山西省不同水碘地区成人甲状腺疾病流行病学调查  

An epidemiological survey of thyroid disease in adults in different water iodine areas of Shanxi Province

作　　者：郭俊敏[1] 王青平[2] 张向东[3] 张峰峰[4] 贾清珍[3] Guo Junmin;Wang Qingping;Zhang Xiangdong;Zhang Fengfeng;Jia Qingzhen(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 Iodine Deficiency Disorders,Shanxi Institute for Endemic Disease Prevention and Treatment,Linfen 041000,China;Clinical 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超声室,临汾041000 [2]山西省地方病防治研究所内科,临汾041000 [3]山西省地方病防治研究所碘缺乏病研究室,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》2022年第1期44-48,共5页Chinese Journal of Endemiology

基　　金：山西省卫生健康委员会公共卫生专项(2018GW35)。

摘　　要：目的调查山西省不同水碘地区成人甲状腺疾病患病情况,探讨碘与甲状腺疾病的关系。方法2016年5月,采用横断面调查方法,选择山西省文水县高车村和马西村分别作为高碘和低碘地区调查点,太原市西温庄村作为适碘地区调查点,对18~65岁常住居民进行问卷调查、尿碘含量测定、甲状腺超声检查、甲状腺功能以及自身抗体测定。结果共调查898人,其中高碘地区288例,低碘地区324例,适碘地区286例。高碘、低碘和适碘地区各采集尿样288、324和286份,尿碘中位数(417.8、126.6和216.5μg/L)地区间比较差异有统计学意义(H=288.61,P<0.05)。经年龄和性别标化后,低碘、适碘和高碘地区甲状腺功能亢进(甲亢)检出率分别为0.27%、1.06%和1.43%;亚临床甲状腺功能亢进(亚临床甲亢)检出率分别为0.57%、0.31%和0.30%;甲状腺功能减退(甲减)检出率分别为1.45%、1.15%和1.85%;亚临床甲状腺功能减退(亚临床甲减)检出率分别为19.34%、28.50%和32.76%;甲状腺结节检出率分别为20.51%、20.17%和33.78%;甲状腺球蛋白抗体(TgAb)阳性率分别为18.13%、19.41%和11.99%;甲状腺过氧化物酶抗体(TPOAb)阳性率分别为9.25%、12.04%和8.97%。logistic回归分析显示,只有高碘地区甲状腺结节检出率高于适碘地区(OR=0.4885,95%置信区间为0.3272~0.7292,P<0.05)。结论山西省不同水碘地区甲状腺结节的患病情况不同,高碘地区检出率高于其他地区。Objective To investigate the prevalence of thyroid disease in adults in different water iodine areas and to explore the association between iodine and thyroid disease.Methods In May of 2016,using cross-sectional survey,Gaoche Village and Maxi Village of Wenshui County were selected in Shanxi Province as a high-iodine area and a low-iodine area,respectively,Xiwenzhuang Village of Taiyuan City as an appropriate-iodine area.Questionnaire surveys,urinary iodine levels,thyroid ultrasound,determination of thyroid function and autoantibody were conducted for permanent residents aged 18-65.Results A total of 898 people were investigated,including 288 in high-iodine area,324 in low-iodine area and 286 in appropriate-iodine area.The medians urinary iodine were 417.8,126.6 and 216.5μg/L in high,low and appropriate-iodine areas,respectively,and the difference was statistically significant(H=288.61,P<0.05).After age and sex standardization,the detection rates of hyperthyroidism in low,appropriate and high-iodine areas were 0.27%,1.06%and 1.43%,respectively.The detection rates of sub-clinical hyperthyroidism were 0.57%,0.31%and 0.30%,respectively.The detection rates of hypothyroidism were 1.45%,1.15%and 1.85%,respectively.The detection rates of sub-clinical hypothyroidism were 19.34%,28.50%and 32.76%,respectively.The detection rates of thyroid nodule were 20.51%,20.17%and 33.78%,respectively.The positive rates of anti-thyroglobulin antibodies(TgAb)were 18.13%,19.41%and 11.99%,respectively.The positive rates of thyroid peroxidase antibody(TPOAb)were 9.25%,12.04%and 8.97%,respectively.The appropriate-iodine area was used as control,logistic regression analysis showed that only the detection rate of thyroid nodule in high-iodine area was significantly higher than that in appropriate-iodine area[odds ratio(OR)=0.4885,95%confidence interval(CI)=0.3272-0.7292,P<0.05].Conclusion In Shanxi Province,the detection rate of thyroid nodules is different in different areas of water iodine,and the detection rate of thyroid nodule in adults

关 键 词：碘 饮用水 成人 甲状腺疾病 

分 类 号：R181.3[医药卫生—流行病学] R581[医药卫生—公共卫生与预防医学]