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181.0 μg/L,妊娠早、中和晚期的孕妇尿碘中位数分别为 211.3 μg/L、179.1 μg/L和170.2 μg/L。547名孕妇TSH、FT₃和FT₄的均数分别为1.8 μIU/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＜150 μg/L的甲亢检出率(2.4%)与≥150 μg/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 and understand the iodine nutrition level and thyroid function among pregnant women in Anhui province, so as to provide a basis for scientific supplementation of iodine and thyroid function mornitoring in pregnant women. Methods From April to September in 2016, six counties(districts)were selected according to geographical location and topography, relying on maternal and child health care service centers at county level or health clinics at township level and 100 early, middle and late pregnant women each in every county were selected. Samples of edible salt, urine and blood were collected and measured. Results A total of 600 pregnant women were investigated, the median salt and urinary iodine levels were 23.0 mg/kg and 181.0μg/L, respectively, the median urinary iodine levels in pregnant women at early, middle and late stages were 211.3, 179.1 and 170.2 μg/L, respectively. Thyroid function of 547 pregnant women were measured, the mean TSH, FT₃, FT₄ were 1.8uIU/ml、5.7pmol/L and 13.8 pmol/L, the median TgAb and TPOAb were 29.3and 1.5 IU/ml, respectively. The rate of thyroid function disorders of pregnant women was 15.4%. Prevalence rates of hyperthyroidism , subclinical hyperthyroidism, hypothyroidism and subclinical hypothyroidism were 1.1%(6/547),1.8%(10/547), 5.7%(31/547)and 6.8%(37/547), respectively. The detection rates of hyperthyroidism and subclinical hyperthyroidism were statistics significance in different period of pregnancy. There were significant differences in urinary iodine ＜150 μg/L rate of hyperthyroidism and urinary iodine ≥150 μg/L rate of hyperthyroidism. Conclusion The level of iodine nutrition was suitables,as a whole but malnutrition still existed in some pregnant women of Anhui province. Subclinical hypothyroidism was the common in all thyroid function disorders of pregnant women. The detection rates of hyperthyroidism was higher in iodine nutrition deficiency.