青海地区不同碘营养背景居民甲状腺结节检出情况及相关危险因素分析  

Analysis of Thyroid Nodule Detection and Related Risk Factors among Residents with Different Iodine Nutritional Background in Qinghai

作　　者：米娜[1] 杨历新[1] 李正[1] 崇显瑾 姜志藠[1] 李国彤[1] Mi Na;Yang Lixin;Li Zhen;Chong Xianjing;Jiang Zhixiao;Li Guotong(The People's Hospital of Qinghai,810007)

机构地区：[1]青海省人民医院内分泌科,810007

出　　处：《高原医学杂志》2020年第3期28-33,共6页Journal of High Altitude Medicine

基　　金：青海省科技项目基金(2014-SF-530)。

摘　　要：目的:比较青海两个不同碘营养背景人群甲状腺结节检出率及相关危险因素。方法:2014年—2016年对西宁和玉树两个地区3 212例观察对象进行超声筛查,测定尿碘水平、促甲状腺素(TSH)、游离甲状腺激素(FT4)、血清甲状腺球蛋白抗体(TGAb)、过氧化物酶抗体(TPOAb)、糖化血红蛋白(Hb A1c)水平、计算体重指数(BMI),进行比较。结果:(1)两地区居民性别构成、尿碘中位数、TGAb、BMI均有差异(P<0.05);(2)西宁地区人群甲状腺结节检出率与性别、尿碘中位数、TSH中位数及TGAb相关;(3)玉树地区人群甲状腺结节与性别、尿碘中位数、FT4、TPOAb、TGAb及Hb A1c相关。结论:有碘缺乏背景的成年人群在长期补碘后,其碘营养状况和甲状腺自身免疫状态与甲状腺结节的发生和维持相关,超足量碘营养是无缺碘背景成人甲状腺结节发生的影响因素之一。Objective:This study is aimed to compare the detection rate and risk factors of thyroid nodule in two different iodine nutritional backgrounds in Qinghai.Methods:Ultrasound screening was performed on3 212 people in Xining and Yushu,whose urine iodine level,thyrotrophin(TSH),free thyroid hormone(FT4), serum thyroglobulin antibody(TGAb),peroxidase antibody(TPOAb),and glycosylated hemoglobin(HbA1 c)were measured,and body mass index(BMI)was calculated,the conducting the compare.Results: ① There were differences in gender composition,median urinary iodine,TGAb and BMI between the two regions(P<0.05);② The detection rate of thyroid nodules in Xining population was correlated with gender,median urinary iodine、median TSH and TGAb;③ Thyroid nodules were associated with gender、median urinary iodine、FT4、TPOAb、TGAb、BMI and HbAlc in Yushu population.Conclusion:The iodine nutritional status and the thyroid autoimmune status are related to the occurrence and maintenance of thyroid nodules in the adult population with iodine deficiency background after long-term iodine supplementation. Excessive iodine nutrition is one of the influencing factors of thyroid nodule occurrence in adults with iodine background.

关 键 词：甲状腺结节 碘营养 危险因素 

分 类 号：R339.5+4[医药卫生—人体生理学] R581[医药卫生—基础医学]