西安市不同水碘地区成人甲状腺健康调查及碘营养分析  

Prevalence of thyroid diseases and status of iodine nutrition in the population of different water iodine areas in Xi'an City

作　　者：时学花[1] 陈伟[1] 李平[1] 何姗姗[1] 董璐[1] Shi Xuehua;Chen Wei;Li Ping;He Shanshan;Dong Lu(Department of Endemic Disease Control,Xi'an Center for Disease Control and Prevention,Xi'an 710054,China)

机构地区：[1]西安市疾病预防控制中心地方病防治科,710054

出　　处：《中华地方病学杂志》2020年第12期892-896,共5页Chinese Journal of Endemiology

基　　金：西安市卫生计生委员会科技基金(J201603058)。

摘　　要：目的分析西安市不同水碘地区居民甲状腺健康状况,了解人群碘营养水平。方法采用分层整群抽样的方法,参照2017年水碘调查结果,将西安市各乡镇按照水碘中位数分为<10、10~100、>100μg/L 3个层次,每个层次抽取1个街道(乡镇),每个街道(乡镇)抽取2个社区(自然村),每个社区(自然村)抽取100户家庭开展调查,每户家庭采集1份饮用水水样,进行水碘含量测定;每户家庭抽取18岁以上常住居民作为调查对象,进行甲状腺B超检查和尿碘含量检测。结果3个水碘含量地区分别采集水样343、227、226份,水碘中位数分别为4.14、38.95、124.15μg/L。共调查1308人,甲状腺形态异常检出率为9.86%(129/1308),甲状腺回声异常检出率为10.86%(142/1308),甲状腺占位检出率为33.94%(444/1308),甲状腺结节检出率为26.22%(343/1308)。女性甲状腺回声异常、占位、结节检出率均高于男性[11.75%(120/1021)比7.67%(22/287),35.85%(366/1021)比27.18%(78/287),27.82%(284/1021)比20.56%(59/287),χ^2=3.868、7.509、6.101,P均<0.05];不同年龄甲状腺回声异常、占位、结节检出率比较差异均有统计学意义(χ^2=11.223、68.032、64.543,P均<0.05);不同水碘地区甲状腺回声异常检出率比较差异有统计学意义(χ^2=6.297,P<0.05)。女性甲状腺多发结节检出率高于男性[11.75%(120/1021)比7.32%(21/287),χ^2=4.584,P<0.05];不同年龄甲状腺单发结节、多发结节、结节直径≤1 cm、结节直径>1 cm检出率比较,差异均有统计学意义(χ^2=26.010、31.807、22.859、10.392,P均<0.05);水碘<10μg/L地区甲状腺结节直径>1 cm的检出率高于水碘10~100、>100μg/L地区(P均<0.05)。共采集尿样755份,尿碘中位数为217.00μg/L,不同水碘地区居民尿碘水平比较差异有统计学意义(H=93.806,P<0.05)。结论西安市甲状腺疾病检出率较高,成人碘营养处于超适宜水平。甲状腺结节检出率随年龄增加而增高,女性高于男性,应加强随访和早期诊治�Objective To analyze the thyroid health status of residents in different water iodine areas in Xi'an City and understand the iodine nutritional level of the population.Methods Using the stratified cluster sampling method,the towns in Xi'an City were divided into 3 levels of<10,10-100,and>100μg/L according to the median of water iodine of 2017.One street(township)was selected from each level,two communities(natural villages)were selected from each street(township),and 100 households were selected from each community(natural village)to carry out the survey.One drinking water sample was collected from each household for determination of water iodine content.Residents over 18 years old were selected as the subjects of the survey,and their urine iodine content test and thyroid B-ultrasound examination were carried out.Results A total of 343,227,226 water samples were collected in 3 regions with water iodine content,and the median water iodine was 4.14,38.95,124.15μg/L,respectively.A total of 1308 people were investigated.The detection rate of abnormal thyroid morphology was 9.86%(129/1308),the detection rate of abnormal echo was 10.86%(142/1308),and the detection rate of thyroid space-occupancy was 33.94%(444/1308).The detection rate of nodules was 26.22%(343/1308).The detection rates of thyroid abnormal echo,space-occupying,and nodules in women were higher than those in men[11.75%(120/1021)vs 7.67%(22/287),35.85%(366/1021)vs 27.18%(78/287),27.82%(284/1021)vs 20.56%(59/287),χ^2=3.868,7.509,6.101,P<0.05].The differences of detection rates of thyroid abnormal echo,space-occupying,and nodules were statistically significant in different age groups(χ^2=11.223,68.032,64.543,P<0.05);the detection rate of thyroid abnormal echo was different in different water iodine areas(χ^2=6.297,P<0.05).The detection rate of multiple thyroid nodules in women was higher than that in men[11.75%(120/1021)vs 7.32%(21/287),χ^2=4.584,P<0.05];the detection rates of single nodules,multiple nodules,nodule diameter≤1 cm and nodule diameter>1

关 键 词：碘 甲状腺疾病 流行病学 

分 类 号：R195[医药卫生—卫生统计学]