[临床医学]甲状腺疾病发病趋势碘缺乏学会北戴河2012062.ppt

* * 3 妊娠期TPOAb阳性者的亚临床甲减发病率显著高于TPOAb阴性者。妊娠前半期，亚临床甲减中28.86%为TPOAb阳性 Prevalence of thyroid ATAs in the contaminated and noncontaminated Belarusian villages. The prevalence of TPOAbs alone was significantly higher in subjects living in the contaminated Lelchitsy village than in those living in the noncontaminated Braslav village. A slightly, but not significantly, higher prevalence of TgAbs alone and/or with TPOAb was also observed in subjects living in the contaminated village. NS, Not significant. Prevalence of thyroid ATAs in the contaminated and noncontaminated Ukrainian villages. The prevalence of TPOAbs alone was slightly, but not significantly, higher in subjects living in the contaminated Korosten village than those living in the noncontaminated Borispol village. No difference was observed in the prevalence of positive TgAbs alone and/or with TPOAb. NS, Not significant. Prevalence of thyroid ATAs in the contaminated and noncontaminated Russian villages. The prevalence of TPOAbs alone and/or with TgAbs was low and not different in exposed and nonexposed subjects. The prevalence of TgAb alone was significantly higher in the exposed village of Klintsy than in the nonexposed village of Maloarchangelsk. NS, Not significant. 来自斯洛伐克的研究，对严重多氯联苯污染区研究，比较血中多氯联苯在上1/4和下1/4比较，发现TPOAb抗体阳性率显著增加，生活在污染区，有PCBs暴露与不暴露的妇女比较，TPOAb、 TgAb和TRAb阳性率显著增加。 * 小结 甲状腺疾病是妊娠妇女最常见的疾病之一 妊娠期亚临床甲状腺疾病主要有亚临床甲减、低甲状腺素血症、甲功正常的TPOAb阳性及亚临床甲亢 妊娠期亚临床甲状腺疾病显著增加产科并发症，减低后代智力发育水平 积极应用L-T4治疗亚临床甲状腺疾病，可有效降低产科并发症，改善后代智力发育 应对妊娠妇女和计划妊娠的妇女进行亚临床甲状腺疾病的筛查 * 甲状腺疾病相关的主要环境因素 射线暴露 碘 硒 感染 吸烟 化学毒物 … … 射线暴露与甲状腺疾病 核泄漏后射线暴露 医用射线暴露 Prevalence of thyroid autoantibodies in children and adolescents from Belarus exposed to the Chernobyl radioactive fallout Lancet. 1998 Sep 5;352(9130):763-6. 暴露组：乌克兰 核泄漏时年龄：4-6岁（1986,4，26） 评估时间：核泄漏后6-8年（1999-2001） 对照组：无核泄漏暴露匹配 结果： The prevalence of TgAb or TPOAb, or both, was significantly higher (p=0.0001) in individuals living in Hoiniki (56 [19.5%] of 287) than in those living in Braslav (eight [3.8%]