本文關(guān)鍵詞： 碘營養(yǎng) 妊娠不同時期 孕婦 甲狀腺功能　出處：《中國地方病防治雜志》2017年06期 　論文類型：期刊論文

【摘要】：目的研究孕婦妊娠不同時期碘營養(yǎng)及甲狀腺功能的動態(tài)變化情況。方法選取我院2015年3月~2016年5月接收的196例常規(guī)產(chǎn)前檢查的妊娠期婦女,根據(jù)妊娠周期分為孕早期組(n=52,1~12周)、孕中期組(n=70,13~27周)和孕晚期組(n=74,28~40周),另選取同期63例于我院進行健康體檢的女性志愿者作為對照組,對比各組間碘營養(yǎng)水平及FT4、TSH、FT3水平。結(jié)果孕早期組和孕中期組尿碘中位數(shù)水平均達到世界衛(wèi)生組織提出的碘足量水平,孕晚期組尿碘中位數(shù)水平低于世界衛(wèi)生組織提出的碘足量水平,處于碘缺乏狀態(tài)。經(jīng)統(tǒng)計學(xué)檢驗可知,孕早期組尿碘水平高于孕中期組和孕晚期組,差異具有統(tǒng)計學(xué)意義(P0.05)。孕中期組和孕晚期組尿碘水平分布情況比較差異無統(tǒng)計學(xué)意義(P0.05)。孕早期組碘缺乏發(fā)生率低于孕中期組和孕晚期組,差異具有統(tǒng)計學(xué)意義(P0.05)。孕早期組碘足量發(fā)生率高于孕中期組和孕晚期組,差異具有統(tǒng)計學(xué)意義(P0.05)。孕早期組FT4、FT3水平與對照組相比,差異無統(tǒng)計學(xué)意義(P0.05);孕中期組和孕晚期組FT4、FT3水平低于對照組,差異具有統(tǒng)計學(xué)意義(P0.05)。孕早期組TSH水平低于對照組,差異具有統(tǒng)計學(xué)意義(P0.05)。孕中期組和孕晚期組TSH水平與對照組相比,差異無統(tǒng)計學(xué)意義(P0.05)。隨著妊娠期的延長FT4、FT3水平呈逐漸降低趨勢,各組間差異具有統(tǒng)計學(xué)意義(P0.05),TSH水平呈逐漸上升趨勢,孕中期組和孕晚期組TSH水平高于孕早期組,差異具有統(tǒng)計學(xué)意義(P0.05);血清FT4、TSH、FT3水平先升高后降低,再升高后趨于穩(wěn)定變化。孕早期組碘營養(yǎng)狀態(tài)與甲狀腺功能指標TSH呈U形關(guān)系曲線。結(jié)論孕婦妊娠不同時期碘營養(yǎng)及甲狀腺功能呈特異性動態(tài)變化,妊娠中晚期較易出現(xiàn)碘營養(yǎng)缺乏和甲狀腺功能減退情況,妊娠期應(yīng)加強對碘營養(yǎng)和甲狀腺功能的篩查,并根據(jù)篩查結(jié)果指導(dǎo)妊娠期婦女合理正確補碘,避免妊娠期甲狀腺相關(guān)疾病的發(fā)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.
【作者單位】： 新鄉(xiāng)學(xué)院校醫(yī)院;
【分類號】：R714.256
【正文快照】： 甲狀腺激素(TH)是生長發(fā)育的必須激素,可促進組織分化、物質(zhì)代謝、能量代謝,對機體具有重要的作用,尤其是對于胎兒的腦發(fā)育起著至關(guān)重要的作用。在胎兒大腦發(fā)育時期,若發(fā)生甲狀腺激素缺乏現(xiàn)象,可造成神經(jīng)運動發(fā)育障礙,出現(xiàn)運動功能失調(diào)、智力低下等現(xiàn)象,嚴重者可對胎兒腦部造

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