重庆市人群甲状腺功能亢进发病情况调查分析

Analysis on the Influence of Universal Salt Iodization to Hyperthyroidism

目的调查全民食盐加碘是否影响甲亢发病升高。方法抽取碘盐覆盖率较高的永川区1个乡和碘盐覆盖率较低的涪陵区2个乡,以回顾性调查方法调查1990-2008年逐年甲亢发病情况;收集历年碘盐监测资料;采集成人尿液检测碘含量;FT3、FT4升高,TSH降低,有甲亢临床表现者诊断为甲亢;趋势检验(F)、t检验和χ2检验作统计学分析。结果 1997-2008年碘盐覆盖率,永川区为93.8%～100.0%;涪陵2005年及其以前为22.5%～72.78%,2006-2008年为86.55%～97.22%。尿碘中位数永川为271.43μg/L,显著高于涪陵的130.68μg/L(P<0.05)。共发现甲亢病例234例,食用碘盐前(1990-1996)年均甲亢发病率永川为5.92/10万,涪陵为4.55/10万,差异无统计学意义(P>0.05);食用碘盐后(1997-2008)年均甲亢发病率永川为40.51/10万,显著高于涪陵的12.19/10万(P<0.01),食用碘盐后两地的发病率显著上升(P<0.05)。患甲亢相对危险度永川为6.84,涪陵为2.68。病例中女性多于男性,发病年龄最小12岁,最大82岁,症状为多食、多饮、体重下降、心悸、眼球突出、多汗和甲状腺肿。结论全民食用碘盐后甲亢发病率升高,存在碘过量,应降低食盐加碘浓度。

Objective To find whether the universal salt iodization cause increase of hyperthyroidism,and provide scientific basis for hyperthyroidism control and prevention. Methods Retrospectively method was applied to study the morbidity of hyperthyroidism in 3 townships in the period from 1990 to 2008,including 1 township with high coverage of iodized salt in Yongchuan prefecture and 2 townships with low coverage of iodized salt in Fuling prefecture. Surveillance data of iodized salt was collected and analyzed. Urine iodine concentration of adult was detected. People suffered symptoms of hyperthyroidism with high FT3 and FT4,low TSH were diagnosed as hyperthyroidism cases. F test,t test and χ2 test were used for statistical analysis. Results The coverage of iodized salt was between 93.8% to 100% in Yongchuan from 1997 to 2008,while,the coverage of iodized salt was between 22.5% to 72.78% in Fuling before 2005 and between 86.55% to 97.22% from 2006 to 2008. The median concentration of urinary iodine in Yongchuan,which is 271.43 μg / L,significantly higher than that in Fuling,which is 130.68 μg / L （P0.05）. There were 234 cases totally. Before eating iodized salt,the average mobility was 5.92 per 100 thousand man-year in Yongchuan and 4.55 per 100 thousand man-year in Fuling,no significant difference between the two areas（P0.05）. The average mobility of Yongchuan,which is 40.51 per 100 thousand man-year,is significantly higher than that in Fulingm,which is 12.19 per 100 thousand man-year（P0.01）. The mobility obviously increased in both the two areas after consuming iodized salt （P0.05）. The relative risk （RR） in Yongchuan and Fuling was 6.84 and 2.68 respectively. Female cases were more than male cases. The youngest patient is 12 years old and the oldest is 82 years old. Polyphagia,polydipsia,lose weight,palpitate,exophthalmos,hidrosis and goite are the common symptoms. Conclusion The morbidity of hyperthyroidism increase after universal salt iodization. It is related to excessive iodine. Iodized concentration in salt should be reduced.