中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2014年
1期
45-48
,共4页
任艳婷%贾清珍%张向东%郭百锁%温新平%张峰峰%王永平%王娟娟
任豔婷%賈清珍%張嚮東%郭百鎖%溫新平%張峰峰%王永平%王娟娟
임염정%가청진%장향동%곽백쇄%온신평%장봉봉%왕영평%왕연연
甲状腺疾病%碘%过量%育龄妇女
甲狀腺疾病%碘%過量%育齡婦女
갑상선질병%전%과량%육령부녀
Thyroid diseases%Iodine%Excess%Fertile women
目的 了解不同碘摄入量地区育龄妇女甲状腺疾病患病情况,探讨碘对妇女甲状腺功能及甲状腺自身免疫的影响.方法 采用描述流行病学横断面对比研究方法,于2011年在山西省高碘地区(水碘含量＞ 150 μg/L)和适碘地区(水碘含量10～ 150 μg/L)共抽取236名19～ 45岁育龄妇女,记录调查地点、姓名、年龄、联系方式等一般资料,留取随机一次尿样、家庭生活饮用水水样及静脉血,实验室以砷铈催化分光光度法检测水碘、尿碘含量,全自动化学发光免疫分析法检测血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH),放射免疫法检测血甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TGAb).结果 (1)高碘和适碘地区育龄妇女尿碘中位数分别为486.9 μg/L和192.6 μg/L,尿碘水平差异有统计学意义(Z=-10.676,P=0.000).(2)高碘地区妇女血FT3、FT4水平较适碘地区明显降低(t=-2.884,P=0.004;t=-2.862,P=0.005),TSH水平明显升高(t=2.332,P=0.021).(3)高碘、适碘地区妇女甲状腺自身抗体(TPOAb和TGAb)阳性者甲状腺功能异常率明显高于抗体阴性者(x2=20.941,P=0.000;x2=5.596,P=0.018);高碘地区妇女甲状腺自身抗体阳性者甲状腺功能异常率及血TSH水平均高于适碘地区抗体阳性者(x2=5.708,P=0.37;t=-2.177,P=0.031).(4)高碘地区妇女亚临床甲状腺功能减低(亚甲减)患病率明显高于适碘地区(x2=9.542,P=0.003),高碘、适碘两地区妇女甲状腺自身抗体阳性者亚甲减患病率均高于抗体阴性者(x2=17.264,P=0.000;x2=6.002,P=0.044).结论 高碘地区育龄妇女亚甲减患病率明显高于适碘地区,过量碘摄入和甲状腺自身抗体阳性均可增加其发病的潜在风险,应加强高碘地区妇女碘营养及甲状腺功能监测.
目的 瞭解不同碘攝入量地區育齡婦女甲狀腺疾病患病情況,探討碘對婦女甲狀腺功能及甲狀腺自身免疫的影響.方法 採用描述流行病學橫斷麵對比研究方法,于2011年在山西省高碘地區(水碘含量＞ 150 μg/L)和適碘地區(水碘含量10～ 150 μg/L)共抽取236名19～ 45歲育齡婦女,記錄調查地點、姓名、年齡、聯繫方式等一般資料,留取隨機一次尿樣、傢庭生活飲用水水樣及靜脈血,實驗室以砷鈰催化分光光度法檢測水碘、尿碘含量,全自動化學髮光免疫分析法檢測血清遊離三碘甲狀腺原氨痠(FT3)、遊離甲狀腺素(FT4)、促甲狀腺素(TSH),放射免疫法檢測血甲狀腺過氧化物酶抗體(TPOAb)和甲狀腺毬蛋白抗體(TGAb).結果 (1)高碘和適碘地區育齡婦女尿碘中位數分彆為486.9 μg/L和192.6 μg/L,尿碘水平差異有統計學意義(Z=-10.676,P=0.000).(2)高碘地區婦女血FT3、FT4水平較適碘地區明顯降低(t=-2.884,P=0.004;t=-2.862,P=0.005),TSH水平明顯升高(t=2.332,P=0.021).(3)高碘、適碘地區婦女甲狀腺自身抗體(TPOAb和TGAb)暘性者甲狀腺功能異常率明顯高于抗體陰性者(x2=20.941,P=0.000;x2=5.596,P=0.018);高碘地區婦女甲狀腺自身抗體暘性者甲狀腺功能異常率及血TSH水平均高于適碘地區抗體暘性者(x2=5.708,P=0.37;t=-2.177,P=0.031).(4)高碘地區婦女亞臨床甲狀腺功能減低(亞甲減)患病率明顯高于適碘地區(x2=9.542,P=0.003),高碘、適碘兩地區婦女甲狀腺自身抗體暘性者亞甲減患病率均高于抗體陰性者(x2=17.264,P=0.000;x2=6.002,P=0.044).結論 高碘地區育齡婦女亞甲減患病率明顯高于適碘地區,過量碘攝入和甲狀腺自身抗體暘性均可增加其髮病的潛在風險,應加彊高碘地區婦女碘營養及甲狀腺功能鑑測.
목적 료해불동전섭입량지구육령부녀갑상선질병환병정황,탐토전대부녀갑상선공능급갑상선자신면역적영향.방법 채용묘술류행병학횡단면대비연구방법,우2011년재산서성고전지구(수전함량＞ 150 μg/L)화괄전지구(수전함량10～ 150 μg/L)공추취236명19～ 45세육령부녀,기록조사지점、성명、년령、련계방식등일반자료,류취수궤일차뇨양、가정생활음용수수양급정맥혈,실험실이신시최화분광광도법검측수전、뇨전함량,전자동화학발광면역분석법검측혈청유리삼전갑상선원안산(FT3)、유리갑상선소(FT4)、촉갑상선소(TSH),방사면역법검측혈갑상선과양화물매항체(TPOAb)화갑상선구단백항체(TGAb).결과 (1)고전화괄전지구육령부녀뇨전중위수분별위486.9 μg/L화192.6 μg/L,뇨전수평차이유통계학의의(Z=-10.676,P=0.000).(2)고전지구부녀혈FT3、FT4수평교괄전지구명현강저(t=-2.884,P=0.004;t=-2.862,P=0.005),TSH수평명현승고(t=2.332,P=0.021).(3)고전、괄전지구부녀갑상선자신항체(TPOAb화TGAb)양성자갑상선공능이상솔명현고우항체음성자(x2=20.941,P=0.000;x2=5.596,P=0.018);고전지구부녀갑상선자신항체양성자갑상선공능이상솔급혈TSH수평균고우괄전지구항체양성자(x2=5.708,P=0.37;t=-2.177,P=0.031).(4)고전지구부녀아림상갑상선공능감저(아갑감)환병솔명현고우괄전지구(x2=9.542,P=0.003),고전、괄전량지구부녀갑상선자신항체양성자아갑감환병솔균고우항체음성자(x2=17.264,P=0.000;x2=6.002,P=0.044).결론 고전지구육령부녀아갑감환병솔명현고우괄전지구,과량전섭입화갑상선자신항체양성균가증가기발병적잠재풍험,응가강고전지구부녀전영양급갑상선공능감측.
Objective To understand the prevalence of thyroid diseases and its influencing factors of iodine on thyroid gland function and autoimmune among fertile women in different iodine intake areas.Methods Cross-sectional method was used for descriptive epidemiology.236 women aged 19 to 45 years were sampled in 2011,in Shanxi province.Questionnaire was used to include general data on place,name,age etc.Sample of water from home,one time random urine sample and venous blood were collected to test the iodine contents using arsenic and cerium catalysis spectrophotometric methods.Finally,in blood,free triiodothyronine (FT3),free thyroxine (FT4),thyrotrophin (TSH)in blood were tested under auto-CLIA and anti-thyroid peroxidase (antiTPO),anti-thyroglobulin (anti-TG) through radio-immunogical methods.Results 1) The urine iodine' s medians were 486.9 μg/L for fertile women in high iodine areas,and 192.6 μg/L in low iodine areas,with difference on urine iodine level statistically significant (Z=-10.676,P=0.000).2)Levels of blood FT3 and FT4 in women from high iodine areas were obviously lower than those from proper iodine areas (t=-2.884,P=0.004; t=-2.862,P=0.005),but the level of TSH in high iodine areas was higher than that of proper iodine areas(t=2.332,P=0.021).3) In both areas,the rate of the thyroid dysfunction with positive antibodies was obviously higher than those with negative antibodies (x2=20.941,P =0.000; x2=5.596,P =0.018),while the rate of the thyroid dysfunction with positive antibodies and the level of TSH in the blood for high iodine women higher than those in women with prope iodine level (x2=5.708,P=0.37; t=-2.177,P=0.031).4) The morbidity rate of inferior clinical hyperthyroidism for women in high iodine areas was obviously higher than those in proper iodine areas (x2=9.542,P=0.003),while the morbidity rate of inferior clinical hypothyroidism for women with positive antibodies in two areas obviously higher than those with negative antibodies (x2=17.264,P=0.000; x2=6.002,P=0.044).Conclusion Morbidity rate of inferior clinical hypothyroidism for women in high iodine areas was obviously higher than those in proper iodine areas,suggesting that there were potential risks of hypothyroidism for overdose iodine intake which causing the existence of positive thyroid antibodies.Monitoring programs on iodine nutrition and thyroid function among women living in high iodine areas should be strengthened.
