沿海地区东台市甲状腺疾病影响因素病例对照研究  

A case-control study on the risk factors of thyroid diseases in a coastal area,Dongtai City

作　　者：张长桂[1] 赵越 周兴军[2] 徐丽[3] 王培桦[4] Zhang Changgui;Zhao Yue;Zhou Xingjun;Xu Li;Wang Peihua(Chronic Infectious Disease Prevention and Control Department,Dongtai City Center for Disease Control and Prevention,Dongtai 224200,China;Dongtai City Center for Disease Control and Prevention,Dongtai 224200,China;Department of Public Health,Dongtai People's Hospital,Dongtai 224200,China;Institute of Environment and Health,Jiangsu Provincial Center for Disease Control and Prevention,Nanjing 210009,China)

机构地区：[1]东台市疾病预防控制中心慢性传染病防治科,东台224200 [2]东台市疾病预防控制中心,东台224200 [3]东台市人民医院公共卫生科,东台224200 [4]江苏省疾病预防控制中心环境与健康所,南京210009

出　　处：《中华地方病学杂志》2024年第11期874-878,共5页Chinese Journal of Endemiology

基　　金：江苏省血地寄科研项目(X201823)

摘　　要：目的探讨沿海地区东台市居民甲状腺疾病影响因素,为进一步开展沿海地区甲状腺疾病防控提供科学依据。方法以2019年1-12月东台市人民医院确诊的沿海地区东台市甲状腺疾病患者作为调查对象,分析各病种接诊情况及性别、年龄分布。病例对照研究选取确诊新发病例作为病例组,按村组、性别、年龄进行1∶1配对的健康者作为对照组,进行问卷调查以及尿碘检测、甲状腺B型超声检查等,并对结果进行汇总分析(Wilcoxon秩和检验、条件logistic回归多因素分析等)。结果(1)累计诊断甲状腺疾病患者3508例,占总人口的319.46/10万。其中,女性患者2616例,占74.57%;30~69岁2824例,占80.50%;甲状腺功能亢进(甲亢)1539例,占43.87%;甲状腺功能减退(甲减)961例,占27.39%。(2)病例对照研究共调查492对984例。多因素分析显示,甲状腺疾病的危险因素有人均月收入、家族史、曾经进行手术、性格、工作压力、人际关系情况、尿碘分级(均P<0.05);甲亢的危险因素有职业、甲亢家族史、性格、家庭经济支出压力、人际关系情况(均P<0.05);甲状腺肿的危险因素有尿碘分级(P=0.008)。结论沿海地区东台市甲状腺疾病的发生与家族史、性别、年龄、性格、工作压力等有关,甲状腺肿与碘营养水平偏低有关,进一步佐证了食盐加碘在沿海地区防治碘缺乏病策略的正确性。Objective To study the influencing factors of thyroid diseases among residents in a coastal area,Dongtai City,and provide scientific basis for further prevention and control of thyroid diseases.Methods Thyroid disease patients of Dongtai City in the coastal area diagnosed by Dongtai People's Hospital from January to December 2019 were selected as the survey subjects,and diagnosis of various diseases and their gender and age distribution were analyzed.In the case-control study,confirmed new cases were selected as the case group,and healthy individuals matched 1∶1 by village group,gender,and age as the control group.A questionnaire survey and related examinations such as urinary iodine test and thyroid ultrasound examination were conducted.The survey results were summarized and analyzed(Wilcoxon rank sum test,conditional logistic regression multivariate analysis).Results(1)A total of 3508 patients with thyroid diseases were diagnosed,accounting for 319.46/100000 of the total population,including 2616 female patients,accounting for 74.57%;2824 cases aged 30 to 69 years old,accounting for 80.50%;1539 cases of hyperthyroidism,accounting for 43.87%;and 961 cases of hypothyroidism,accounting for 27.39%.(2)A total of 984 cases were surveyed in a 1∶1 paired manner.Multivariate analysis showed that the risk factors for thyroid diseases included monthly average income,family history,related surgeries,personality,working pressure,interpersonal relationships,and urinary iodine grading(P<0.05).The risk factors for hyperthyroidism included occupation,family history of hyperthyroidism,personality,family financial pressure,and interpersonal relationships(P<0.05),while the risk factor for goiter included urinary iodine grading(P=0.008).Conclusions The occurrence of thyroid diseases in a coastal area,Dongtai City,may be related to family history,gender,age,personality,and working pressure.There is a correlation between goiter and low iodine nutrition level,which further confirms the correctness of the strategy of salt iodizatio

关 键 词：甲状腺 甲状腺功能亢进 碘 营养 

分 类 号：R581[医药卫生—内分泌]