天津地区甲状腺肿瘤患者尿碘检测与临床分析

Detecion and Clinical Analysis of Urinary Iodine in Patients with Thyroid Tumor in Tianjin

目的:研究甲状腺肿瘤患者临床表现与尿碘含量关系,初步探讨患者个体化碘摄入的依据。方法:2009年8月至2010年2月天津医科大学附属肿瘤医院甲状腺颈部肿瘤科收治的天津地区甲状腺肿瘤疾病患者542例,其中甲状腺癌患者240例,甲状腺良性肿瘤302例,所有患者采集空腹晨尿,测定尿中碘含量,采用过硫酸铵消化-砷铈催化分光光度法。测定尿肌酐含量,用碱性苦味酸法。天津地区甲状腺正常人群400例同法检测尿碘用以对照。结果:甲状腺良性肿瘤、恶性肿瘤患者尿碘中位数均处于碘过量状态(良性:519μg/L;恶性:524μg/L)。而无甲状腺疾病对照组,处于碘营养超足量状态。甲状肿瘤患者的经尿肌酐校正的每日尿排碘量(CCDUI)在性别、及不同年龄组之间差异无统计学意义。甲状腺癌患者中存在颈部淋巴结转移、被膜侵犯组的CCDUI分别高于无淋巴结转移组、无被膜侵犯组。甲状腺良性肿瘤中存在乳头状增生及不典型增生组的患者的CCDUI高于未存在乳头状增生及不典型增生组。存在典型胶质改变的甲状腺良性肿瘤组的CCDUI高于无典型胶质改变组。结论:本研究表明了本地区甲状腺肿瘤患者碘摄入量可能存在偏高现象,建议适当调整,行科学个体化碘摄入。

Objective： To study the relationship between thyroid tumor and urine iodine, and to discuss the evidence of individual iodine supplement. Methods： A total of 502 patients of Tianjin with 302 thyroid benign and 240 malignant tumor seen in our hospital between August 2009 and February 2010 were detected for urine iodine concentration and creatinine by arsenic-cerium catalytic spectrophotometry and method of alkaline picric acid. Meanwhile 400 normal people were set as the control group. Result： There was no significant difference between median urinary iodine （ MUI ） of benign thyroid tumor patients （ 519 μg/L ） and malignant thyroid tumor patients （ 524 μg/L ） （ P 〉 0.05 ）, which were both in excessive iodine intake. MUI of the control group without thyroid disease was 201 μg/L, in adequate iodine intake, lower than that in the above two groups （ P 〈 0.05 ）. There was no significant difference in creatinine corrected daily urinary iodine （ CCDUI ） among different age-sex groups in thyroid tumor patients （ P 〉 0.05 ）. CCDUI of patients with lymph node metastasis and extrathyroidal invasion was respectively higher than that in patients without lymph node metastasis and extrathyroidal invasion （ P 〈 0.05 ）. CCDUI of patients with benign thyroid papillary hyperplasia was higher than that in those without hyperplasia （ P 〈 0.05 ）. CCDUI of patients with typical colloid thyroid goiter was higher than that in those without typical colloid thyroid goiter （ P 〈 0.05 ）. Conclusion： Iodine intake of patients with thyroid tumor in Tianjin may be excessive and should be adjusted by scientific and individual necessity.