中国不同人群亚临床甲状腺功能减退症检出率的横断面调查分析  

Cross-sectional survey of detectable rate of subclinical hypothyroidism in different people in China

作　　者：陈善辉[1] 刘鹏[1] 刘丽香[1] 刘守军[1] 

机构地区：[1]哈尔滨医科大学中国疾病预防控制中心地方病控制中心碘缺乏病防治研究所,黑龙江哈尔滨150081

出　　处：《吉林大学学报（医学版）》2011年第5期948-952,共5页Journal of Jilin University：Medicine Edition

基　　金："十一五"国家科技支撑计划资助课题(2006BAI06B05)

摘　　要：目的：调查我国8~10岁儿童、18~45岁成人、哺乳妇女和孕妇4类人群亚临床甲状腺功能减退症（SH）的检出情况,分析不同尿碘水平和不同免疫状态人群的SH检出率状况,为我国碘缺乏病防治提供新的监测指标。方法：于2009年4月—2010年4月采用典型调查方法对我国6类地区4类目标人群（8~10岁儿童633人、18~45岁成人703人、哺乳妇女334人、孕妇329人）共1 999人进行采样,采集样本人群晨起空腹血样与3次随意尿样,检测血清促甲状腺激素（TSH）、游离甲状腺素（FT4）、甲状腺微粒体抗体（TMAb）和甲状腺球蛋白抗体（TGAb）及尿碘。结果：儿童、成人、哺乳妇女、孕妇SH的检出率分别为10.43%、4.84%、4.19%和3.95%,其中儿童组SH检出率高于成人组（P〈0.01）;儿童尿碘适宜组SH检出率与高碘组比较差异无统计学意义（P〉0.05）;全部人群SH组TMAb和TGAb阳性率高于甲状腺功能正常组（P〈0.01）。结论：8~10岁儿童SH检出率高于其他3组,提示应将儿童亚SH指标纳入碘相关疾病常规监测。Objective To investigate the detectable rates of subclinical hypothyroidism（SH） of children aged 8-10 years,adults aged 18-45 years,breastfeeding women and pregnant women,and analyze the differences of the detectable rates in different people with different levels of urinary iodine concentrations and immune status in order to provide new indexes for prevention and treatment of iodine deficiency disorders.Methods A cross-sectional survey was performed in four kinds of 1 999 target people（633 children aged 8-10 years,703 adults aged 18-45 years,334 breastfeeding women and 329 pregnant women） in six different areas in China from the April 2009 to April 2010.The morning blood samples and three urine samples selected randomly of different people were collected and the thyroid stimulating hormone（TSH）,free thyroxine（FT4）,thyroid microsome antibody（TMAb）,thyroid globulin antibody（TGAb） in blood samples and iodine in urine samples were detected.Results The detectable rates of subclinical hypothyroidism of children aged 8-10 years old,adults aged 18-45 years old,breast feeding women and pregnant women were 10.43%,4.84%,4.19%,and 3.95%,respectively.The detectable rate of SH in children group was significantly higher than that in adults group（P0.01）.There was no significant differences of the detectable rates of SH between children whose urinary iodine were normal and children whose urinary iodine were elevated（P0.05）.The positive rates of TMAb and TGAb of people with SH were significantly higher than those of people with normal thyroid function（P0.01）.Conclusion The detectable rate of SH of children aged 8-10 years is higher than those in other three groups,which indicates that the index of SH should be used in routine monitoring of iodine disorder control in children.

关 键 词：亚临床甲状腺功能减退症 尿碘 甲状腺自身抗体 

分 类 号：R581.2[医药卫生—内分泌]