CAJ | 학술논문

目的评价轻度碘缺乏城市贵阳食盐加碘25年后的碘营养状态及各种甲状腺疾病的患病情况.方法采用分层整群抽样方法,抽取贵阳市云岩区宅吉社区20岁及以上居民1509人,测定其血清促甲状腺素(TSH)、游离T3、游离T4、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)水平、尿碘水平及甲状腺B超检查；同时抽取8～10岁学龄儿童80名,测定其尿碘水平.结果 8～10岁儿童尿碘中位数为228.7 μg/L.成人临床甲状腺功能减退症(甲减)、亚临床甲减、临床甲状腺功能亢进症(甲亢)及亚临床甲亢的患病率分别为1.79％、14.12％、1.52％及1.06％,亚临床甲减的患病率显著高于临床甲减(P＜0.05)；TPOAb及TgAb的阳性率分别为14.38％及13.59％,自身免疫性甲状腺炎的患病率为4.44％.甲状腺肿大患病率为1.06％,其中,弥漫性甲状腺肿(0.86％)较结节性甲状腺肿(0.20％)多见(P＜0.05).结论食盐加碘25年后,贵阳市处于碘超足量状态,成人临床甲减、亚临床甲减、甲状腺自身抗体阳性及自身免疫性甲状腺炎的患病率均较高.
목적 평개경도전결핍성시귀양식염가전25년후적전영양상태급각충갑상선질병적환병정황.방법 채용분층정군추양방법,추취귀양시운암구택길사구20세급이상거민1509인,측정기혈청촉갑상선소(TSH)、유리T3、유리T4、갑상선과양화물매항체(TPOAb)、갑상선구단백항체(TgAb)수평、뇨전수평급갑상선B초검사；동시추취8～10세학령인동80명,측정기뇨전수평.결과 8～10세인동뇨전중위수위228.7 μg/L.성인림상갑상선공능감퇴증(갑감)、아림상갑감、림상갑상선공능항진증(갑항)급아림상갑항적환병솔분별위1.79％、14.12％、1.52％급1.06％,아림상갑감적환병솔현저고우림상갑감(P＜0.05)；TPOAb급TgAb적양성솔분별위14.38％급13.59％,자신면역성갑상선염적환병솔위4.44％.갑상선종대환병솔위1.06％,기중,미만성갑상선종(0.86％)교결절성갑상선종(0.20％)다견(P＜0.05).결론 식염가전25년후,귀양시처우전초족량상태,성인림상갑감、아림상갑감、갑상선자신항체양성급자신면역성갑상선염적환병솔균교고.
Objective To investigate the current status of iodine nutrition and the prevalence of thyroid diseases in Guiyang,a mild iodine deficiency city practiced salt iodization for 25 years.Methods A representative sample of 1509 adults aged 20 years old or above in Guiyang,selected by a multistage stratified sampling method,participated in the study.After an overnight fasting,serum thyroid hormones,serum thyroid autoantibodies,and urine iodine were measured.B-mode ultrasonography of the thyroid was performed in the population.Meanwhile,urine iodine of 80 children aged 8-10 years old in the same community were measured after an overnight fasting.Results The median of 8-10 years old children's urinary iodine was 228.7 μg/L.The prevalence of overt hypothyroidism,subclinical hypothyroidism,overt hyperthyroidism and subclinical hyperthyroidism was 1.79％,14.12％,1.52％ and 1.06％ respectively.The prevalence of subclinical hypothyroidism was significantly higher than overt hypothyroidism (P ＜ 0.05)and was significantly higher in female than that in male (P ＜ 0.05).The prevalence of positive thyroid peroxidase antibody,positive thyroglobulin antibody and autoimmune thyroiditis was 14.38％,13.59％ and 4.44％ respectively,which were significantly higher in female than that in male (all P values ＜ 0.05).The prevalence of diffuse goiter and nodular goiter was 0.86％ and 0.20％ respectively,with a significant difference (P ＜ 0.05).Conclusion After 25 years of salt iodization,the iodine nutrition in Guiyang is more than adequate with high prevalence of overt hypothyroidism,subclinical hypothyroidism and autoimmune thyroiditis.