CAJ | 학술논문

目的探索重庆市全民食盐加碘(USI)后是否存在甲状腺功能亢进(甲亢)发病升高,为制定防治方案提供依据.方法 2008年,在永川区大安镇和涪陵区珍溪镇和新妙镇,以当地常住人口为调查对象,逐户调查1990年以后甲亢发病情况,计算发病率;抽取永川大安镇2个村,涪陵区珍溪和新妙镇3个村,每村选择30名18～45岁成人,男女各半,采集尿液检测尿碘;并选择永川区所在的重庆医科大学附属永川区医院,收集1990-2010年永川区就诊的甲亢病例,记录性别、年龄、甲状腺容积,计算甲状腺肿大率和甲亢发现率;分析甲亢发病率、发现率、甲状腺容积、甲状腺肿大率变化趋势和尿碘水平.结果 1997-2008年居民食用碘盐覆盖率,永川区为93.85％～100.00％,涪陵区1997-2005年为15.00％～72.78％,2006-2008年为86.55％～97.22％;检测18～ 45岁尿碘,永川区尿碘中位数(271.43 μg/L)显著高于涪陵区(130.68 μg/L,t=5.95,P＜0.05);USI前(1990-1996年),永川区人群甲亢年均发病率为5.92/10万,涪陵区为4.55/10万,组间比较差异无统计学意义(x2=0.36,P＞0.05);USI后(1997-2008年),永川区人群甲亢年均发病率为40.51/10万,涪陵区为12.19/10万,永川区显著高于涪陵区(x2=73.20,P＜0.01),两地发病率均显著高于USI前(x2=46.26、15.46,P＜0.01);医院就诊病例年均发现率USI前、后分别为5.91/10万和30.78/10万,组间比较差异有统计学意义(x2=1318.32,P＜ 0.01).结论调查结果显示,USI后甲亢发病率显著上升,碘盐覆盖率和尿碘高,发病率高,相反则发病低,需降低食盐加碘浓度,以保持人群适宜的碘营养水平.
목적 탐색중경시전민식염가전(USI)후시부존재갑상선공능항진(갑항)발병승고,위제정방치방안제공의거.방법 2008년,재영천구대안진화부릉구진계진화신묘진,이당지상주인구위조사대상,축호조사1990년이후갑항발병정황,계산발병솔;추취영천대안진2개촌,부릉구진계화신묘진3개촌,매촌선택30명18～45세성인,남녀각반,채집뇨액검측뇨전;병선택영천구소재적중경의과대학부속영천구의원,수집1990-2010년영천구취진적갑항병례,기록성별、년령、갑상선용적,계산갑상선종대솔화갑항발현솔;분석갑항발병솔、발현솔、갑상선용적、갑상선종대솔변화추세화뇨전수평.결과 1997-2008년거민식용전염복개솔,영천구위93.85％～100.00％,부릉구1997-2005년위15.00％～72.78％,2006-2008년위86.55％～97.22％;검측18～ 45세뇨전,영천구뇨전중위수(271.43 μg/L)현저고우부릉구(130.68 μg/L,t=5.95,P＜0.05);USI전(1990-1996년),영천구인군갑항년균발병솔위5.92/10만,부릉구위4.55/10만,조간비교차이무통계학의의(x2=0.36,P＞0.05);USI후(1997-2008년),영천구인군갑항년균발병솔위40.51/10만,부릉구위12.19/10만,영천구현저고우부릉구(x2=73.20,P＜0.01),량지발병솔균현저고우USI전(x2=46.26、15.46,P＜0.01);의원취진병례년균발현솔USI전、후분별위5.91/10만화30.78/10만,조간비교차이유통계학의의(x2=1318.32,P＜ 0.01).결론 조사결과현시,USI후갑항발병솔현저상승,전염복개솔화뇨전고,발병솔고,상반칙발병저,수강저식염가전농도,이보지인군괄의적전영양수평.
Objective To evaluate the effect of universal salt iodization(USI) on incidence of hyperthyroidism so as to provide a scientific evidence for development of prevention and treatment programs.Methods The incidence of hyperthyroidism were investigated by retrospective investigation in 3 townships from 1990 to 2008,including 1 township in Yongchuan and 2 townships in Fuling.Two villages of Yongchuan and 3 villages of Fuling were seccected.30 people aged 18-45 in every village were investigated.Urine iodine of the people was examined.The residents with hyperthyroidism diagnosed in Yongchun district were collected from 1990-2010 in Yongchun Hospital,Chongqing Medical University.Gender,age,thyroid volume were recorded,and goiter rate and incidence were calculated; the incidence of hyperthyroidism,detection rate,thyroid volume,trends of goiter rate and urinary iodine levels were analyzed.Results The coverage of iodized salt was between 93.85％ to 100％ in Yongchuan from 1997 to 2008,but the rate was between 15.00％ to 72.78％ in Fuling from 1997 to 2005 and between 86.55％ to 97.22％ from 2006 to 2008.The median concentration of urinary iodine in Yongchuan(271.43 g/L) was significantly higher than that in Fuling(130.68 μg/L,t =5.95,P ＜ 0.05).Before USI,the average annual incidence rate was 5.92/100 000 in Yongchuan and 4.55/100 000 in Fuling.There was no significant difference between the two areas(x2 =0.36,P ＞ 0.05).After USI,the average annual incidence rate(40.51/100 000) in Yongchuan was significantly higher than that(12.19/100 000) in Fulingm(x2 =73.20,P ＜ 0.01).The annual incidence rate significantly increased in both the two areas after eating iodized salt(x2 =46.26,15.46,P ＜ 0.01).The annual average incidence of hyperthyroidism(5.91/100 000) before USI was lower than that (30.78/100 000) after USI(x2 =1318.32,P ＜ 0.01).Conclusions The incidence of hyperthyroidism increases after universal salt iodization.There is an inverse correlation between the incidence of hyperthyroidism and coverage of iodized salt and urinary iodine.Iodized concentration in salt should be reduced.