不同碘营养、不同孕期孕妇的甲状腺激素变化

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1、不同碘营养、不同孕期孕妇的甲状腺激素变化作者：苏会璇，钟宇华，梁华晟，韦慈，连冬梅【摘要】目的探讨北海市不同碘营养状况、不同孕期孕妇的甲状腺激素变化及其甲状腺功能状态。方法采用ACS-180化学发光分析仪检测623例孕妇的血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)、促甲状腺激素(TSH)和人绒毛膜促性腺激素(hCG);利用碘催化砷铈反应原理，采用冷消解快速尿碘定量检测方法测定孕妇1次随意尿的尿碘含量。结果孕早、中期的FT3、FT4和hCG高于孕晚期(P<0.05)，而TSH低于孕晚期(P<0.05)。高尿碘组的FT3、FT4和hCG低于正常尿碘

2、、低尿碘组(P<0.05)，3组的TSH差异无显著性(P>0.05)。甲状腺功能紊乱发生率为7.54%，不同孕期、不同尿碘组间的甲状腺功能紊乱发生率的差异无显著性(P>0.05)。亚临床甲状腺功能减退(甲减)、亚临床甲状腺功能亢进(甲亢)的发生率分别为3.53%、2.57%，甲减、甲亢的发生率分别为1.12%、0.32%。孕早、晚期和各尿碘组均以亚临床甲减居多，孕中期以亚临床甲亢居多。结论碘营养水平及孕期激素变化不是引起孕妇甲状腺功能紊乱的主要因素，可能妊娠期母体免疫状态的改变才是主要的启动因素。【关键词】孕期;碘营养;甲状腺激素;孕妇11　　Abstra

3、ct:ObjectiveToinvestigatethevariationsofthyroidhormonelevelsandstatusofthyroidfunctioninpregnantwomenwithdifferentiodinenutritionstatusandinstagesofgestationinBeihai.MethodsFreetriiodothyronine(FT3),freethyroxine(FT4),thyroidstimulatinghormone(TSH)andhumanchoronicgonadotropin(hCG)weredeter

4、minedin623pregnantwomenbyACS-180automaticchemiluninescenceanalyzer.TheurinaryiodinecontentinarandomurinationwasmeasuredusingcolddigestionmethodofrapidquantitativedetectionurinaryiodineaccordingtoiodinecatalyticeffectofArsenic-Cerium.ResultsSerumFT3,FT4andhCGlevelsinthefirstandsecondtrimest

5、erswerehigherthanthoseinthethirdtrimester(P<0.05),andTSHlevelswerelowerthanthoseinthethirdtrimester(P<0.05).FT3,FT4andhCGlevelswerelowerinhighurineiodinegroupthaninnormalandlowurineiodinegroups(P<0.05).Nosignificantdifferenceswerefoundinthe3groups(P>0.05).Theincidenceofthyroidd

6、ysfunctionwas7.54%,withnosignificantdifferencesbetweenthegestationstagesandurineiodinegroups(P>0.05).Theincidenceofsubclinicalhyperthyroidismandsubclinicalhypothyroidismwas3.53%and2.57%,respectivelyandtheincidenceofhyperthyroidismandhypothyroidismwas1.12%and110.32%,respectively.Theincid

7、enceofsubclinicalhyperthyroidismwasdominantintheurinaryiodinegroups,whileinthefirstandthirdtrimesters,theincidenceofsubclinicalhypothyroidismprevailsinthesecondtrimester.ConclusionTheiodinenutritionconditionsandthevariationsofhCGlevelsduringpregnancywerenotthe