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目的研究襄阳市妊娠妇女在不同妊娠时期的甲状腺功能及尿碘状况,建立襄阳地区妊娠月份特异性血清甲状腺激素的正常参考范围,为实施妊娠妇女甲状腺功能筛查或碘营养监测提供依据。方法选取2013年3月-2015年12月在该院就诊,进行妊娠常规检查的妇女600例为研究对象,其中非妊娠妇女150例,妊娠妇女450例。对参与试验者进行尿碘酸消化砷——铈接触法检测和血清化学发光法检测,分别记录其体内游离三碘甲状腺原氨酸(FT_-3)、游离甲状腺素(FT_4)、促甲状腺激素(TSH)和尿碘相关数据。结果妊娠早、中、晚期受测妇女的尿碘中位数及非妊娠妇女的尿碘中位数分别为176、169、157及174μg/L;妊娠早、中、晚期妇女TSH水平分别为0.13~3.28,0.24~3.84和0.34~4.05 m IU/L,FT3水平分别为3.11~9.53,2.84~8.62和2.79~8.32 pmol/L,FT4水平分别为10.20~21.58,10.09~17.83和9.70~16.82 pmol/L。结论襄阳市孕妇碘营养状态处于适宜程度。妊娠期妇女甲状腺功能有着明显变化,针对襄阳地区人群碘摄入、生活饮食、经济文化等不同于其他地区,有必要建立襄阳市妊娠月份特异性的血清TSH、FT_3、FT_4正常参考范围。
Objective To study the thyroid function and urinary iodine status of pregnant women in Xiangyang during different gestation periods and establish the normal reference range of thyroid hormones for month of pregnancy in Xiangyang for the purpose of providing thyroid function screening and iodine nutrition monitoring in pregnant women. Methods Six hundred and sixty-five women who underwent routine pregnancy examination from March 2013 to December 2015 in our hospital were enrolled. Among them, 150 were non-pregnant women and 450 were pregnant women. Participants were tested for urinary iodine digestion by arsenic-cerium contact method and serum chemiluminescence method. The contents of free triiodothyronine (FT_3), free thyroxine (FT_4), thyrotropin (TSH) and urinary iodine related data. Results The median urinary iodine of pregnant women in the early, middle and late pregnancy was 176,169,157 and 174 μg / L respectively, and the median of urinary iodine in nonpregnant women was respectively 0.13 ~ 3.28,0.24 ~ 3.84 and 0.34 ~ 4.05 m IU / L, FT3 levels were 3.11 ~ 9.53,2.84 ~ 8.62 and 2.79 ~ 8.32 pmol / L, FT4 levels were 10.20 ~ 21.58,10.09 ~ 17.83 and 9.70 ~ 16.82 pmol / L. Conclusion The iodine nutrition status of pregnant women in Xiangyang is at a suitable level. Thyroid function in pregnant women has obvious changes, for Xiangyang population iodine intake, living and eating, economic and cultural different from other areas, it is necessary to establish the Xiangyang month of pregnancy-specific serum TSH, FT_3, FT_4 normal reference range.