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目的调查和评估江北区孕妇碘营养状况和新生儿甲状腺功能情况,为科学补碘防控策略提供依据。方法以2014年3—10月江北区3个调查点(分别代表城区、城乡结合部、农村)161名孕妇为调查对象,采集孕妇尿样检测尿碘含量,比较分析不同地理区域、不同孕期孕妇碘营养状况。采集孕妇静脉血及配对新生儿脐带血测定血清中游离三碘甲状腺原氨酸(FT3)、游离甲状素(FT4)及促甲状腺素(TSH),并分析两者间关系。结果 161名孕妇尿碘水平的中位数为178.67μg/L。其中,碘过量者(尿碘>500μg/L)占3.73%(6/161),碘足量者(尿碘250~499μg/L)占33.54%(54/161),碘适量者(尿碘150~249μg/L)占22.36%(36/161),碘缺乏者(尿碘<150μg/L)占40.37%(65/161)。江北区城区、城乡结合部、农村3个不同地理区域孕妇尿碘水平有一定差异,农村高于城区。孕晚期孕妇尿碘中位数为159.06μg/L。36名新生儿血清中FT3、FT4水平分别为(2.60±0.35)、(13.81±1.63)pmol/L,血清TSH水平的平均数为3.38 m IU/L。孕妇尿碘水平与新生儿血清FT3和TSH水平无关(P>0.05),但与FT4水平有关(P<0.01)。结论江北区大部分孕妇碘营养状况处于适宜水平,但仍有部分孕妇存在碘缺乏,孕晚期孕妇尿碘含量偏低,配对孕妇与新生儿FT4水平呈正相关。应加强孕妇碘营养状况及新生儿甲状腺功能监测。
Objective To investigate and evaluate the nutritional status of iodine in pregnant women in Jiangbei District and the thyroid function of newborn infants, so as to provide scientific basis for the prevention and control of iodine supplements in science. Methods A total of 161 pregnant women from 3 survey sites in Jiangbei District (representative of urban area, urban-rural area and rural areas respectively) from March to October in 2014 were enrolled in this study. Urinary iodine levels of pregnant women were collected to detect urinary iodine content in different geographies and pregnant women Iodine nutrition status. Serum free triiodothyronine (FT3), free FT4, and thyrotropin (TSH) were measured in venous blood from pregnant women and matched neonates with umbilical cord blood. The relationship between them was analyzed. Results The median urinary iodine level of 161 pregnant women was 178.67μg / L. Among them, iodine excess (urinary iodine> 500μg / L) accounted for 3.73% (6/161), iodine sufficient (urinary iodine 250-499μg / L) accounted for 33.54% (54/161) 150 ~ 249μg / L) accounted for 22.36% (36/161), iodine deficiency (urinary iodine <150μg / L) accounted for 40.37% (65/161). Jiangbei District urban, rural and urban areas, rural areas of three different geographical areas of pregnant women have different levels of urinary iodine, rural areas than urban areas. The median urinary iodine of pregnant women in the third trimester was 159.06μg / L. The serum levels of FT3 and FT4 in 36 neonates were (2.60 ± 0.35) and (13.81 ± 1.63) pmol / L, respectively. The average serum TSH level was 3.38 mIU / L. Urinary iodine levels in pregnant women had no correlation with FT3 and TSH levels in neonates (P> 0.05), but correlated with FT4 levels (P <0.01). Conclusion Most of pregnant women in Jiangbei district have adequate iodine nutrition status. However, some pregnant women still have iodine deficiency. Urinary iodine content of pregnant women in the third trimester is low. Paired pregnant women and neonates have a positive correlation with FT4 levels. Iodine nutrition status of pregnant women should be strengthened and neonatal thyroid function monitoring should be strengthened.