721例中老年体检者原发性甲状腺功能减退状况调查

Research of the prevalence of primary hypothyroidism in 721 cases of middle and old-aged people

目的了解目前中老年人群甲状腺功能减退(甲减)的患病率和相应的甲状腺形态学改变。方法参加我院体检的40～79岁的中老年721例为研究对象。电化学发光法检测血清促甲状腺激素(TSH)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(A-TPO)和甲状腺球蛋白抗体(A-TG)。全部行甲状腺高灵敏度超声探查。结果筛查出原发性临床甲减患者17例,原发性亚临床甲减患者64例。老年组与中年组临床甲减患病率之比为1.27∶1;亚临床甲减患病率之比为2.26∶1。其中,老年组女性亚临床甲减患病率较中年组女性患病率明显升高,差异有统计学意义(P<0.05);老年组亚临床甲减总患病率高达11.50%,较中年组明显升高(P<0.05)。甲减患者甲状腺抗体阳性的患病率、临床甲减和亚临床甲减患者甲状腺结节的患病率均较高。结论与中年人群相比,老年人群具有更高的原发性甲减患病率;甲减患者的甲状腺抗体阳性率和甲状腺结节患病率均明显升高。应加强对老年人甲减和甲状腺结节的筛查。

Objective To determine the current prevalence of hypothyroidism in elderly and middle-aged people and to evaluate the morphology of thyroid. Methods 721 eases, aged 40 to 79, were enrolled in this study. Fasting venous blood were collected for detecting serum thyroid stimulating hormone （TSH）, free thyroxine （FT4 ）, thyroid peroxidase anti- body（A-TPO） and thyroglobulin antibody （A-TG） with electrochemilumineseenee assay. Thyroid in every case was screened by high sensitivity ultrasound. Results Seventeen cases with primary clinical hypothyroidism and 64 cases with primary subclinical hypothyroidism were found in all objects. The ratio of old group vs. middle-aged group was 1.27：1 in prevalence of clinical hypothyroidism and 2. 26：1 in prevalence of primary subclinical hypothyroidism. The prevalence of subclinical hypothyroidism was 14. 77% in old women, which was significantly higher than that in middle-aged women （P 〈 0. 05 ）. The overall prevalence rate of subclinical hypothyroidism was 11.50% in old people, which was significantly higher than that in middle-aged people （ P 〈 O. 05 ）. The prevalence rate of thyroid antibody-positive in patients with hypot- hyroidism was higher than that of other people. The prevalence rate of thyroid nodule was 88. 24% and 82. 81% in clinical hypothyroidism patients and subclinical hypothyroidism patients, respectively. Conclusions Old people have a higher prevalence of primary hypothyroidism than middle-aged people. Patients with hypothyroidism tend to be thyroid antibody positive and to suffer from thyroid nodules easily. Screening of hypothyroidism and thyroid nodules should be strengthened in old people.