马品江, 黄佳, 王琛琛, 段依敏, 张玲. 新疆维吾尔自治区南部干预补碘地区妊娠妇女碘营养及甲状腺水平分析[J]. 疾病监测, 2018, 33(6): 528-530. DOI: 10.3784/j.issn.1003-9961.2018.06.019
引用本文: 马品江, 黄佳, 王琛琛, 段依敏, 张玲. 新疆维吾尔自治区南部干预补碘地区妊娠妇女碘营养及甲状腺水平分析[J]. 疾病监测, 2018, 33(6): 528-530. DOI: 10.3784/j.issn.1003-9961.2018.06.019
Ma Pinjiang, Huang Jia, Wang Chenchen, Duan Yimin, Zhang Ling. Analysis on iodine nutrition and thyroid levels of pregnant women with access to iodine supplement intervention in Xinjiang Uygur Autonomous Region[J]. Disease Surveillance, 2018, 33(6): 528-530. DOI: 10.3784/j.issn.1003-9961.2018.06.019
Citation: Ma Pinjiang, Huang Jia, Wang Chenchen, Duan Yimin, Zhang Ling. Analysis on iodine nutrition and thyroid levels of pregnant women with access to iodine supplement intervention in Xinjiang Uygur Autonomous Region[J]. Disease Surveillance, 2018, 33(6): 528-530. DOI: 10.3784/j.issn.1003-9961.2018.06.019

新疆维吾尔自治区南部干预补碘地区妊娠妇女碘营养及甲状腺水平分析

Analysis on iodine nutrition and thyroid levels of pregnant women with access to iodine supplement intervention in Xinjiang Uygur Autonomous Region

  • 摘要: 目的 调查新疆维吾尔自治区(新疆)南部碘缺乏高危地区妊娠妇女口服碘油后的碘营养状况及甲状腺激素水平的差异变化,为科学补碘提供理论依据。方法 2015年10月以实施干预补碘的(2次/年,每次200 mg)拜城和乌什县为调查点,按设计方案要求每个县选2个乡镇,每个乡镇选2个村,每个村抽取18~40岁妊娠妇女15人、非妊娠妇女50人,测定其尿碘和甲状腺激素水平。结果 实施干预补碘后妊娠组、非妊娠组尿碘中位数分别为181.73 μg/L和228.35 μg/L。妊娠组尿碘水平<50 μg/L和100 μg/L分别占各组总人数的5.83%和16.66%。两组尿碘水平差异有统计学意义(χ2=6.470,P<0.05);血清游离甲状腺素(FT4)异常率为16.76%,其中妊娠组和非妊娠组偏低,分别占25.83%和13.43%,促甲状腺素(TSH)异常率为22.35%;两组血清游离三碘甲状腺原氨酸(FT3)和FT4差异有统计学意义(t=15.027、9.070,P<0.05),TSH差异无统计学意义(t=0.380,P>0.05);妊娠组甲状腺机能减退(甲减)、亚临床甲减发生率分别为3.33%和10.00%。非妊娠组甲状腺机能亢进(甲亢)、甲减、亚临床甲减发生率分别为0.72%、5.04%和17.98%,两组亚临床甲减发生率差异有统计学意义(χ2=4.380,P<0.05)。结论 实施干预补碘,妊娠妇女碘营养水平处于适宜范围;甲状腺功能异常以亚临床甲减为主,可能是该地区甲状腺功能紊乱的常见类型。TSH、FT3、FT4的检测对甲状腺功能异常的早期诊断、治疗和防治有重要意义。

     

    Abstract: Objective To understand the pregnant women's nutritional status and thyroid hormone level difference after oral iodine oil supplement in areas at high-risk in southern Xinjiang and provide evidence for scientific iodine supplement. Methods A survey was conducted in Baicheng and Wushi counties where iodine supplement intervention had been carried out since 2015. In county,two villages were selected from each of two townships selected. In each village,15 pregnant women and 50 non-pregnant women aged 18-40 years were surveyed to test their urinary iodine and thyroid hormones levels. Results After the iodine supplement intervention,the median of urinary iodine levels in pregnant group and non-pregnant group were 181.73 μg/L and 228.35 μg/L respectively. In pregnant group,those whose urine iodine level <50 μg/L and <100 μg/L accounted for 5.83% and 16.66%,respectively. There were differences between the two groups in urine iodine level (χ2=6.470,P<0.05). The abnormal rate of serum free thyroxine (FT4)was 16.76%,and those with the low rate accounted for 25.83% in pregnant group and 13.43% in non-pregnant group. The abnormal rate of thyroid stimulating hormone (TSH)was 22.35%. The difference in FT3 and FT4 abnormal rates between two groups had statistical significance (t=15.027,t=9.070,P<0.05),the difference in TSH abnormal rate between two groups had no statistical significance (t=0.380,P>0.05). The incidence of hypothyroidism was 3.33% and the incidence of subclinical hypothyroidism was 10.00% in pregnant group. In non-pregnant group,the incidence of hyperthyroidism was 0.72%,the incidence of hypothyroidism was 5.04% and the incidence of subclinical hypothyroidism was 17.98%. There was significant difference in incidence of hypothyroidism between two groups (χ2=4.380,P<0.05). Conclusion After the intervention of iodine supplement,the iodine nutrition level of the pregnant women was in a suitable range. Subclinical hypothyroidism was the main form of abnormal thyroid function,which might be the common type of thyroid dysfunction in this area. TSH, FT3, FT4 detections were important for the early diagnosis, treatment and prevention of abnormal thyroid function.

     

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