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目的研究青岛地区妊娠期妇女碘营养状况及其与甲状腺功能减退症的相关性。方法随机选取妊娠妇女663例,检测空腹尿碘、血清TSH、FT4、甲状腺过氧化物酶抗体(TPOAb)。结果妊娠期妇女尿碘在2.50~3 366.00μg/L,尿碘中位数(MUI)为161.59μg/L,碘缺乏、碘足量、碘超足量、碘过量的比例分别为44.95%、34.09%、15.69%、5.28%;妊娠T2、T3期尿碘水平以及轻度碘缺乏的比例均明显高于T1期,差异有统计学意义(均P<0.05);妊娠T2、T3期碘足量的比例低于T1期妇女,差异也有统计学意义(均P<0.05);妊娠期临床甲减、亚临床甲减、低T4血症的患病率分别为0.60%、3.77%、6.49%,妊娠各期之间的患病率差异均无统计学意义(均P>0.05);妊娠期TPOAb总阳性率为9.80%,碘缺乏组中亚临床甲减患者TPOAb的阳性率明显高于甲功正常组(P<0.01),且TPOAb阳性组亚临床甲减的患病率明显高于TPOAb阴性组(P<0.01)。结论青岛地区妊娠期妇女群体不存在碘缺乏,但有44.95%的妊娠妇女个体存在碘缺乏,随着妊娠期的延长,碘缺乏呈加重趋势;TPOAb阳性与妊娠妇女发生亚临床甲减相关。
Objective To study iodine nutrition in pregnant women in Qingdao and its relationship with hypothyroidism. Methods 663 pregnant women were randomly selected to detect urinary iodine, serum TSH, FT4 and thyroid peroxidase antibody (TPOAb). Results The urinary iodine was 2.50-3 366.00 μg / L and the median urinary iodine (MUI) was 161.59 μg / L in pregnant women. The rates of iodine deficiency, iodine deficiency, iodine excess and iodine excess were 44.95% 34.09%, 15.69% and 5.28% respectively. The levels of urinary iodine and mild iodine deficiency in T2 and T3 were significantly higher than those in T1 (P <0.05) (P <0.05). The prevalence rates of clinical hypothyroidism, subclinical hypothyroidism and hypo-T4 hyperlipidemia in pregnancy were 0.60%, 3.77% and 6.49% respectively, which were significantly lower than those of T1 women (P> 0.05). The positive rate of TPOAb in pregnancy was 9.80%. The positive rate of TPOAb in subclinical hypothyroidism in iodine deficiency group was significantly higher than that in subclinical hypothyroidism (P <0.01), and the prevalence of subclinical hypothyroidism in TPOAb-positive group was significantly higher than that in TPOAb-negative group (P <0.01). Conclusion There is no iodine deficiency in the pregnant women in Qingdao. However, 44.95% pregnant women have iodine deficiency. As the pregnancy progresses, the iodine deficiency tends to increase. The subclinical hypothyroidism is associated with TPOAb positive pregnancy.