浙江省全民食盐加碘后甲状腺疾病发病趋势分析

The incidence trend analysis of thyroid gland disease after universal salt iodization of Zhejiang Province

目的分析全民食盐加碘(USI)后甲状腺功能亢进(甲亢)、甲状腺肿大(甲肿)、甲状腺瘤(甲瘤)和甲状腺癌(甲癌)的发病趋势。方法在原碘缺乏病病区县、非病区县中各抽取1个县,再将每类县(市)的乡镇分成2类,一类为自1996年起,食用碘盐覆盖率>90%、尿碘中位数>200μg/L的乡镇(A乡镇),另一类为至2002年食用碘盐覆盖率仍然<50%、尿碘中位数<100μg/L的乡镇(B乡镇)。在2类乡镇中随机各抽取1个调查点,调查并比较USI前、后4种甲状腺疾病的发病率。结果原病区县USI前4种甲状腺疾病年均发病率依次为0.11/10万、0.08/10万、0.42/10万、0,USI后依次为0、0、0.43/10万、0,经χ2检验,差异无统计学意义(P>0.05)。原非病区县USI后的8年中,A乡镇4种甲状腺疾病年均发病率依次为4.15/10万、0.61/10万、0.31/10万、0,B乡镇依次为0.88/10万、8.93/10万、0.88/10万、0,经χ2检验,两乡镇间甲亢、甲肿年均发病率差异有统计学意义(P均<0.01),甲瘤差异无统计学意义(P>0.05),甲癌均无发病。结论原病区县USI后4种甲状腺疾病年均发病率没有增高;原非病区县贯彻USI后8年内A乡镇比B乡镇年均甲亢发病率增高,甲肿发病率降低,甲瘤和甲癌的发病率无改变。

Objective To analyze the incidence trend of hyperthyroidism,simple goiter,tumor of thyroid and thyroid carcinoma after universal salt iodization （USI）. Methods Each town of different fraction of iodine salt coverage both from former thyroid gland disease and non-disease area counties was sampled to investigate the incidence of 4 thyroid gland diseases before and after USI. Furthermore, all the counties were classified into A or B type： for A type, from 1996, the salt iodization covered more than 90% of the families and the median urine was more than 200 μg/L; for B type, till 2002, the salt iodization coverage still was less than 50%, and median urine was less than 100 μg/L. Results In the former disease areas ,the mean incidences rate of 4 thyroid gland diseases were 0.11,0.08,0.42,0 of per 10 000 in turn before USl,and 0,0,0.43,0 of hundred thousandth in turn after USI,P 〉 0.05 by X2 analysis,without statistical significance. In non-disease area counties,the mean annual incidences of 4 thyroid gland diseases during 8 years after USI were 4.15,0.61,0.31,0 in turn in A-typed town,and 0.88,8.93, 0.88,0 in B-typed town,P 〈 0.01 by X^2 analysis,showing a statistical significance of hyperthyroidism and simple goiter incidences and no difference of tumor of thyroid （P 〉 0.05）. No thyroid carcinoma cases were found. Conclusions In the former disease areas, the mean incidences rate of 4 thyroid gland diseases have not increased after USl;in non-disease areas during 8 years after USl,the average incidence of hyperthyroidism of A-typed town is higher than that of B-typed town, and the incidence of simple goiter is lower, the mean incidences of tumor of thyroid and thyroid carcinoma remain the same.