重庆市食盐加碘前后甲状腺功能亢进发病调查分析  

Incidence of hyperthyroidism in Chongqing City before and after universal salt iodization

作　　者：肖邦忠[1] 李心术[2] 廖文芳[2] 吴成果[2] 何建华[3] 陈克江[4] 廖云贞 李海燕[4] 张仁平[5] 

机构地区：[1]重庆市疾病预防控制中心,400042 [2]重庆市疾病预防控制中心地方病控制所,400042 [3]重庆医科大学附属永川医院 [4]重庆市永川区疾病预防控制中心 [5]重庆市涪陵区疾病预防控制中心

出　　处：《中华地方病学杂志》2013年第6期682-686,共5页Chinese Journal of Endemiology

摘　　要：目的探索重庆市全民食盐加碘（USI）后是否存在甲状腺功能亢进（甲亢）发病升高，为制定防治方案提供依据。方法2008年，在永川区大安镇和涪陵区珍溪镇和新妙镇，以当地常住人口为调查对象，逐户调查1990年以后甲亢发病情况，计算发病率；抽取永川大安镇2个村，涪陵区珍溪和新妙镇3个村，每村选择30名18～45岁成人，男女各半，采集尿液检测尿碘；并选择永川区所在的重庆医科大学附属永川区医院，收集1990—2010年永川区就诊的甲亢病例，记录性别、年龄、甲状腺容积，计算甲状腺肿大率和甲亢发现率；分析甲亢发病率、发现率、甲状腺容积、甲状腺肿大率变化趋势和尿碘水平。结果1997—2008年居民食用碘盐覆盖率，永川区为93．85％～100．00％，涪陵区1997—2005年为15．00％～72．78％，2006—2008年为86．55％～97．22％；检测18～45岁尿碘，永川区尿碘中位数（271．43μg／L）显著高于涪陵区（130．68μg/L，t=5．95，P〈0．05）；USI前（1990—1996年），永川区人群甲亢年均发病率为5．92／10万，涪陵区为4．55／10万，组问比较差异无统计学意义（X^2=0．36，P〉0．05）；USI后（1997—2008年），永川区人群甲亢年均发病率为40．51／10万，涪陵区为12．19／10万，永川区显著高于涪陵区（X^2=73．20，P〈0．01），两地发病率均显著高于USI前（X^2=46．26、15．46，P〈0．01）；医院就诊病例年均发现率USI前、后分别为5．91／10万和30．78／10万，组间比较差异有统计学意义（X^2=1318．32，P〈0．01）。结论调查结果显示，USI后甲亢发病率显著上升，碘盐覆盖率和尿碘高，发病率高，相反则发病低，需降低食盐加碘浓度，以保持人群适宜的碘营养水平。Objective To evaluate the effect of universal salt iodization（USI） on incidence of hyperthyroidism so as to provide a scientific evidence for development of prevention and treatment programs. Methods The incidence of hyperthyroidism were investigated by retrospective investigation in 3 townships from 1990 to 2008, including 1 township in Yongchuan and 2 townships in Fuling. Two villages of Yongchuan and 3 villages of Fuling were seccected. 30 people aged 18 - 45 in every village were investigated. Urine iodine of the people was examined. The residents with hyperthyroidism diagnosed in Yongchun district were collected from 1990 - 2010 in Yongchun Hospital, Chongqing Medical University. Gender, age, thyroid volume were recorded, and goiter rate and incidence were calculated; the incidence of hyperthyroidism, detection rate, thyroid volume, trends of goiter rate and urinary iodine levels were analyzed. Results The coverage of iodized salt was between 93.85% to 100% in Yongchuan from 1997 to 2008, but the rate was between 15.00% to 72.78% in Fuling from 1997 to 2005 and between 86.55% to 97.22% from 2006 to 2008. The median concentration of urinary iodine in Yongehuan （271.43 μg/L） was significantly higher than that in Fuling（130.68 μg/L, t = 5.95, P 〈 0.05）. Before USI, the average annual incidence rate was 5.92/100 000 in Yongchuan and 4.55/100 000 in Fuling. There was no significant difference between the two areas（x2 = 0.36, P 〉 0.05）. After USI, the average annual incidence rate（40.51/lO0 000） in Yongchuan was significantly higher than that （12.19/100 000） in Fulingm（x2 = 73.20, P 〈 0.01 ）. The annual incidence rate significantly increased in both the two areas after eating iodized salt（x2 = 46.26,15.46, P 〈 0.01 ）. The annual average incidence of hyperthyroidism（5.91/100 000） before USI was lower than that （30.78/100 000） after USI（x2 = 1318.32, P 〈 0.0! ）. Conclusions The incidence of hyperthyroidism increases after universal salt iodization. There is an

关 键 词：甲状腺功能亢进症 碘 盐类 

分 类 号：R581.1[医药卫生—内分泌]