【摘要】 目的评估碘缺乏病高危地区新疆阿克苏城镇采取持续补碘措施后孕妇甲状腺功能和子女脑发育状况。方法非孕育龄妇女（非孕组）35例和孕妇组165例,其中5例孕妇因脱落未测促甲状腺激素（TSH）与甲状腺激素（TH）;孕妇组160例分为早、中、晚期组3个亚组,分别对应为孕0¹3周、孕14²7周和孕28⁴0周。采集2组清晨一次性随意尿样和静脉血样,使用过硫酸铵消化砷-铈催化分光光度法测定其尿碘浓度,免疫化学发光法测定其TSH、游离四碘甲状腺原氨酸（FT₄）、游离三碘甲状腺原氨酸（FT₃）、总甲状腺素（TT₄）、总三碘甲状腺原氨酸（TT₃）水平。2年后追踪入组孕妇所育子女,使用格赛尔发展诊断量表（Gesell）测量其神经认知发育水平。结果孕妇总体尿碘中位数为196.7（122.9,269.2）μg/L;孕妇总体尿碘水平≤150μg/L及>150μg/L以上者分别为52例（32.5%）和108例（67.5%）。孕妇组与非孕组比较,孕早期FT₃水平降低,TT₄、TT₃水平升高;中期和晚期FT₄、FT₃水平均降低,而TT₄、TT₃水平均升高（P<0.05）。孕早期FT₃水平高于孕中期和孕晚期（P<0.05）,3组间其他指标差异均无统计学意义。孕妇组甲状腺异常发生率为8.75%（14/160）。其中,亚临床甲减占5.63%（9/160）;甲状腺球蛋白抗体（Tg-Ab）阳性（Tg-Ab+）占3.13%（5/160）,亚临床甲减与Tg-Ab+无重叠病例;无甲状腺功能减退、甲状腺功能亢进和低T₄血症病例。追踪观察的80例维吾尔族孕妇子女中,语言商得分偏低,Gesell诊断异常率为3.75%（3/80）,可疑12.50%（10/80）,正常83.75%（67/80）。结论家庭合格碘盐食用率达标多年后,维吾尔族城镇孕妇碘营养状况适宜,甲状腺功能正常,结果可用于后续研究。更多还原

【Abstract】 Objective To evaluate thyroid function of pregnant women and neurocognitive development of theiroffspring after continuous iodine supplementation in Aksu of Xinjiang, and to provide the basis for further research.Methods This study included 35 non-pregnancies(non-pregnant group) and 165 pregnant women(pregnant group). Therewere 5 pregnant cases did not take the detection of SH and TH due to the loss of follow-up. Pregnant group was subdividedinto three groups including pregnancy week 0- 13(early stage group), pregnancy week 14- 27(middle stage group) andpregnancy week 28- 40(late stage group). The random urine samples of early morning and venous blood samples werecollected in two groups to determine the urinary iodine concentration by the arsenic cerium catalytic spectrophotometry, andthyroid hormone levels(TSH, FT4, FT3, TT4, and TT3 were detected by immunochemiluminometric assay. Offsprings ofpregnant group were followed up two years. Gesell scale was used to assess their neurocognitive function. Results The totalMUIC of pregnant women was 196.7(122.9,269.2) μg/L. There were 52 cases in pregnant group(32.5%) and 108 in non-pregnant group(67.5%) with total UIC ≤150 μg/L and >150 μg/L. The FT3 level was lower and TT4 and TT3 levels were increased at the early stage of pregnancy in pregnant group compared with those of non-pregnant group. FT4 and FT3 levelswere decreased and TT4 and TT3 levels increased in the middle stage group and late stage group(P<0.05). FT3 level washigher at the early stage group than that of middle stage group and late stage group(P<0.05). There were no significantdifferences in the other indicators between three groups. The abnormal rates of thyroid were 8.75%(14/160) in pregnantgroup, of which 5.63% cases were subclinical hypothyroidism(9/160), 3.13% were Tg- Ab +(5/160). There was nooverlapping cases between subclinical hypothyroidism and Tg-Ab+ cases. There were no patients with overt hypothyroidism,hyperthyroidism and hypothyroxinemia in pregnant group. The offsprings of uygur pregnant women in this tracing studyshowed a lower language quotient score, and abnormal rate of Gesell was 3.75%(3/80), and the suspicious rate was 12.50%(10/80), normal rate was 83.75%(67/80). Conclusion After two years or more of family eligible iodized salt consumptioncome to qualified,the pregnant women in township of Aksu show adequate iodine nutrition with no overt abnormality ofthyroid function, which can be considered as a group of control group for the subsequent research.更多还原