CAJ | 학술논문

目的调查疑似高碘性甲状腺肿病例,确定陕西省富平县刘集镇是否为饮水型高碘性甲状腺肿病区.方法触诊法普查陕西省富平县刘集镇6333名7～15岁儿童甲状腺.采集刘集镇所辖23个村和3所小学校居民生活饮用水各1份,用硫酸砷铈催化分光光度法测定含碘量,离子电极法测定含氟量,乙二胺四乙酸二钠滴定法测定含钙量,百里酚分光光度法测定含硝酸盐量.采集刘集镇所辖3所小学校60名7～15岁儿童尿样,用硫酸砷铈催化分光光度法测定含碘量,采集3所小学校儿童家中食用盐样188份,用直接滴定法检测含碘量.另按水碘＜ 100、100～、200～、300～、≥400μg/L分为5组,按水氟＜1.0、1.0～、1.5～、≥2.0 mg/L分为4组,按水中硝酸盐含量分为超标组(＞ 20 mg/L)和未超标组(≤20 mg/L),分别进行甲状腺肿大率组间比较.结果刘集镇7～15岁儿童甲状腺肿大率为30.06％(1904/6333)；尿碘中位数为1013.13 μg/L,＞500μg/L的比例占76.67％ (46/60)；水碘中位数为450.34 μg/L;儿童甲状腺肿大率随着水碘升高而呈先降后升趋势[36.84％(91/247)、28.38％(573/2019)、24.73％(294/1189)、31.64％ (205/648)、33.23％(741/2230),x2=9.52,P＜ 0.05],随着水氟升高而降低[35.36％(93/263)、32.94％(533/1618)、29.79％(914/3068)、26.30％ (364/1384),x2=19.21,P＜ 0.01],而与水中硝酸盐含量无关[29.04％ (966/3326)、31.19％ (938/3007),x2=3.47,P＞0.05].结论根据调查结果,陕西省富平县刘集镇是陕西省第一个确定的地方性饮水型高碘甲状腺肿病区.
목적 조사의사고전성갑상선종병례,학정합서성부평현류집진시부위음수형고전성갑상선종병구.방법 촉진법보사합서성부평현류집진6333명7～15세인동갑상선.채집류집진소할23개촌화3소소학교거민생활음용수각1빈,용류산신시최화분광광도법측정함전량,리자전겁법측정함불량,을이알사을산이납적정법측정함개량,백리분분광광도법측정함초산염량.채집류집진소할3소소학교60명7～15세인동뇨양,용류산신시최화분광광도법측정함전량,채집3소소학교인동가중식용염양188빈,용직접적정법검측함전량.령안수전＜ 100、100～、200～、300～、≥400μg/L분위5조,안수불＜1.0、1.0～、1.5～、≥2.0 mg/L분위4조,안수중초산염함량분위초표조(＞ 20 mg/L)화미초표조(≤20 mg/L),분별진행갑상선종대솔조간비교.결과 류집진7～15세인동갑상선종대솔위30.06％(1904/6333)；뇨전중위수위1013.13 μg/L,＞500μg/L적비례점76.67％ (46/60)；수전중위수위450.34 μg/L;인동갑상선종대솔수착수전승고이정선강후승추세[36.84％(91/247)、28.38％(573/2019)、24.73％(294/1189)、31.64％ (205/648)、33.23％(741/2230),x2=9.52,P＜ 0.05],수착수불승고이강저[35.36％(93/263)、32.94％(533/1618)、29.79％(914/3068)、26.30％ (364/1384),x2=19.21,P＜ 0.01],이여수중초산염함량무관[29.04％ (966/3326)、31.19％ (938/3007),x2=3.47,P＞0.05].결론 근거조사결과,합서성부평현류집진시합서성제일개학정적지방성음수형고전갑상선종병구.
Objective To survey the suspected patients with high iodine goiter in Liuji Town Fuping County of Shaanxi Province.Methods Totally 6333 students aged 7 to 15 were examined their thyroid by the palpation method at Liuji Town.One copy of drinking water sample was collected in the 23 villages and three schools under jurisdiction of Liuji Town.Iodine,fluorine,calcium and nitrate content in the water were determined by cerium sulfate catalytic spectrophotometry,fluoride ion electrode,EDTA titration and thymol spectrophotometry,respectively.Iodine levels of 60 student's urine samples and 188 copies of household salt samples were determined.The research was divided into 5 groups according to the water iodine level of ＜ 100,100-,200-,300-and ≥400 μg,/L; into 4 groups according to the water fluoride level of ＜ 1.0,1.0-,1.5-and ≥2.0 mg/L; into 2 groups(＞ 20 mg/L and ≤20 mg/L groups,respectively) according to the levels of water nitrate,and goiter rate was compared between groups.Results Goiter rate of the students was 30.06％ (1904/6333),the median of urinary iodine level was 1013.13 μg/L,of which proportions of more than 500 μg/L accounted for 76.67％ (46/60).The median water iodine level was 450.34 μg/L.Student's goiter rate first decreased and then increased [36.84％(91/247),28.38％(573/2019),24.73％(294/1189),31.64％(205/648),33.23％(741/2230),x2=9.52,P ＜ 0.05] with water iodine increasing,and decreased with water fluorine increasing [35.36％(93/263),32.94％(533/1618),29.79％(914/3068),26.30％(364/1384),x2 =19.21,P ＜ 0.01].The goiter rate had nothing to do with the content of nitrate[29.04％(966/3326),31.19％(938/3007),x2 =3.47,P ＞ 0.05].Conclusion Liuji Town Fuping County of Shaanxi Province is the first identified endemic area of drinking-water-borne high iodine thyroid.