甲状腺结节性疾病尿碘水平与临床病理关系分析  

Relationship between urinary iodine level and clinical pathology in patients with thyroid nodule

作　　者：刘卫怀 李鹏飞 张远炎 施孝海 朱林波 

机构地区：[1]浙江宁波市北仑区人民医院普通外科,浙江宁波315800

出　　处：《中华全科医学》2016年第6期957-958,992,共3页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技项目(2011KYB104)

摘　　要：目的研究甲状腺结节性疾病患者尿碘水平与临床病理的关系,指导本地居民科学补碘。方法 2012年6月—2014年1月期间宁波市北仑区人民医院普通外科收治北仑籍甲状腺结节疾病患者98例,采集所有患者空腹晨尿,运用砷铈催化分光光度法测定尿碘含量。以本地区325例甲状腺正常居民尿碘作对照。结果我区居民尿碘中位数(MUI)为135.2μg/L,属碘足量水平。甲状腺结节性疾病患者尿碘水平在不同年龄、性别之间差异无统计学意义(P=0.23,P=0.18)。甲状腺良性结节患者(结节性甲状腺肿、甲状腺腺瘤)和甲状腺癌患者尿碘中位数分别为155.9μg/L和149.5μg/L。甲状腺良性结节患者和甲状腺癌患者尿碘水平与对照组比较差异均无统计学意义(P>0.05)。甲状腺癌患者尿碘水平与甲状腺良性结节患者组比较差异无统计学意义(P=0.75)。甲状腺癌中淋巴转移者尿碘水平均较无淋巴转移者高,差异有统计学意义(P=0.040)。结论宁波市北仑区居民碘营养处于碘足量水平,甲状腺结节发病与碘营养无明显相关,居民可继续当前碘营养摄入。高碘与甲状腺癌淋巴结转移相关,高度怀疑甲状腺恶变患者需并适当限制碘盐摄入。Objective To study the relationship between urinary iodine level and clinical pathology in patients with thyroid nodule,and to guide scientific iodine supplementation for local citizen. Methods A total of 98 patients of Beilun district in Zhejiang in our hospital between June,2012 and January,2014 were detected for urine iodine concentration by arsenic-cerium catalytic spectrophotometry. Meanwhile 325 normal people were set as the control group. Results The median urinary iodine of our district was 135. 2 μg / L of adequate iodine intake level. There was no significant difference in urinary iodine among different age-sex group in thyroid node patients（ P = 0. 23,P = 0. 18）. MUI of benign thyroid nodules（ nodular goiter,thyroid adenoma） and thyroid cancer was 155. 9 μg/L and 149. 5 μg/L respectively. There were no significant difference among benign thyroid nodules,thyroid cancer and the control group（ P = 0. 88,P = 0. 59,P = 0. 59）.MUI of patients with lymph node metastasis was higher than that in patients without lymph node metastasis（ P = 0. 04）.Conclusions The Iodine nutrition of people in Beilun district is in adequate iodine intake level. There is no obvious relationship between Iodine nutrition and the incidence of thyroid node. The local citizen may continue the current iodine intake. However,there is an obvious relationship between high MUI and thyroid cancer patients with lymph node metastasis,promote that those patients should limit iodized salt intake appropriately.

关 键 词：甲状腺结节 尿碘 甲状腺癌 

分 类 号：R581.3[医药卫生—内分泌] R736.1[医药卫生—内科学]