| 任艳婷,贾清珍,张向东,郭百锁,温新平,张峰峰,王永平,王娟娟.山西省不同碘摄人量地区育龄妇女甲状腺疾病调查[J].Chinese journal of Epidemiology,2014,35(1):45-48 |
| 山西省不同碘摄人量地区育龄妇女甲状腺疾病调查 |
| Epidemiological investigation on thyroid disease among fertile women in different iodine intake areas of Shanxi province |
| Received:July 30, 2013 |
| DOI： |
| KeyWord: 甲状腺疾病 碘 过量 育龄妇女 |
| English Key Word: Thyroid diseases Iodine Exces Fertile women |
| FundProject:山西省卫生厅科技攻关项目(20100122) |
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| Abstract: |
| 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 pg／L)和适碘地区(水碘含量10一150¨g／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i碘甲状腺原氨酸(FT，)、游离甲状腺素(FT。)、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486.9μg／L和192.6μg／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=一2.884，P=0.004；t=一2.862，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(χ2=20.941，P=0.000；χ2=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(χ2=5.708，P=0.37；仁一2.177，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(f=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(χ2=17.264，P----0.000；χ2=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。 |
| English Abstract: |
| 0bjecfive 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 includegeneral 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(anti.TPO).anti.thyroglobulin(anti.TG)through radio.immunogical methods.Results 1)The urineiodine’S medians were 486.9μg／L for fertile women in high iodine areas，and 192.6μg／Lin lowiodine areas.with difference on urine iodine level statistically significant(Z=一10.676，P=0.000).2) Levels of blood FT3 and FT,in women from high iodine areas were obviously lower than those from proper iodine areas(t=一2.884，P=0.004；T=一2.862，P=0.005)，but the 1evel ofTSH in high iodine areas was higher than that ofproper iodine areas(T=2.332，P=0.021).3)In both areas，the rate ofthethyroid dysfunction with positive antibodies was obviously higher than those with negative antibodies (χ2=20.941，P=0.000；χ2=5.596，P=0.018)，while the rate ofthe 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(χ2=5.708，P=0.37；χ2=-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(χ2=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(χ2=17.264，P=0.000；χ2=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 s仃engthened. |
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