CAJ | 학술논문

目的分析广西地区实行全民普遍食盐加碘(universal salt iodization,USI)10年前后不同碘环境下甲状腺疾病谱变迁的特点,探讨碘与广西甲状腺疾病谱变迁的关系.方法分别选取南宁、桂林、百色及北海4城市的解放军三○三、一八一医院、右江民族医学院及北海市医院经手术病理确诊的甲状腺疾病5998例(疾病组)与1000例甲状腺正常人群(对照组),对其尿碘水平行对照分析.结果 USI后2组的尿碘水平均较USI前增高;疾病组尿碘水平高于对照组,其中,在USI前、UAI后5年及USI后10年3个阶段,结节性甲状腺肿尿碘分别为[(56.7、26.4、275.3)μg/L,P＜0.05]、毒性弥漫性甲状腺肿[(228.3、245.6、289.7)μg/L,P＜0.05]、毒性结节性甲状腺肿[(268.4、358.5、346.8) μg/L,P＜0.05)]、慢性淋巴细胞性甲状腺炎[(323.5、384.7、357.6) μg/L,P＜0.05)]、甲状腺乳头状癌(315.8、380.6、378.2)μg/L尿碘水平较USI前明显增高;毒性结节性甲状腺肿构成比呈递增趋势(4.8％、6.25％、7.59％,P＜0.05);甲状腺乳头状癌在甲状腺癌构成比(USI前/USI后10年:77.59％/88.45％;P＜0.05)及慢性淋巴细胞性甲状腺炎的构成比较USI前增高(USI前/USI后5年:3.35％/5.41％,P＜0.05;USI前/USI后10年:3.35％/6.61％,P＜0.05),USI后10年结节性甲状腺肿构成比较USI前下降(USI前/USI后10年,70.54:65.83％,P＜0.05).结论 USI 10来,广西甲状腺疾病谱发生明显变化,碘过量可能是毒性结节性甲状腺肿、慢性淋巴细胞性甲状腺炎、甲状腺乳头状癌的危险因素之一.
목적 분석엄서지구실행전민보편식염가전(universal salt iodization,USI)10년전후불동전배경하갑상선질병보변천적특점,탐토전여엄서갑상선질병보변천적관계.방법 분별선취남저、계림、백색급북해4성시적해방군삼○삼、일팔일의원、우강민족의학원급북해시의원경수술병리학진적갑상선질병5998례(질병조)여1000례갑상선정상인군(대조조),대기뇨전수평행대조분석.결과 USI후2조적뇨전수평균교USI전증고;질병조뇨전수평고우대조조,기중,재USI전、UAI후5년급USI후10년3개계단,결절성갑상선종뇨전분별위[(56.7、26.4、275.3)μg/L,P＜0.05]、독성미만성갑상선종[(228.3、245.6、289.7)μg/L,P＜0.05]、독성결절성갑상선종[(268.4、358.5、346.8) μg/L,P＜0.05)]、만성림파세포성갑상선염[(323.5、384.7、357.6) μg/L,P＜0.05)]、갑상선유두상암(315.8、380.6、378.2)μg/L뇨전수평교USI전명현증고;독성결절성갑상선종구성비정체증추세(4.8％、6.25％、7.59％,P＜0.05);갑상선유두상암재갑상선암구성비(USI전/USI후10년:77.59％/88.45％;P＜0.05)급만성림파세포성갑상선염적구성비교USI전증고(USI전/USI후5년:3.35％/5.41％,P＜0.05;USI전/USI후10년:3.35％/6.61％,P＜0.05),USI후10년결절성갑상선종구성비교USI전하강(USI전/USI후10년,70.54:65.83％,P＜0.05).결론 USI 10래,엄서갑상선질병보발생명현변화,전과량가능시독성결절성갑상선종、만성림파세포성갑상선염、갑상선유두상암적위험인소지일.
Objective To reveal the relationship between the iodine nutrition and the change of spectrum of thyroid diseases by analyzing the change of spectrum of thyroid diseases in different iodine environments before and after universal salt iodization (USI) was put into practice.Methods To compare the urinary iodine concentration between 1000 cases of health control(the control group) and 5998 patients with thyroid disease confirmed by surgery and pathology.All the people were from 4 major cities of Guangxi Zhuang Autonomous Region,covering the iodine deficient areas as well as the iodine rich areas.Results After USI was put into practice,the urinary iodine concentration was higher in patients with thyroid disease than in the control group.The urinary iodine concentration in patients with nodular goiter(56.7,26.4 and 275.3 μg/L,P ＜ 0.05),Grave's disease (228.3,245.6 and 289.7 μg/L,P ＜ 0.05),toxic nodular goiter(268.4,358.5 and 346.8 μg/L,P ＜ 0.05),thyroid papillary carcinoma(315.8,380.6 and 378.2 μg/L) and Hashimoto's thyroiditis(323.5,384.7 and 357.6 μg/L,P ＜ 0.05) increased than that before USI was taken.The proportion of toxic nodular goiter was increasing in 3 stages of USI (4.8 ％,6.25 ％,7.59 ％,P ＜ 0.05),that of thyroid papillary carcinoma in thyroid carcinoma (before USI/10 years after USI:77.59％/88.45 ％ ; P ＜ 0.05) and that of Hashimoto's thyroiditis (before USI:5 years after USI,3.35％/5.41％,P ＜0.05 ;before USI:10 years afer USI,3.35％/6.61％,P ＜0.05) increased than that before USI,while the proportion ofnodular goiter decreased after 10 years of USI (before USI:10 years afer USI,70.54:65.83％,P ＜ 0.05).Conclusion The spectrum of thyroid diseases in Guangxi changes greatly within 10 years since USI was taken.The excessive intake of iodine may be one of the dangerous factors leading to toxic nodular goiter,thyroid papillary carcinoma,and Hashimoto's thyroiditis.