不同碘营养水平儿童甲状腺结节患病情况及结节类型的研究  

Study on prevalence of thyroid nodule and nodular types in children with different iodine nutrition

作　　者：赵明[1] 温松臣[1] 吕胜敏[2] 李顺利[1] 王琳琳[1] 戴其彬 杨凤艳[1] 杨文娜 王万鹏[1] 孙红轩 祁业敏[1] 王立彬[1] ZHAO Ming;WEN Song-chen;LV Sheng-min;LI Shun-li;WANG Lin-lin;DAI Qi-bin;YANG Feng-yan;YANG Wen-na;WANG Wan-peng;SUN Hong-xuan;QI Ye-min;WANG Li-bin(Cangzhou Municipal Center for Disease Prevention and Control, Cangzhou 061001, China)

机构地区：[1]沧州市疾病预防控制中心,河北061001 [2]河北省疾病预防控制中心地方病防治所

出　　处：《中国地方病防治》2017年第7期726-728,共3页Chinese Journal of Control of Endemic Diseases

摘　　要：目的了解不同碘营养水平儿童甲状腺结节患病情况,探讨碘过量对儿童甲状腺结节类型的影响。方法选择供碘盐地区的3个县调查,每个县随机抽取8-10岁学生(男、女各半)200人;在水源性高碘地区抽取水碘含量100-1 100μg/L的13村为调查点,每个调查点随机抽取学校8-10岁学生(男、女各半)100名。对抽取的学生随机采集1次性尿样检测尿碘,用B超法检测甲状腺结节情况,对学校所在的村随机采集2份末梢水样检测水碘。结果检查2 092名8-10岁儿童的甲状腺,检出甲状腺结节患者138例,甲状腺结节总检出率为6.6%。其中,实质性结节占82.6%(114/138),囊实性占16.7%(23/138),囊性占0.7%(1/138)。尿碘中位数100-299μg/L、300-699μg/L、700-1 163μg/L的儿童甲状腺结节检出率经统计有显著差异(χ~2=22.17,P<0.01);甲状腺实质性结节所占比例无差异(χ~2=2.82,P>0.05)。结论碘营养过量可能会造成儿童甲状腺结节患病增加,但对甲状腺结节的囊、实性患病可能无影响。Objective To understand the prevalence of thyroid nodule in children with different iodine nutrition and explore the effect of excessive iodine on the types of thyroid nodule. Methods In areas with iodized salt supply, 3 counties were selected where 200 children aged 8 to 10 years were randomly selected in each county. In water-borne high iodine areas, 13 villages with water iodine content ranging from 100 μg/L to 1100 μg/L were chosen where 100 students were randomly selected in each village. Spot urine samples were collected from the children selected and their thyroids were examined by ultrasound. Two water samples were collected to detect iodine content in each village where the selected schools were located. Results Among 2 092 children examined, 138 cases of thyroid nodule were identified with total prevalenc of 6.6%（138/2 092）. Solid nodules accounted for 82.6%（114/138）, while solid-cystic and cystic nodules accounted for 16.7%（23/138）, 0.7%（1/138）,respectively. There were significant differences among the prevalence of thyroid nodules in children with median urinary iodine content being 100 ~299 μg/L,300 ~ 699 μg/L,700 ~ 1 163 μg/L（χ~2= 22.17, P〈0.01）.There were no significant differences in the proportion of solid nodule among these children（χ~2= 2.82, P〈0.05）.Conclusions Iodine excess could increase the prevalence of children＇s thyroid nodule,However,it could not probablly impact the prevalence of solid and cystic nodule.

关 键 词：甲状腺结节 实性 囊性 尿碘 水碘 

分 类 号：R591.1[医药卫生—内科学]