中文摘要：

目的：探讨碘充足地区妊娠晚期孕妇的碘营养状况及甲状腺功能。方法：收集174例妊娠晚期孕妇的空腹晨尿及静脉血,砷-铈催化分光光度法测定尿碘浓度,化学发光法测定游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）及敏感促甲状腺激素（sTSH）,放射免疫分析法测定甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TGAb）。结果：孕妇平均年龄（28.07±4.87）岁,尿碘中位数217.06μg/L,大部分（63.2%）孕妇碘营养状况适宜,部分个体处于碘缺乏（27.6%）和碘过量（9.2%）状态。TPOAb和TGAb阳性率分别为24.1%和3.4%,有4例（2.3%）患亚临床甲状腺功能减退。尿碘与FT3、FT及sTSH水平之间相关性差异均无统计学意义（P〉0.05）;不同尿碘水平孕妇的抗体阳性率差异无统计学意义（P〉0.05）;与TPOAb阴性孕妇相比,TPOAb阳性者FT3水平降低,sTSH和尿碘水平升高;与TGAb阴性孕妇相比,TGAb阳性者sTSH水平降低（P〈0.05）。结论：该地孕妇整体碘水平适宜,但仍存在碘缺乏和过量的个体,甲状腺自身抗体阳性可能使孕妇甲状腺功能异常,故应加强孕期尿碘水平及甲状腺功能的监测。

英文摘要：

Objective：To explore the iodine nutritional status and thyroid function of pregnant women during the third trimester of pregnancy in an iodine-sufficient area.Methods：The morning-urine and venous blood samples of 174 pregnant women during the third trimester of pregnancy were collected,arsenic-cerium catalytic spectrophotometer was used to detect the content of iodine in urine,chemiluminescence was used to detect the levels of free triiodothyronine（FT3）,free thyroxine（FT4） and sensitive thyroid-stimulating hormone（sTSH）;radioimmunoassay was used to detect thyroid peroxidase antibody（TPOAb） and thyroglobulin antibody（TGAb）.Results：The average age of the pregnant women was（28.07±4.87） years.The median of urinary iodine was 217.06 μg/L,63.2% of the pregnant women had an appropriate iodine nutritional state,and partial pregnant women were found with iodine deficiency（27.6%） and iodine excess（9.2%）.The positive rates of TPOAb and TGAb were 24.1% and 3.4%,respectively.4 pregnant women suffered from subclinical hypothyroidism,accounting for 2.3%.There was no correlation between urinary iodine and FT3,FT4 and sTSH levels（P0.05）.There was no significant difference in positive rate of antibody among the pregnant women with different urinary iodine levels（P0.05）.Compared with the pregnant women with negative TPOAb,the level of FT3 in pregnant women with positive TPOAb decreased,while the levels of sTSH and urinary iodine increased;compared with the pregnant women with negative TGAb,the level of sTSH in pregnant women with positive TGAb decreased（P0.05）.Conclusion：The whole iodine status of pregnant women in this area is adequate,but there are still some individuals with iodine deficiency and iodine excess.Positive thyroid autoantibodies may lead to the disfunction of thyroid in pregnant women.As a result,the monitoring of urinary iodine level and thyroid function should be strengthened during pregnancy.