甲状腺疾病发病趋势碘缺乏学会.pptxVIP

第1页/共58页甲状腺疾病发病趋势碘缺乏学会第2页/共58页甲状腺疾病发病趋势及其环境影响因素第3页/共58页甲状腺、甲状腺激素合成、作用和调节第4页/共58页正常情况下机体内碘的代谢途径 碘主要通过肾清除， 尿碘反映碘的摄入量第5页/共58页甲状腺疾病种类功能状态甲状腺功能亢进症甲状腺功能减退症病因炎症性：细菌性、病毒、自身免疫、化学或药物肿瘤性：良性、恶性增生性：损伤性：遗传性：地方性：碘缺乏特发性：临床型、亚临床型第6页/共58页第7页/共58页甲状腺疾病种类功能状态甲状腺功能亢进症甲状腺功能减退症病因炎症性：细菌性、病毒、自身免疫、化学或药物肿瘤性：良性、恶性增生性：损伤性：遗传性：地方性：碘缺乏特发性：临床型、亚临床型第8页/共58页内 容甲状腺疾病发病趋势自身免疫性甲状腺疾病发病趋势甲状腺癌发病趋势妊娠甲状腺疾病发病趋势环境影响因素辐射碘甲状腺干扰物第9页/共58页第一部分甲状腺疾病的发病趋势第10页/共58页自身免疫性甲状腺疾病的发病趋势自身免疫性甲状腺疾病是一组自身免疫相关性甲状腺疾病包括：Grave病、桥本甲状腺炎、产后甲状腺炎、亚急性淋巴性甲状腺炎、药物相关性甲状腺炎是最常见的自身免疫性疾病，人群发病率的7-8%，女性10%，男性3%，在美国总人数达2千4百万。53%合并其他自身免疫病。甲状腺抗体阳性患者发生临床甲减的风险增加23倍，发生亚临床甲减的风险增加12倍。第11页/共58页Endocrine,2012,May,12,online第12页/共58页Crude incidence rate ratios for autoimmune hypothyroidism reported in similar geographic location since 1970W:1972-1993: Whickham surviviorsT:1994-2001: TEARS studysL1: 1999, LjubljanaL2:2009, LjubljanaEJ:1987-1998, East JutlandDT:1997-2000,DaThyrEndocrine,2012,May,12,online第13页/共58页Age-specific relative incidence of autoimmune hypothyroidism in three studiesWickham study: 1972-1993TEARS: 1993-1996DanTHr study: 1997-2000Endocrine,2012,May,12,online第14页/共58页Worldwide reported incidence of Graves’ disease Endocrine,2012,May,12,online第15页/共58页Crude incidence rate ratios for Graves’ disease reported in similar geographic location since 1970L1: 1999, LjubljanaL2:2009, LjubljanaM1:1970-1974M2: 1988-1990M3: 2003-2005EJ:1987-1998, DT:1997-2000,A1:1987-1989A2:1993As:1995** M3 vs M2Endocrine,2012,May,12,online第16页/共58页Age-specific relative incidence of Graves’ disease in five studiesJamtland, Sweden ,1975-1984;Canterbury, New Zealand,1983-1985;East Jutland, Denmark, 1987-1988The DanThyr Study,1997-2000The Swedish Thyroid study 2003-2005Endocrine,2012,May,12,online第17页/共58页Prevalence of Postpartum Thyroid DysfunctionThe pooled prevalence of PPTD for the general population was 8.1% (6.6%–10.0%). PPTD occurs in 1 of 12 women in the general population worldwide.Global prevalence varied from 4.4% in Asia to 5.7% in USA.1 of 17 women in the U