摘要
目的建立厦门市妊娠早期甲状腺功能的参考范围,探讨妊娠早期妇女甲状腺自身抗体与尿碘/肌酐的关系。方法收集医院2020年3月—2021年3月产科及内分泌门诊进行常规产前检查的妊娠早期(妊娠0~13^(+6)周)妇女作为研究对象,测定尿碘、同步尿肌酐水平及血清促甲状腺激素(serum thyroid stimulating hormone,TSH)、游离甲状腺素(free thyroxine,FT_(4))、游离三碘甲腺原氨酸(free triiodothyronine,FT_(3))、甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、甲状腺球蛋白抗体(thyroglobulin antibody,TGAb)。结果满足TPOAb阴性的256例妊娠早期妇女甲状腺功能指标TSH的参考值范围为0.01~3.97 mIU/L,FT_(4)的参考值范围为11.39~24.65 pmol/L,TPOAb阳性的TSH较TPOAb阴性组高(Z=-2.478,P=0.013)。厦门孕早期尿碘/肌酐中位数132.10μg/mg。TPOAb阴性和TPOAb阳性两组间孕妇的碘营养分布,差异有统计学意义(χ^(2)=8.663,P<0.05),TPOAb阳性的孕妇中尿碘/肌酐低于阴性组(Z=-2.236,P<0.05)。TGAb阴性和TGAb阳性两组间尿碘/肌酐水平比较,差异无统计学意义(Z=-1.289,P=0.197)。结论建立了厦门市孕早期妇女甲状腺激素正常参考值范围。厦门妊娠早期孕妇尿碘/肌酐处于碘缺乏。碘缺乏可能诱发甲状过氧化物酶体阳性,可能是诱发或加重孕早期甲状腺自身免疫紊乱的因素之一。
Objective To study the reference of thyroid function and the relationship between thyroid autoantibody and urinary iodine/creatinine in women in early pregnancy.Methods Women in early pregnancy(0~13^(+6) weeks gestation)from the obstetric and endocrine clinic of our hospital(from March 2020 to March 2021)were collected as the study subjects to determine urinary iodine,synchronous urinary creatinine levels and serum thyroid stimulating hormone(TSH),free thyroxine(FT_(4)),free triiodomeionine(FT_(3)),thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb).Results The reference values for the thyroid function index TSH and FT_(4) were 0.01-3.97 mIU/L and 11.39-24.65 pmol/L in 256 TPOAb negative women in early pregnancy.The TSH in the TPOAb-positive group was higher than in the TPOAb-negative group(Z=-2.478,P=0.013).The median urine iodine/creatinine in Xiamen pregnancy was 132.10μg/mg.The iodine nutrition distribution among pregnant women with TPOAb negative and TPOAb positive groups was statistically significant(χ^(2)=8.663,P<0.05).Pregnant women with positive TPOAb had a lower urinary iodine/creatinine than in the negative group(Z=-2.236,P<0.05).Comparison of urinary iodine/creatinine levels between TGAb negative and TGAb positive groups showed no significant difference(Z=-1.289,P=0.197).Conclusion The normal reference value of thyroid hormones in early pregnant women in Xiamen is established,and the urine iodine/creatinine for early pregnancy was in iodine deficiency.Iodine deficiency may induce positive methyroid peroxisomes and may be one of the factors inducing or aggravating thyroid autoimmune disorders in early pregnancy.
作者
沈小燕
柯文志
林鹭平
罗芳涛
陈英红
涂壹长
林志华
SHEN Xiaoyan;KE Wenzhi;LIN Luping;LUO Fangtao;CHEN Yinghong;TU Yichang;LIN Zhihua(Department of Endocrinology,The Second Affiliated Hospital of Xiamen Medical College,Xiamen Fujian 361021,China;Department of Intensive Care Unit,Xiamen No.3 Hospital,Xiamen Fujian 361100,China)
出处
《中国卫生标准管理》
2022年第16期12-16,共5页
China Health Standard Management
基金
福建省厦门科技计划项目(3502Z20194062)。
关键词
孕早期
甲状腺功能
正常参考值范围
甲状腺过氧化物酶抗体
甲状腺球蛋白抗体
尿碘
尿碘/尿肌酐
the first trimester of pregnancy
thyroid function
reference interval
thyroid peroxidase antibody
thyroglobulin antibody
urinary iodine
urinary iodine to creatinine