroidism,hyperthyroidism,subclinical hypothyroidism,subclinical hyperthyroidism,and low T4 level were 0.99%,0.99%,4.41%,1.26% and 3.15%,respectively.The positive rate of TPOAb was 8.11%(90/1 110),and 8.47%(47/555),8.36%(28/335),6.82%(15/220) in early,middle,late pregnancy,respectively,and the difference was not statistically significant(χ2 =0.616,P>0.05).The positive rate of TgAb was 8.65%(96/1 110),and 10.63%(59/555),7.46%(25/335),5.45%(12/220) in early,middle,late pregnancy,respectively,and the difference was statistically significant(χ2 =6.197,P<0.05).Thyroid nodule detection rate was 14.17%(51/360),and 14.41%(17/118),11.38%(14/123),16.81%(20/119) in early,middle and late pregnancy,respectively,and thedifference was not statistically significant(χ2=1.472,P>0.05).The rate of goiter was 1.67%(6/360),and 1.69%(2/118),1.68%(2/123),1.63%(2/119) in early,middle and late pregnancy,respectively,and the difference was not statistically significant(χ2 =0.002,P>0.05).Conclusion After the reduction of salt iodine content,pregnant women in Dali had good thyroid function,and the detection rate of thyroid nodules and goiter were low.Further research on the relationship between iodine nutrition and thyroid disease in pregnant women is needed to provide evidence for accurate and scientific iodine supplementation.
作者
张海涛
黄文丽
王安伟
郭玉熹
李淑娟
叶枫
ZHANG Hai-tao;HUANG Wen-li;WANG An-wei;GUO Yu-xi;LI Shu-juan;YE Feng(Department for Endemic Disease Control and Prevention,Yunnan Institute for Endemic Diseases Control and Prevention,Dali 671000,China)
出处
《中国地方病防治》
CAS
2020年第4期416-419,共4页
Chinese Journal of Control of Endemic Diseases
基金
徐建国院士工作站资助(2018IC155)。
关键词
碘
孕妇
甲状腺疾病
Iodine
Pregnant women
Thyroid diseases
