调查探究碘及自身免疫性甲状腺疾病发病关系.docVIP

调查探究碘及自身免疫性甲状腺疾病发病关系 　 作者：邬月琴，何岚，刘萍，徐莉 【关键词】 自身免疫性甲状腺疾病；,环境；,碘 　　摘要：目的 了解目前陕西地区自身免疫性甲状腺疾病(AITD)患者碘的营养状况，初步探讨人体内碘的代谢状况与AITD发生、发展的关系。方法 收集病例388例，其中AITD患者283例，非AITD对照105例。进行问卷调查，了解研究对象的一般情况；记录甲状腺的大小、形态、质地等情况；测定尿碘浓度、甲状腺功能以及甲状腺自身抗体。应用SPSS12.0进行数据处理。结果 研究人群中Graves病(GD)组的尿碘中位数是212μg/L，桥本甲状腺炎(HT)组是245.4μg/L，对照组是197.8 μg/ L，三组的尿碘分布有统计学差异。HT组患者在不同的尿碘水平上，血清甲状腺球蛋白抗体(TGAb)、甲状腺微粒体抗体(TMAb)以及高敏促甲状腺激素(HSTSH)水平的差别无统计学差异。结论 在AITD患者中存在饮食碘过多的问题，此可能在AITD的发病中起作用。 　　关键词：自身免疫性甲状腺疾病； 环境； 碘 　　Clinical research on the relationship between iodine and autoimmunity thyroid disease 　　ABSTRACT: Objective To observe the iodine state of patients with autoimmunity thyroid disease(AITD) in Shaanxi province, and to discuss the relationship between the metabolism of iodine and the occurrance, development and prognosis of AITD. Methods A total of 388 cases were collected, among whom 283 were patients with AITD, and 105 were patients with nonAITD. Questionnaires were designed to determine the general state of the patients, the size, shape and texture of the thyroid, the urinary concentration of iodine, the function of thyroid and the autoantibody of thyroid. The data were processed by SPSS12.0. Results The mean urinary concentrations of iodine in patients with GD, with HT, and the control group were 212μg/L, 245.4μg/L, and 197.8μg/L respectively, which were statistically different. In the HT group, wich different urinary concentrations of iodine, there were no statistical difference of TGAb, TMAb, and HSTSH. Conclusion Excessive intake of dietary iodine may be related with AITD. 　　KEY WORDS: autoimmunity thyroid disease; environment; iodine 　　自身免疫性甲状腺病(autoimmunity thyroid disease, AITD)是一个复杂的多基因遗传相关的器官特异性自身免疫性疾病，遗传和环境因素的相互作用决定了其发生、发展及临床表现。近来研究发现，碘是影响AITD发生、发展以及预后的重要环境因素。近年来，AITD的发病率有增加的趋势，有学者认为，这与食盐中的碘量增加有关[1]。本研究旨在运用流行病学方法，通过了解目前陕西地区AITD患者碘的营养状况，初步探讨人体内碘的代谢状况与AITD发生、发展的关系，为临床治疗提供理论依据。 　　1 材料与方法 　　1.1 设计调查表 收集病例共388例，病例来自2003年11月至2005年1月我院门诊就医者及住院患者。其中AITD发病组283例，均为新发病例。根据患者临床症状、体征、血清总T3、总T4、游离T3(FT3)、游离