英文校准0615--.doc

青岛市某区居民碘营养现状调查和妊娠中期妇女甲状腺激素参考值范围探讨在职研究生：封勇 专 业：免疫学 导 师：宋文刚 教授 李雅林 副教授中文摘要目的： 1、通过调查评估青岛市某区居民碘营养现况，指导本地居民科学合理补碘。 2、通过检测本地区妊娠中期妇女甲状腺功能指标，分析妊娠中期妇女甲状腺激素水平变化的特殊性，建立妊娠中期特异性血清促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）的正常参考值范围。方法： 1、青岛市某区学龄儿童碘营养状况的调查随机抽取青岛市某区四所直属小学，包括市内2所、乡镇2所810周岁学龄儿童356名，采用砷铈催化分光广度测定方法进行随机尿的碘含量测定。尿液标本采集的同时进行“学生家庭碘缺乏病健康教育”的问卷调查。2、青岛市某区妊娠中期妇女碘营养状况的调查选取就诊于青岛市某区人民医院和青岛市某区妇幼保健院的妊娠中期妇女104名，采用砷铈催化分光广度测定方法进行随机尿的碘含量测定。3、青岛市某区妊娠中期妇女甲状腺激素参考值范围的计算根据纳入标准选择2012年12月至2014年9月期间就诊于青岛市某区人民医院进行孕中期产检筛查的正常孕妇962名，采集静脉血，采用直接电化学免疫发光法测定血清中甲状腺相关功能指标：TSH、FT4、FT3。妊娠中期妇女甲状腺激素采用95%参考值范围，采用百分位数法计算双侧限值，用P2.5表示下限，P97.5表示上限。结果：1、青岛市某区356例810周岁学龄儿童尿碘中位数为208.7g/L，根据WHO/UNICEF/ICCIDD提出的尿碘中位数(200299)g/L为碘摄入充足标准, 达到碘营养充足水平。2、青岛市某区104例妊娠中期妇女尿碘中位数为130g/L，根据WHO/UNICEF/ICCIDD提出的尿碘中位数碘150g/L为摄入不足的标准,为碘营养不足水平。 3、本地区妊娠中期妇女TSH中位数1.77mIU/L,参考值范围为（0.603.92）mIU/L；妊娠中期妇女FT4中位数12.62pmol/L,参考值范围为（9.1016.21）pmol/L；妊娠中期妇女FT3中位数4.3pmol/L,参考值范围为（3.315.59）pmol/L。结论 1、青岛市某区普通居民碘营养现况整体水平为碘营养充足水平，妊娠中期妇女碘营养状况整体水平为碘营养不足水平。因此，应加强不同人群的碘营养状况监测，科学合理的指导碘摄入。2、建立了本地区正常妊娠中期妇女特异性甲状腺激素参考值范围，有利于妊娠期甲状腺功能异常疾病的正确诊断和及时治疗。关键词：学龄儿童；妊娠期；碘营养状况；甲状腺功能Investigation into Current Situation of Iodine Nutrition among Residents and discussion about the Thyroid Hormone Reference Range of Women in Mid Trimester Pregnancy and monitoring its functional parameter in H District, Qingdao On-the-job Postgraduate: Yong Feng Professional: Immunology Supervisor: Professor Wengang Song Associate professor Yalin LiAbstractObjective: 1.To moniter the iodine nutritional situation by assessing the level of iodine in urine,then to guide the the local residents taking in iodine in a scientific and reasonable way. 2.To analyze the particularity of the changing of thyroid hormones level in women in pregnancy ,then to establish the normal reference ranges of special serum TSH, FT3 and FT4 in mid trimester pregnancy. Methods: 1. The Investigation of current situation of iodine nutrition among residents(pupils) in H District, Qingdao. Sample 356 pupils from 8 to 10 years old from four subsidiary primary schools,included two urban schools, two township schools at random from Qingdao were investigated and use the method for determination of arsenic cerium catalytic spectrophotometry breadth (WS/T 107-2006) to measure urine iodine content randomly. Simultaneously, questionnaires were conducted on the condition of eating household iodized salt and seafood. 2. The Investigation of current situation of iodine nutrition among residents women in trimester pregnancy in H District, Qingdao Sample 104 women in mid trimester pregnancy were randomly selected from the local Peoples Hospital and Maternal and Children Health Hospital were investigated. Urine iodine content were detected by determination of arsenic cerium catalytic spectrophotometry breadth (WS/T 107-2006) 3.The monitoring the functional parameter of women in mid trimester pregnancy in H District, Qingdao 926 normal pregnant women who treated in Peoples Hospital from December 2012 to September 2014 and doing the second trimester prenatal examination screening according to admission criteria were selected. The venous blood were collected, and related functional parameter of thyroid in serum: thyroid-stimulating hormone (TSH), the free thyroxine (FT4) , and the free triiodothyronine (FT3) were detected by electrochemiluminescence immunoassay (Japan Hitachi DA7600). The reference range of thyroid hormone in pregnant women was calculated by the range of 95% confidence intervals, and the double limit values were calculated by percentile, and the limit of P2.5 was expressed by P97.5.Results: 1. The median urinary iodine for 356 cases of 810 year school-age children in H district of Qingdao city is 208.7g/L. The iodine nutrition level is sufficient, according to the the iodine intake adequacy criteria ranging from 200 to 299g/L, which proposed by WHO/UNICEF/ICCIDD.Qingdao city a district 356 cases of 810 year school-age children median urinary iodine for 208.7g/L, reached based on adequacy criteria ranging from 200 to 299g/L intake of iodine WHO/UNICEF/ICCIDD proposed for sufficient iodine nutrition level. 2. The median urinary iodine for 104 cases of pregnant women in mid trimester in H district of Qingdao city is 130g/L. The iodine nutrition level is inadequacy ,according to the the iodine intake insufficient standard 150g/L which put forward by WHO/UNICEF/ICCIDD.Qingdao city a district 104 cases of pregnant women in mid median urinary iodine for 130g/L, below WHO/UNICEF/ICCIDD put forward the iodine intake insufficient standard 150g/L, iodine nutrition level of inadequacy. 3.The median of TSH in local pregnant women is 1.77mIU/L, reference value ranges for (0.60 to 3.92) mIU/L; the median of FT4 is12.62pmol/L, reference value in the range of (9.1016.21) pmol/L; the median of FT3 is 4.3pmol/L and reference values in the range of (3.31 to 5.59 pmol/L).Local pregnant women in mid TSH median 1.77mIU/L, reference ranges for (0.60 to 3.92) mIU/L; pregnant women in mid FT4 median 12.62pmol/L, reference value range (9.1016.21) pmol/L; pregnant women in mid FT3 median 4.3pmol/L and reference values in the range of (3.31 to 5.59 pmol/L).Conclusion: 1. The overall level of iodine nutrition among residents in Qingdao is sufficient, but the overall level of iodine nutrition in pregnant women is deficiency. Therefore, we should strengthen the monitoring of iodine nutrition status among different populations, and scientifically and reasonably to guide iodine intake.The overall level of iodine nutrition among residents