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目的调查了解全省孕妇碘营养水平和甲状腺功能现状,为开展科学补碘和甲状腺功能监测提供依据。方法 2016年4~9月,根据地理位置和地形在安徽省选择6个县(区),依托妇幼保健院或乡镇卫生院选择妊娠早、中、晚期孕妇,每个县(区)各100名,采集孕妇家庭食用盐、尿液和血清,分别测定盐碘、尿碘和甲状腺功能。结果共调查600名孕妇,盐碘和尿碘中位数分别为23.0 mg/kg和181.0μg/L,妊娠早、中和晚期的孕妇尿碘中位数分别为211.3μg/L、179.1μg/L和170.2μg/L。547名孕妇TSH、FT3和FT4的均数分别为1.8μIU/ml、5.7 pmol/L和13.8 pmol/L,TGAb和TPOAb中位数分别为29.3 IU/ml和1.5 IU/ml,均在正常范围内;甲状腺功能异常率为15.4%,其中甲亢、亚甲亢、甲减和亚甲减的检出率分别为1.1%(6/547)、1.8%(10/547)、5.7%(31/547)、6.8%(37/547)。不同孕期孕妇甲亢、亚甲亢检出率比较,差异有统计学意义。尿碘<150μg/L的甲亢检出率(2.4%)与≥150μg/L的甲亢检出率(0.6%)差异有统计学意义。结论安徽省部分地区孕妇碘营养适宜,但仍有部分孕妇处于碘营养不足状态,甲状腺功能异常发生以亚甲减为主,碘营养不足的甲亢检出率较高。
Objective To investigate the level of iodine nutrition and the status of thyroid function in pregnant women in the province and provide basis for scientific iodization and thyroid function monitoring. Methods From April to September 2016, 6 counties (districts) were selected in Anhui Province according to their geographical location and topography. Pregnant women of early, middle and late stages of pregnancy were selected by MCH or township hospitals. Each county (district) , Collected pregnant women eating salt, urine and serum, were measured salt iodine, urinary iodine and thyroid function. Results A total of 600 pregnant women were surveyed. The median of salt iodine and urinary iodine were 23.0 mg / kg and 181.0 μg / L respectively. The median urinary iodine of pregnant women in early, middle and late pregnancy were 211.3μg / L and 179.1μg / L and 170.2 μg / L. The median TSH, FT3 and FT4 scores of 547 pregnant women were 1.8 μIU / ml, 5.7 pmol / L and 13.8 pmol / L, respectively, and the median of TGAb and TPOAb were 29.3 IU / ml and 1.5 IU / ml respectively, all within the normal range ; The rate of thyroid dysfunction was 15.4%. The detection rates of hyperthyroidism, hyperthyroidism, hypothyroidism and hypothyroidism were 1.1% (6/547), 1.8% (10/547), 5.7% (31/547) ), 6.8% (37/547). Different pregnant women with hyperthyroidism, hyperthyroidism detection rate, the difference was statistically significant. The urinary iodine <150μg / L detection rate of hyperthyroidism (2.4%) and ≥ 150μg / L detection rate of hyperthyroidism (0.6%) difference was statistically significant. Conclusion Iodine nutrition is suitable for pregnant women in some areas of Anhui Province. However, some pregnant women are still in iodine deficiency state, while hypothyroidism is the main cause of thyroid dysfunction. The detection rate of hyperthyroidism with iodine deficiency is high.