山西省不同水碘地区成人甲状腺结节现况调查  

The prevalence of thyroid nodule in adults in different water iodine areas of Shanxi Province

作　　者：贾清珍[1] 郭俊敏[2] 王青平[3] 张向东[1] 张峰峰[4] Jia Qingzhen;Guo Junmin;Wang Qingping;Zhang Xiangdong;Zhang Fengfeng(Department of Iodine Deficiency Disorders,Shanxi Institute for Endemic Disease Prevention and Treatment,Linfen 041000,China;Department of Ultrasound,Shanxi Institute for Endemic Disease Prevention and Treatment,Linfen 041000,China;Internal Medicine,Shanxi Institute for Endemic Disease Prevention and Treatment,Linfen 041000,China;Department of Laboratory,Shanxi Institute for Endemic Disease Prevention and Treatment,Linfen 041000,China)

机构地区：[1]山西省地方病防治研究所碘缺乏病研究室,临汾041000 [2]山西省地方病防治研究所超声室,临汾041000 [3]山西省地方病防治研究所内科,临汾041000 [4]山西省地方病防治研究所检验科,临汾041000

出　　处：《中华地方病学杂志》2020年第3期187-190,共4页Chinese Journal of Endemiology

基　　金：山西省卫生和计划生育委员会科技攻关项目(2017123)。

摘　　要：目的掌握山西省不同水碘地区成人甲状腺结节患病情况,探讨碘与甲状腺结节的关系。方法选择山西省太原市西温庄村作为适碘地区,文水县高车村和马西村分别作为高碘和低碘地区,对全部18~65岁常住居民进行问卷调查、甲状腺彩超检查以及尿碘含量测定,分析不同水碘地区成人甲状腺结节的患病情况。结果共调查868人,其中高碘地区286人、适碘地区270人、低碘地区312人,高碘、适碘和低碘地区人群尿碘中位数(418.7、218.5、127.1μg/L)组间比较差异有统计学意义(H=289.70,P<0.05)。高碘、适碘和低碘地区成人甲状腺结节检出率[31.1%(89/286)、27.4%(74/270)、19.2%(60/312)]组间比较差异有统计学意义(χ^2=11.65,P<0.05),且高碘和适碘地区甲状腺结节检出率均高于低碘地区(P均<0.05)。高碘、适碘和低碘地区成人甲状腺单发结节检出率[17.8%(51/286)、14.1%(38/270)、13.1%(41/312)]组间比较差异无统计学意义(χ^2=2.83,P>0.05)。高碘、适碘和低碘地区成人甲状腺多发结节检出率[13.3%(38/286)、13.3%(36/270)、6.1%(19/312)]组间比较差异有统计学意义(χ^2=10.89,P<0.05),且高碘和适碘地区检出率均高于低碘地区(P均<0.05)。高碘地区成人甲状腺结节以囊性结节为主。结论碘营养适宜状态下,成人甲状腺结节的检出率最低,高碘摄入可能是甲状腺多发结节的一个危险因素。Objective To master the prevalence of thyroid nodule in adults in different water iodine areas and to explore the association between high iodine intake through drinking water and thyroid nodule prevalence.Methods Xiwenzhuang Village of Taiyuan City was selected as iodine-adequate area,and Gaoche Village and Maxi Village of Wenshui County as high-iodine area and low-iodine area,respectively,in Shanxi Province.Questionnaire surveys were conducted,thyroid ultrasound was used and urinary iodine levels were determined of residents aged 18 to 65 years.Analysis of the prevalence of thyroid nodules in adults in different wated iodine areas.Results A total of 868 person were investigated,including 286 in high-iodine area,270 in iodine-adequate area and 312 in low-iodine area.The medians urinary iodine in high,adequate and low iodine areas were 418.7,218.5 and 127.1μg/L,respectively,and the differences were statistically significant(H=289.70,P<0.05).The detection rate of thyroid nodule in adults with high,adequate and low iodine levels were 31.1%(89/286),27.4%(74/270)and 19.2%(60/312),respectively,the differences were significant statistically among three groups(χ2=11.65,P<0.05).The detection rates of solitary nodule in adults were 17.8%(51/286),14.1%(38/270),and 13.1%(41/312),respectively,the differences were not significant statistically among the three groups(χ2=2.83,P>0.05).The detection rate of multiple nodules in adults were 13.3%(38/286),13.3%(36/270),and 6.1%(19/312),respectively,the differences were significant statistically among the three groups(χ2=10.89,P<0.05)high-iodine area and iodine-adequate area have higher detection rates than low-iodine area(P<0.05).The thyroid nodules were mainly the cyst nodules in high-iodine area.Conclusions The detection rate of thyroid nodule in adults is the lowest in adequate iodine nutrition level.More iodine intake is probably a risk factor for thyroid multiple nodules.

关 键 词：碘 饮用水 成人 甲状腺结节 

分 类 号：R5[医药卫生—内科学]