全民普遍食盐加碘后广西地区甲状腺疾病谱的变迁  

The Change of Spectrum of Thyroid Diseases Within Ten Years Implementation of Universal Salt Iodization in Guangxi Zhuang Autonomous Region

作　　者：韦丽宁[1] 张嘉越[1] 李松明[1] 陈佑江[2] 浦涧[3] 李金明[4] 李瑞[1] 冷津立[1] 庞飞雄[1] 岑延增[1] 农江[5] 何红艳[1] 叶艳妮[1] 

机构地区：[1]中国人民解放军第三○三医院普外科,广西南宁530021 [2]中国人民解放军第一八一医院普外科,广西桂林541000 [3]广西右江民族医学院附属医院普外科,广西百色533000 [4]北海市人民医院普外科,广西北海536000 [5]中国人民解放军第三○三医院病理科,广西南宁530021

出　　处：《中国普外基础与临床杂志》2013年第12期1374-1380,共7页Chinese Journal of Bases and Clinics In General Surgery

基　　金：广西壮族自治区自然科学基金项目(项目编号:0728254)~~

摘　　要：目的分析实行全民普遍食盐加碘前后广西沿海、山区等不同碘环境下甲状腺疾病谱变迁的特点,探讨普遍食盐加碘对甲状腺疾病谱的影响。方法收集广西南宁、桂林、百色及北海4城市的解放军三○三医院、解放军一八一医院、广西右江民族医学院附属医院及北海市人民医院1991年1月至2006年12月期间经手术治疗的甲状腺疾病患者共5 998例,所有病例均有病理诊断并检测了尿碘水平;另检测同期1 000位甲状腺正常人群的尿碘水平作对照。分析普遍食盐加碘前后碘环境的改变与甲状腺疾病谱变迁的关系。结果普遍食盐加碘后,结节性甲状腺肿患者的构成比较加碘前下降(P<0.05),而毒性结节性甲状腺肿、慢性淋巴细胞性甲状腺炎及甲状腺乳头状癌患者的构成比较加碘前增高(P<0.05);同时,结节性甲状腺肿、毒性弥漫性甲状腺肿、毒性结节性甲状腺肿、慢性淋巴细胞性甲状腺炎及甲状腺乳头状癌患者尿碘水平较加碘前明显增高(P<0.05),并且甲状腺疾病患者的尿碘水平高于对照组(P<0.05),甲状腺疾病患者及对照组的尿碘水平均较加碘前增高(P<0.05)。结论全民普遍食盐加碘10年来,广西所调查地区平均尿碘水平及甲状腺疾病谱均发生了明显变化,碘过量可能是导致毒性结节性甲状腺肿、慢性淋巴细胞性甲状腺炎、慢性淋巴细胞性甲状腺炎合并乳头状癌及甲状腺乳头状癌发病率增高的环境因素之一。Objective To reveal the relationship between the iodine nutrition and the change of spectrum of thyroid diseases by analyzing the change of spectrum of thyroid diseases in different iodine environments before and after the implementation of universal salt iodization （USI）. Methods To compare the urinary iodine concentration between the normal people （1 000 eases） and the patients with thyroid diseases （5 998 cases） by surgical operations who were from 4 cities of Guangxi Zhuang Autonomous Region, covering the iodine deficient areas and the iodine rich areas. Results After the USI was put into practice, the proportions of nodular goiter decreased, but the proportions of toxic nodular goiter, thyroid papillary carcinoma, and Hashimoto thyroiditis were higher than those before USI （P〈 0. 05）. The urinary iodine concentrations of nodular goiter, Graves disease, toxic nodular goiter, thyroid papillary carcinoma, and Hashimoto thyroiditis were higher than those before the measure was taken （P〈 0. 05）. The urinary iodine concentration of patients with thyroid was higher than that of normal people （P 〈 0. 05）, and the urinary iodine concentration of patients with thyroid and normal people was higher than those before the USI （P〈 0. 05）. Coneluslons The change of spectrum of thyroid diseases in Guangxi Zhuang Autonomous Region is obvious within 10 years after USI had been taken. The excessive intake of iodine may be one of the dangerous factors leading to toxic nodular goiter, thyroid papillary carcinoma, and Hashimoto thyroiditis.

关 键 词：食盐加碘 甲状腺疾病谱 碘营养过剩 

分 类 号：R581[医药卫生—内分泌] R195.4[医药卫生—内科学]