高碘地区人群甲状腺自身抗体的分布及其影响因素  

Distribution of thyroid autoantibodies in people fromiodine excess areas and its influencing factors

作　　者：钞虹[1] 程宇[1] 李刚[1] 杜琳琳[1] 杨晓蕾[1] 李洪杰 钱学艳[1] Chao Hong;ChengYu;Li Gang;Du Linlin;Yang Xiaolei;Li Hongjie;Qian Xueyan(Public health school,Qiqihar Medical College,Qiqihar,Heilongjiang,161006,China)

机构地区：[1]齐齐哈尔医学院公共卫生学院,黑龙江齐齐哈尔161006

出　　处：《齐齐哈尔医学院学报》2021年第24期2182-2184,共3页Journal of Qiqihar Medical University

基　　金：黑龙江省卫生计生委科研课题(2018100);齐齐哈尔医学科学院青年博士专项基金(QMSI2019B-07)。

摘　　要：目的研究探讨高水碘地区人群甲状腺自身抗体的分布及其影响因素。方法选择2013年4-6月水碘含量在164.13-447.68μg/L的山东省巨野县孔庄村18岁以上的常住居民405名作为研究对象,采用整群抽样方法,按甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TgAb)检测结果分为TPOAb、TgAb双阳性组(抗体+/+组)、TPOAb、TgAb任一阳性组(抗体+/-组)和TPOAb和TgAb双阴性组(抗体-/-组)三组,TPOAb、TgAb双阳性组(抗体+/+组)30名,TPOAb、TgAb任一阳性组(抗体+/-组)262名,TPOAb和TgAb双阴性组(抗体-/-组)113名。测定比较三组人群的血清甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)、促甲状腺激素(TSH)、游离三碘甲状腺氨酸(FT3)、游离甲状腺素(FT4)、甲状腺体积(TV)和尿碘浓度(UIC)水平。采用多因素Logistic回归分析研究甲状腺自身抗体阳性的影响因素。结果三组不同抗体人群的性别构成比较,差异具有统计学意义(P<0.05);三组不同抗体人群的甲状腺容积中位数比较,差异具有统计学意义(P<0.05);三组不同抗体人群的血清TSH水平比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,女性人群甲状腺自身抗体阳性是男性的2.95倍(OR=2.95;95%CI 1.08-8.02;P<0.05),血清TSH水平较高人群的甲状腺自身抗体阳性是TSH水平较低人群的1.19倍(OR=1.19;95%CI 1.10-1.28;P<0.05)。结论女性、血清TSH水平较高是甲状腺自身抗体阳性的影响因素。Objective To investigate the distribution thyroid autoantibodies in people fromiodine excess areasand its influencing factors.Methods From April and June 2013,405 residents aged over 18 years old were selected as study objects from Kongzhuang village,Juye county,Shandong province by using the cluster sampling method,the iodine content of water in this village was ranged from 164.13μg/L to 447.68μg/L.The objects were divided into three antibody groups:30 objects had both the positive TPOAb and TgAb(antibody+/+group),262 objects had the either positive TPOAb or positive TgAb(antibody+/-group),and 113 objects had both negative TPOAb and TgAb(antibody-/-group).In our research,serum thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TgAb),thyroid stimulating hormone(TSH),free triiodothyrine(FT3),free thyroxine(FT4),thyroid volume(TV)and urinary iodine concentration(UIC)were measured.Multiple Logistic regression analysis was used to analyze the influencing factors of positive thyroid autoantibodies.Results There were statistically significant differences in gender,serum TSH level and Thyroid volumemedian amongthe three groups of different antibody expression(P<0.05).In the multiple Logistic regression analysisshowed that the positive rate of thyroid autoantibody in female population was 2.95 times higher than that in male population(OR=2.95;95%CI 1.08 to 8.02;P<0.05).The positive rate of thyroid autoantibody in people with higher TSH level was 1.19 times higher than that in people with lower TSH level(OR=1.19;95%CI 1.10 to 1.28;P<0.05).Conclusions Female and the higher TSH level were the influencing factors of positive thyroid autoantibodies.

关 键 词：甲状腺自身抗体 甲状腺过氧化物酶抗体 甲状腺球蛋白抗体 高碘 

分 类 号：R581[医药卫生—内分泌]