山西不同碘摄入量地区妇女甲状腺疾病流行病学调查.docVIP

山西省不同碘摄入地区育龄妇女甲状腺疾病流行病学调查 任艳婷 贾清珍 张向东 郭百锁 温新平 张峰峰 王永平 【摘要】 目的 了解不同碘摄入地区育龄妇女甲状腺疾病的患病情况，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(g/L)和适碘地区 (水碘含量10~150(g/L)共抽取18~50岁育龄妇女236例，记录调查地点、姓名、年龄、联系方式等一般资料，留取妇女随机一次尿样、家中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FT3、FT4、TSH，放射免疫法检测血Anti-TPO和Anti-Tg。结果 ①高碘和适碘地区育龄妇女的尿碘中位数分别为486.9(g/L和192.6(g/L，尿碘水平具有统计学差异（Z=-10.676，P=0.000）。②高碘地区妇女血FT3、FT4水平与适碘地区比较明显降低（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阳性者的甲状腺功能异常率明显高于抗体阴性者（(2=20.941，P=0.000；(2=5.596，P=0.018）；高碘地区妇女甲状腺自身抗体阳性者的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（(2=5.708，P=037；t=-2.177，P=0.031）。④高碘地区妇女的亚临床甲减患病率明显高于适碘地区（(2=9.542，P=0.003），高碘、适碘两地区妇女甲状腺自身抗体阳性者的亚临床甲减患病率均高于抗体阴性者（(2=17.264，P=0.000；(2=6.002，P=0.044）。结论 高碘地区育龄妇女亚临床甲减的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甲状腺功能减退的潜在风险，应加强高碘地区妇女的碘营养及甲状腺功能监测。 【关键词】 育龄妇女；碘；过量；甲状腺疾病 Epidemiology investigation on thyroid disease of fertile women in different iodine intake areas of Shanxi Province REN Yan-ting, JIA Qing-zhen, ZHANG Xiang-dong, GUO Bai-suo, WEN Xin-ping, ZHANG Feng-feng, WANG Yong-ping, WANG Juan-juan.. Department of Iodine Deficiency Disorders and Ke-shan Diseases, Shanxi Institute for Endemic Disease Prevention and Treatment, Linfen 041000, China 【Abstract】 Objective To understand the prevalence of?thyroid diseases?of fertile women?in different iodine intake areas, investigate the influence of iodine for womens?thyroid gland function and autoimmune. Method Adopt cross section method for descriptive epidemiology, collecting 236 women aged from 18 to 50 years for reproductive life in 2011 in Shanxi province. Design and fill in questionnaire, record common data for place, name, age, contact way and so on, get random urine for one time, water sample at home and theirs venous blood, and then detect the iodine contents for water and urine in arsenic and cerium catalysis spectrophotometric method, finally detect FT3, FT4, TSH in the blood in auto-CLIA, and also detect Anti-TPO and Anti-T