太原市郊区内陆高碘地方性甲状腺肿患者的调查及其免疫学改变

A SURVEY OF INLAND IODINE EXCESS GOITER IN TAIYUAN SUBURBS AND ITS IMMUNOLOGICAL CHANGES

对浅井饮用水含碘量462.5μg/L的高家堡村之120例中、小学生进行调查,甲状腺总肿大率为65％,生长发育、神经学及智力检查均正常,无明显甲亢或甲低之临床表现;但血清TSH增高,FT_4增高,T_3低,说明有亚临床甲状腺功能减低之倾向。血清免疫球蛋白测定中发现甲状腺刺激免疫球蛋白(TGI)强阳性者占75％,而标志慢性淋巴细胞性甲状腺炎之TGA、TMA之阳性率却很低。

A survey of 120 pupils was done in Gaojiabu village in southern suburbs of Taiyuan. The iodine level in drinking water was 462.5 μg/L. The average urinary iodine excretion of the children examined was 1236.5 ± 1.48μg/g of creatinine. Goiter was found in 65% of the subjects. Their neurological findings, mental state, growth and development showed all normal; but the serum TSH and free T4 were elevated and T3 was low, denoting the tendency of hypo-thyroidism, whereas all subjects were clinically euthyroid. Assay of serum immunoglobulins revealed TGI (thyroid growth-stimulating immunoglobulin) was strongly positive in 75% cases, while the positive rate of TGA, TMA which is pathognomonic for chronic lymphocytic thyroiditis was very low. The immunologic changes in inland iodine excess goiter deserves further investigation.