目的为掌握全民食盐加碘后吉林省孕妇在不同孕期碘营养和甲状腺功能状况,为今后实施孕妇甲状腺功能监测的必要性和可能性提供依据。方法以省为单位,按“人口比例概率抽样方法”(PPS)抽取30个抽样单位(县)。用单纯随机抽样法从上述抽到的每个抽样单位中抽取3个乡(镇、街道办事处),每个乡(镇、街道办事处)抽取孕妇8人,每县(市、区、旗)孕妇24人。收集被调查对象尿样、血样及家中的食用盐、饮用水。采用化学发光法检测甲状腺功能(包括甲状腺抗体)指标,砷铈催化分光光度法检测尿、水碘含量,直接滴定法检测食盐碘含量。结果孕早、中、晚期妇女的尿碘中位数分别为188.6μg/L、201.9μg/L、175.7μg/L且不同孕期尿碘中位数及频数分布无显著性差异。孕早、中期妇女甲状腺功能异常主要为低FT4血症和亚临床甲状腺功能减退。孕晚期除低FT4血症和亚临床甲状腺功能减退外还有一定比例4.2%(10/240)甲状腺功能亢进(亚临床甲状腺功能亢进)存在。孕晚期妇女与孕早、中期相比甲状腺功能异常比率明显增加,孕妇抗体阳性率为10.2%(77/755)。抗体阳性者发生亚甲减3例占3.8%(3/77),低FT4血症1例占1.3%(1/77),甲亢(亚甲亢)3例占3.8%(3/77)。结论吉林省孕妇的碘营养处于适宜水平;建议在孕早期开展尿碘监测和甲功筛查。 Objective To understand the status of iodine nutrition and thyroid function of pregnant women in Jilin Province during different stages of pregnancy after iodized salt, and to provide evidence for the necessity and possibility of future thyroid function monitoring in pregnant women. Methods By province, 30 sampling units (counties) were drawn according to “Population Probability Probability Sampling Method” (PPS). Three townships (towns and sub-district offices) were drawn from each of the above sampling units by using the simple random sampling method. Eight pregnant women were taken from each township (towns and sub-district offices), and counties (cities, districts and banners 24 pregnant women. Urine samples were collected, blood samples and home salt, drinking water. Chemiluminescence method was used to detect thyroid function (including thyroid antibody), arsenic and cerium catalytic spectrophotometry to detect urine and water iodine content, and direct titration method to measure salt iodine content. Results The urinary iodine median of pregnant women in early, middle and late stages were 188.6μg / L, 201.9μg / L and 175.7μg / L, respectively. There was no significant difference in the median and frequency of urinary iodine between different pregnancies. Pregnancy early and mid-term women with abnormal thyroid function are mainly low FT4 blood and subclinical hypothyroidism. In addition to the low third trimester hypothyroidism in late pregnancy, there is a certain proportion of 4.2% (10/240) of hyperthyroidism (subclinical hyperthyroidism) exist. The rate of thyroid dysfunction in pregnant women in late third trimester is significantly higher than that in early trimester and middle trimester, and the positive rate of pregnant women is 10.2% (77/755). 3 cases (3.8%) had hypothyroidism, while 1 case had low FT4 hyperlipidemia (1/77), hyperthyroidism (3 cases) accounted for 3.8% (3/77). Conclusion The iodine nutrition of pregnant women in Jilin Province is at an appropriate level. Urine iodine monitoring and thyroid function screening are recommended in early pregnancy.