山东省高碘地区学龄儿童甲状腺检查结果分析

Analysis on the diagn osis results of thyroid gland on school-aged children in excessive iodine region of Shandong Province

目的了解山东省高碘地区学龄儿童甲状腺肿大（简称甲肿）情况。方法采用B超法和触诊法，对高碘地区6415名8—10岁学龄儿童进行了甲状腺检查，测定甲状腺容积，计算肿大率。结果B超法检查，8、9、10岁组甲肿儿童甲状腺容积分别为（5．67±1．49）、（6．07±1．24）、（7．30±2．01）ml，甲肿率分别为28．84％（683／2368）、20．89％（448／2144）、11．82％（225／1903）；8、9、10岁组非甲肿儿童甲状腺容积分别为（3．36±0．67）、（3．64±0．77）、（4．02±0．94）ml。将8、9岁组儿童甲状腺容积正常值下调0．5ml后，甲肿率分别为18．20％（430／2368）、12．92％（277／2144）。男、女儿童甲状腺容积为（4．20±1．38）、（4．18±1．73）ml，甲肿率为21．92％（732／3340）、20．29％（624／3075）。触诊法检查，8、9、10岁组儿童甲肿率分别为10．05％（238／2368）、10．31％（221／2144）、14．45％（275／1903）。结论山东省高碘地区8—10岁学龄儿童甲状腺容积随年龄的增长而逐渐增大，儿童甲肿率随年龄的增长而降低，呈现低年龄组病情重于高年龄组的反常现象。不适当的儿童甲状腺容积正常值可能是导致该现象的主要因素之一，建议及时对正常值进行研究、修订，对低年龄组儿童甲状腺容积正常值应适当加大。

Objective To find out prevelence of thyroid goiter on school-aged children in excessive iodine region of Shandong Province. Methods By employing B-uhrasonography and palpation method,the thyroid volume were investigated and the thyroid goiter rate were calculated among 6415 children aged 8- 10 years old in excessive iodine region. Results By employing B-uhrasonography method. The volumes of thyroid in goiter children aged 8,9, 10 years were（5.67 ± 1.49）, （6.07± 1.24）, （7.30 ± 2.01 ）ml, respectively. The goiter rates were 28.84% （683/2368）, 20.89% （448/2144）, 11.82% （225/1903）. The volumes of thyroid in non-goiter children aged 8,9,10 years were （3.36±0.67）, （3.64 ±0.77）, （4.02 ± 0.94）ml. When the normal value of thyroid volume in 8 and 9 year-groups lowered 0.5 ml,the goiter rate would be changed to 18.20%（430/2368） and 12.92%（277/2144） respectively. The thyroid volumes of boys and girls were（4.20 ±1.38）, （4.18 ± 1.73）ml, respectively. The goiter rates of boys and girls were 21.92%（732/3340） and 20.29% （624/3075）respectively. The rates of goiter detected by palpation in 8,9 and 10 year-groups were 10.05%（238/2368）,10.31% （221/2144）and 14.45% （275/1903） respectively. Conclusions Along with the increasing age, the volume of thyroid in children aged 8 - 10 is increasing in excessive iodine region of Shandong Province. But the goiter rate is decreasing along the increasing age. This phenomena may be caused by improper normal value of thyroid volume. Therefore, the normal value of thyroid volume should be revised urgently.