甲亢和亚临床甲亢患者碘营养状态变化及意义  

Change and significance of iodine nutritional status in hyperthyroidism and subclinical hyperthyroidism patients

作　　者：王凤玲[1] 邓海荣 刘玉枝[1] 侯振江[1] 陈立新[3] 高亚坤 WANG Fengling;DENG Hairong;LIU Yuzhi;HOU Zhenjiang;CHEN Lixin;GAO Yakun(Cangzhou Medical College,Cangzhou 061001,China)

机构地区：[1]沧州医学高等专科学校,河北沧州061001 [2]黄骅市中医医院 [3]沧州中西医结合医院

出　　处：《山东医药》2018年第30期19-23,共5页Shandong Medical Journal

基　　金：河北省科技计划自筹经费项目(162777206)

摘　　要：目的检测甲状腺功能亢进症(以下简称甲亢)和亚临床甲状腺功能亢进症(以下简称亚临床甲亢)患者的尿碘水平变化,探讨甲亢和亚临床甲亢患者碘营养状态的变化及意义。方法选取甲亢患者251例为甲亢组、亚临床甲亢患者242例为亚临床甲亢组、健康人群130例作为对照组。取空腹静脉血标本5 m L,采用化学发光免疫法测定各组甲状腺功能五项指标,包括促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT_3)、游离甲状腺素(FT_4)、总甲状腺素(TT4)、总三碘甲腺原氨酸(TT_3)。采集一次性晨尿10 m L,采用尿碘定量检测试剂盒AR型测定各组尿碘水平,以尿碘水平中位数(MUI)评价碘营养状态。结果甲亢组、亚临床甲亢组尿碘水平均高于对照组(P均<0.05),甲亢组、亚临床甲亢组尿碘水平差异无统计学意义(P>0.05)。甲亢组、亚临床甲亢组不同碘营养状态者的分布差异均有统计学意义(P均<0.01),均以碘过量和碘超量状态构成比最多、碘缺乏状态构成比最少。甲亢组、亚临床甲亢组不同碘营养状态者的血清FT_3、FT_4、TT_3、TT4、TSH水平差异均无统计学意义(P均>0.05)。甲亢组碘缺乏、碘超量和碘过量者的尿碘量与血清FT_3、FT_4、TT_3、TT_4水平均呈明显相关性,亚临床甲亢组碘过量和碘缺乏者的尿碘量与血清FT_3、FT_4均呈明显相关性(P<0.05或0.01)。结论亚临床甲亢患者处于碘过量状态,甲亢患者处于碘超量状态,但同时都存在高碘与低碘并存现象,长期碘摄入过量在甲亢和亚临床甲亢疾病的发生发展过程中起了非常重要的作用。Objective To detect the change in the urine iodine of hyperthyroidism patients and subclinical hyperthyroidism patients and to explore the change and significance of iodine nutrition status on the pathogenesis of hyperthyroidism and subclinical hyperthyroidism. Methods Totally 251 hyperthyroidism patients（ hyperthyroidism group）,242 patients with subclinical hyperthyroidism（ subclinical hyperthyroidism group）,and 130 subjects of healthy controls（ control group）were selected. The venous blood（ 5 mL） of empty stomach was extracted to detect the serum levels of thyroid stimulating hormone（ TSH）,free triiodothyronine（ FT3）,free thyroxine（ FT4）,total triiodothyronine（ TT3） and total thyroxine（ TT4） by chemiluminescence immunoassay. The disposable morning urine（ 10 m L） was collected. Iodine level in each group was detected by AR type of urine iodine quantitative test kit. Iodine nutritional status was evaluated with median of urine iodine levels（ MUL）. Results The levels of iodine urine in the hyperthyroidism group and subclinical hyperthyroidism group were higher than that of the control group（ P〈0. 05）. There was no significant difference in the urinary iodine level between the hyperthyroidism group and subclinical hyperthyroidism group（ P〉0. 05）. The distributional difference in patients with different iodine nutrition between the hyperthyroidism group and subclinical hyperthyroidism group was statistically significant（ P〈0. 01）. There was no significant difference in serum levels of FT3,FT4,TT3,TT4 and TSH in patients with different iodine nutrition between the hyperthyroidism and subclinical hyperthyroidism（ all P〉0. 05）. The urinary iodine levels were significantly correlated with FT3,FT4,TT3,and TT4 in patients with in sufficient iodine intake,more than adequate iodine intake,and excessive iodine intake in the hyperthyroidism group; the urinary iodine levels in patients with in sufficient iodine intake and more than adequate iodine intake in th

关 键 词：尿碘 碘营养状态 甲状腺功能亢进症 亚临床甲状腺功能亢进症 

分 类 号：R581[医药卫生—内分泌]