碘营养水平与甲状腺功能减退症关系的研究  

Study on Relationship between Iodine Nutritional Level and Hypothyroidism

作　　者：王凤玲[1] 侯振江[1] 刘玉枝[1] 侯英荣[2] 代荣琴[1] WANG Fengling;HOU Zhenjiang;LIU Yuzhi;HOU Yingrong;DAI Rongqing(Department of Medical Technology of Cangzhou Medical College,Cangzhou 061001,China;Medical Examination Center of Cangzhou Traditional Chinese Medicine-Western Hospital,Cangzhou 061001,China)

机构地区：[1]沧州医学高等专科学校医技系,河北沧州061001 [2]沧州中西医结合医院体检中心,河北沧州061001

出　　处：《医学综述》2019年第3期608-611,共4页Medical Recapitulate

基　　金：河北省省级科技计划自筹经费项目(162777206)

摘　　要：目的探讨碘营养水平与甲状腺功能减退症(临床甲减)和亚临床甲状腺功能减退症(亚临床甲减)发生的相关性。方法选取2015年3月至2017年12月沧州中西医结合医院内分泌科收治的255例临床甲减患者为临床甲减组,276例亚临床甲减患者为亚临床甲减组,同期选取130名健康体检者作为对照组,各组受试者均检测尿碘和甲状腺功能指标[血清游离三碘甲腺原氨酸(FT_3)、游离甲状腺素(FT_4)、总甲状腺素(TT_4)、总三碘甲腺原氨酸(TT_3)和促甲状腺激素(TSH)]水平。结果各组尿碘水平比较差异无统计学意义(P> 0. 05);各组碘营养状态构成比较差异有统计学意义(P <0. 05),亚临床甲减组和临床甲减组碘缺乏比例高于对照组[31. 2%(86/276)、23. 1%(59/255)比16. 9%(22/130)],亚临床甲减组碘缺乏比例高于临床甲减组(P <0. 05)。临床甲减组尿碘水平与血清FT_3、FT_4、TT_3、TT_4呈负相关(P <0. 05);亚临床甲减组尿碘与血清FT_3、FT_4呈负相关(P <0. 05),与TSH呈正相关(P <0. 05)。结论临床甲减和亚临床甲减患者碘营养过量和碘营养缺乏现象仍较严重,其疾病的发生与尿碘密切相关,建议将限制患者碘的摄入作为治疗措施之一,加强对临床甲减和亚临床甲减患者尿碘的监测,以采取针对性的治疗和预防措施。Objective To discuss the relationship between the iodine nutritional level and the hypothyroidism/subclinical hypothyroidism.Methods A total of 255 patients with hypothyroidism and 276 patients with subclinical hypothyroidism from the Department of Endocrinology of Cangzhou Traditional Chinese Medicine-Western Hospital during Mar.2015 and Dec.2017 were included in the study as a hypothyroidism group and a subclinical hypothyroidism group respectively.And 130 healthy controls from Physical Examination Center during the same period were included as a control group.Urinary iodine and thyroid function indexes[serum free triiodothyronine(FT3),free thyroxine(FT4),total thyroxine(TT4),total triiodothyronine(TT3)and thyroid stimulating hormone(TSH)]of each group were measured and detected.Results There was no significant difference in urinary iodine level among the three groups(P >0.05);there were significant differences in iodine nutritional status among groups(P<0.05).The proportion of iodine deficiency in the subclinical hypothyroidism group and hypothyroidism group was higher than that in the control group[31.2%(86/276),23.1%(59/255)vs 16.9%(22/130)],and the iodine deficiency rate in the subclinical hypothyroidism group was higher than that in the hypothyroidism group(P<0.05).The urine iodine was negatively correlated with serum FT3,FT4,TT3 and TT4 in hypothyroidism patients(P<0.05).There was a negative correlation between the urine iodine and serum FT3 and FT4(P<0.05)and a positive correlation between the urine iodine and TSH in the subclinical hypothyroidism patients(P<0.05).Conclusion The phenomenon of iodine excess and iodine deficiency is still serious in patients with clinical and subclinical hypothyroidism,the occurrence of which is closely related to urinary iodine.Iodine intake restriction is recommended as one of the treatment measures,and the monitoring of urine iodine should be strengthened to take targeted treatment and preventive measures.

关 键 词：甲状腺功能减退症 亚临床甲状腺功能减退症 尿碘 碘营养状态 

分 类 号：R581[医药卫生—内分泌]