论文部分内容阅读
目的:调查山西省不同水碘地区成人甲状腺疾病患病情况，探讨碘与甲状腺疾病的关系。方法:2016年5月，采用横断面调查方法，选择山西省文水县高车村和马西村分别作为高碘和低碘地区调查点，太原市西温庄村作为适碘地区调查点，对18 ~ 65岁常住居民进行问卷调查、尿碘含量测定、甲状腺超声检查、甲状腺功能以及自身抗体测定。结果:共调查898人，其中高碘地区288例，低碘地区324例，适碘地区286例。高碘、低碘和适碘地区各采集尿样288、324和286份，尿碘中位数（417.8、126.6和216.5 μg/L）地区间比较差异有统计学意义（n H = 288.61，n P < 0.05）。经年龄和性别标化后，低碘、适碘和高碘地区甲状腺功能亢进（甲亢）检出率分别为0.27%、1.06%和1.43%；亚临床甲状腺功能亢进（亚临床甲亢）检出率分别为0.57%、0.31%和0.30%；甲状腺功能减退（甲减）检出率分别为1.45%、1.15%和1.85%；亚临床甲状腺功能减退（亚临床甲减）检出率分别为19.34%、28.50%和32.76%；甲状腺结节检出率分别为20.51%、20.17%和33.78%；甲状腺球蛋白抗体（TgAb）阳性率分别为18.13%、19.41%和11.99%；甲状腺过氧化物酶抗体（TPOAb）阳性率分别为9.25%、12.04%和8.97%。logistic回归分析显示，只有高碘地区甲状腺结节检出率高于适碘地区（ n OR = 0.488 5，95%置信区间为0.327 2 ~ 0.729 2，n P < 0.05）。n 结论:山西省不同水碘地区甲状腺结节的患病情况不同，高碘地区检出率高于其他地区。“,”Objective:To investigate the prevalence of thyroid disease in adults in different water iodine areas and to explore the association between iodine and thyroid disease.Methods:In May of 2016, using cross-sectional survey, Gaoche Village and Maxi Village of Wenshui County were selected in Shanxi Province as a high-iodine area and a low-iodine area, respectively, Xiwenzhuang Village of Taiyuan City as an appropriate-iodine area. Questionnaire surveys, urinary iodine levels, thyroid ultrasound, determination of thyroid function and autoantibody were conducted for permanent residents aged 18 - 65.Results:A total of 898 people were investigated, including 288 in high-iodine area, 324 in low-iodine area and 286 in appropriate-iodine area. The medians urinary iodine were 417.8, 126.6 and 216.5 μg/L in high, low and appropriate-iodine areas, respectively, and the difference was statistically significant ( n H = 288.61, n P < 0.05). After age and sex standardization, the detection rates of hyperthyroidism in low, appropriate and high-iodine areas were 0.27%, 1.06% and 1.43%, respectively. The detection rates of sub-clinical hyperthyroidism were 0.57%, 0.31% and 0.30%, respectively. The detection rates of hypothyroidism were 1.45%, 1.15% and 1.85%, respectively. The detection rates of sub-clinical hypothyroidism were 19.34%, 28.50% and 32.76%, respectively. The detection rates of thyroid nodule were 20.51%, 20.17% and 33.78%, respectively. The positive rates of anti-thyroglobulin antibodies (TgAb) were 18.13%, 19.41% and 11.99%, respectively. The positive rates of thyroid peroxidase antibody (TPOAb) were 9.25%, 12.04% and 8.97%, respectively. The appropriate-iodine area was used as control, logistic regression analysis showed that only the detection rate of thyroid nodule in high-iodine area was significantly higher than that in appropriate-iodine area [odds ratio ( n OR) = 0.488 5, 95% confidence interval (n CI) = 0.327 2 - 0.729 2n , P < 0.05].n Conclusion:In Shanxi Province, the detection rate of thyroid nodules is different in different areas of water iodine, and the detection rate of thyroid nodule in adults in high-iodine area is higher than that in other areas.