轻度碘缺乏城市食盐加碘后甲状腺疾病流行病学调查研究  

An epidemiological survey of the prevalence of thyroid diseases in mild iodine deficiency city after salt iodization

作　　者：彭年春[1] 时立新[1] 张巧[1] 徐淑静[1] 李红[1] 张淼[1] 张松[1] 庄惠君[1] 贡明贤[1] 王睿[1] 吴丹荣[1] 胡颖[1] 刘璐[1] 

机构地区：[1]贵阳医学院附属医院内分泌代谢病科,550004

出　　处：《中华内科杂志》2013年第1期16-20,共5页Chinese Journal of Internal Medicine

基　　金：贵阳市科技局科技计划项目（[2010]筑科农合同号第1.2社-20号）

摘　　要：目的评价轻度碘缺乏城市贵阳食盐加碘25年后的碘营养状态及各种甲状腺疾病的患病情况。方法采用分层整群抽样方法，抽取贵阳市云岩区宅吉社区20岁及以上居民1509人，测定其血清促甲状腺素（TSH）、游离T3、游离T4、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TgAb）水平、尿碘水平及甲状腺B超检查；同时抽取8—10岁学龄儿童80名，测定其尿碘水平。结果8—10岁儿童尿碘中位数为228．7μg/L。成人临床甲状腺功能减退症（甲减）、亚临床甲减、临床甲状腺功能亢进症（甲亢）及亚临床甲亢的患病率分别为1．79％、14．12％、1．52％及1．06％，亚临床甲减的患病率显著高于临床甲减（P〈0．05）；TPOAb及TgAb的阳性率分别为14．38％及13．59％，自身免疫性甲状腺炎的患病率为4．44％。甲状腺肿大患病率为1．06％，其中，弥漫性甲状腺肿（0．86％）较结节性甲状腺肿（0．20％）多见（P〈0．05）。结论食盐加碘25年后，贵阳市处于碘超足量状态，成人临床甲减、亚临床甲减、甲状腺自身抗体阳性及自身免疫性甲状腺炎的患病率均较高。Objective To investigate the current status of iodine nutrition and the prevalence of thyroid diseases in Guiyang, a mild iodine deficiency city practiced salt iodization for 25 years. Methods A representative sample of 1509 adults aged 20 years old or above in Guiyang, selected by a multistage stratified sampling method, participated in the study. After an overnight fasting, serum thyroid hormones, serum thyroid autoantibodies, and urine iodine were measured. B-mode uhrasonography of the thyroid was performed in the population. Meanwhile, urine iodine of 80 children aged 8-10 years old in the same community were measured after an overnight fasting. Results The median of 8-10 years old children＇s urinary iodine was 228.7 ixg/L. The prevalence of overt hypothyroidism, subclinical hypothyroidism, overt hyperthyroidism and subclinical hyperthyroidism was 1.79%, 14. 12%, 1.52% and 1.06% respectively. The prevalence of subclinical hypothyroidism was significantly higher than overt hypothyroidism （ P 〈 0. 05 ） and was significantly higher in female than that in male （ P 〈 0. 05 ）. The prevalence of positive thyroid peroxidase antibody, positive thyroglobulin antibody and autoimmune thyroiditis was 14. 38% , 13.59% and 4. 44% respectively, which were significantly higher in female than that in male （ all P values 〈 0.05）. The prevalence of diffuse goiter and nodular goiter was 0. 86% and 0. 20% respectively, with a significant difference （P 〈 0. 05）. Conclusion After 25 years of salt iodization, the iodine nutrition in Guiyang is more than adequate with high prevalence of overt hypothyroidism, subclinical hypothyroidism and autoimmune thyroiditis.

关 键 词：碘 甲状腺疾病 流行病学 

分 类 号：R581[医药卫生—内分泌]