不同碘摄入量地区甲亢的对比流行病学研究

A comparative epidemiologic survey of hyperthyroidism in areas with different iodine intake

目的 研究 1996年实行普遍食盐碘化 (Universalsaltiodization ,USI)后 3个不同碘摄入量的农村社区甲亢的流行病学情况和USI对甲亢发病率的影响。方法 盘山地区的研究对象未食用碘化食盐 ,彰武和黄骅地区的研究对象 1996年起均食用碘化食盐。在 3个地区分别对 110 3人、15 84人及 10 74人进行甲状腺功能、甲状腺自身抗体、甲状腺B超和尿碘含量检查 ,并统计 3个地区实行USI前 5年及后 3年的甲亢患者数 ,计算甲亢发病率。结果 3个地区的尿碘中位数分别为 10 3μg/L、375 μg/L和 6 15 μg/L ;临床甲亢的患病率分别为 1.6 %、2 .0 %和 1.2 % ;亚临床甲亢的患病率分别为 3 .7%、3.9%和 1.1%。盘山地区 1996年之后的甲亢发病率显著高于 1996年之前 ,彰武和黄骅地区的甲亢发病率前后对比差异无显著性。结论 USI最终不能导致甲亢和亚临床甲亢患病率的显著增加。

Objective To investigate the epidemiology of hyperthyroidism in three rural communities with different iodine intake after universal salt iodization (USI) since 1996 as well as the influence of USI on the incidence of hyperthyroidism. Methods Inhabitants in Panshan community did not take iodized salt whereas inhabitants in Zhangwu and Huanghua communities have taken iodized salt since 1996. The thyroid function, thyroid autoantibodies, urinary iodine concentration and thyroid B ultrasound were performed in 1103, 1584 and 1074 subjects respectively in the three communities and the number of hyperthyroidism patients between 1991 and 1999 was collected to calculate the yearly average incidence of hyperthyroidism. Results The median urinary iodine concentrations in Panshan, Zhangwu and Huanghua were 103 μg/L, 375 μg/L and 615 μg/L, respectively (P<0.05). Theprevalenceofactivehyperthyroidism was 1.6%, 2.0% and 1.2% (P>0.05) andtheprevalenceofsubclinicalhyperthyroidism was 3.7%, 3.9% and 1.1%, respectively. Comparing the yearly average incidence of hyperthyroidism of 1996～1999 with that of 1991～1995, a significant increased incidence in Panshan, while a slight but insignificant elevated one in Zhangwu and a fixed one in Huanghua were found. Conclusion USI can not result in a raise of the prevalence of active hyperthyroidism as well as subclinical hyperthyroidism. The increase of iodine intake is not the only explanation for the raising of the incidence of hyperthyroidism.