孕妇妊娠不同时期碘营养及甲状腺功能的动态变化研究

发布时间：2018-01-25 21:50

本文关键词： 碘营养妊娠不同时期孕妇甲状腺功能　出处：《中国地方病防治杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的研究孕妇妊娠不同时期碘营养及甲状腺功能的动态变化情况。方法选取我院2015年3月~2016年5月接收的196例常规产前检查的妊娠期妇女,根据妊娠周期分为孕早期组(n=52,1~12周)、孕中期组(n=70,13~27周)和孕晚期组(n=74,28~40周),另选取同期63例于我院进行健康体检的女性志愿者作为对照组,对比各组间碘营养水平及FT4、TSH、FT3水平。结果孕早期组和孕中期组尿碘中位数水平均达到世界卫生组织提出的碘足量水平,孕晚期组尿碘中位数水平低于世界卫生组织提出的碘足量水平,处于碘缺乏状态。经统计学检验可知,孕早期组尿碘水平高于孕中期组和孕晚期组,差异具有统计学意义(P0.05)。孕中期组和孕晚期组尿碘水平分布情况比较差异无统计学意义(P0.05)。孕早期组碘缺乏发生率低于孕中期组和孕晚期组,差异具有统计学意义(P0.05)。孕早期组碘足量发生率高于孕中期组和孕晚期组,差异具有统计学意义(P0.05)。孕早期组FT4、FT3水平与对照组相比,差异无统计学意义(P0.05);孕中期组和孕晚期组FT4、FT3水平低于对照组,差异具有统计学意义(P0.05)。孕早期组TSH水平低于对照组,差异具有统计学意义(P0.05)。孕中期组和孕晚期组TSH水平与对照组相比,差异无统计学意义(P0.05)。随着妊娠期的延长FT4、FT3水平呈逐渐降低趋势,各组间差异具有统计学意义(P0.05),TSH水平呈逐渐上升趋势,孕中期组和孕晚期组TSH水平高于孕早期组,差异具有统计学意义(P0.05);血清FT4、TSH、FT3水平先升高后降低,再升高后趋于稳定变化。孕早期组碘营养状态与甲状腺功能指标TSH呈U形关系曲线。结论孕妇妊娠不同时期碘营养及甲状腺功能呈特异性动态变化,妊娠中晚期较易出现碘营养缺乏和甲状腺功能减退情况,妊娠期应加强对碘营养和甲状腺功能的筛查,并根据筛查结果指导妊娠期妇女合理正确补碘,避免妊娠期甲状腺相关疾病的发生。
[Abstract]:Objective to study the dynamic changes of iodine nutrition and thyroid function in pregnant women during pregnancy. Methods 196 pregnant women receiving routine prenatal examination from March 2015 to May 2016 in our hospital were selected. According to the pregnancy cycle, it was divided into two groups: the early pregnancy group (n = 52), the second trimester group (n = 70, 1327 weeks) and the late pregnancy group (n = 74, 28 ~ 40 weeks). Another 63 female volunteers who underwent physical examination in our hospital during the same period were selected as the control group. The iodine nutrition level and FT4TSH were compared among the three groups. Results the median level of urinary iodine in early pregnancy group and second trimester group reached the level of sufficient iodine level proposed by the World Health Organization, and the level of urinary iodine median level in late pregnancy group was lower than that in World Health Organization group. The level of urinary iodine in the early pregnancy group was higher than that in the second trimester group and the third trimester group. The difference was statistically significant (P 0.05). There was no significant difference in the distribution of urinary iodine level between the second trimester group and the third trimester group (P 0.05). The incidence of iodine deficiency in the early pregnancy group was lower than that in the second trimester group and the third trimester group. The incidence of iodine adequacy in the early pregnancy group was higher than that in the second trimester group and the third trimester group, and the difference was statistically significant (P 0.05). FT4 in the early pregnancy group was significantly higher than that in the second trimester group. There was no significant difference in FT3 level between the control group and the control group (P 0.05). The level of FT _ 4 FT _ 3 in the second trimester group and the third trimester group was lower than that in the control group, and the difference was statistically significant (P 0.05). The TSH level in the early pregnancy group was lower than that in the control group. The difference was statistically significant (P 0.05). Compared with the control group, the level of TSH in the second trimester group and the third trimester group was not significantly different from that in the control group. With the prolongation of FT4 during pregnancy, there was no significant difference between the two groups. The level of FT3 decreased gradually and the difference among the groups was statistically significant. The level of TSH was higher in the second trimester and the third trimester than in the first trimester. The difference was statistically significant (P 0.05). The level of serum FT 4 TSHN FT 3 increased at first and then decreased. The iodine nutritional status of early pregnancy group and thyroid function index TSH showed U-shaped relationship curve. Conclusion iodine nutrition and thyroid function of pregnant women showed specific dynamic changes in different periods of pregnancy. Iodine deficiency and hypothyroidism are more likely to occur in the middle and late pregnancy. The screening of iodine nutrition and thyroid function should be strengthened during pregnancy, and the rational and correct iodine supplement should be guided according to the results of the screening. Avoid thyroid associated diseases during pregnancy.
【作者单位】：新乡学院校医院;
【分类号】：R714.256
【正文快照】： 甲状腺激素(TH)是生长发育的必须激素,可促进组织分化、物质代谢、能量代谢,对机体具有重要的作用,尤其是对于胎儿的脑发育起着至关重要的作用。在胎儿大脑发育时期,若发生甲状腺激素缺乏现象,可造成神经运动发育障碍,出现运动功能失调、智力低下等现象,严重者可对胎儿脑部造

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