摘要
目的了解不同碘摄入量地区育龄妇女甲状腺疾病患病隋况，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〉150μg／L）和适碘地区（水碘含量10～150μg/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（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FT]、F1r4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（t=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，过量碘摄人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。
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-CL1A and anti-thyroid peroxidase （anti- TPO）, anti-thyroglobulin （anti-TG） through radio-immunogical methods. Results 1） The urine iodine＇s medians were 486.9μg/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 0=-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.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2014年第1期45-48,共4页
Chinese Journal of Epidemiology
基金
基金项目：山西省卫生厅科技攻关项目（20100122）
关键词
甲状腺疾病
碘
过量
育龄妇女
Thyroid diseases
Iodine
Excess
Fertile women
