碘摄入量增加后甲状腺疾病发病率的变化

Study on the effects of increased iodized salt intake on the incidence of thyroid diseases

目的 观察食用碘盐应用前后甲状腺疾病谱的变化。方法 采用问卷形式自 1999年8月中旬至 12月底共调查宝钢集团 2 6 0 10人。结果 ① 1990年 1月 1日至 1999年 7月 31日确诊的甲状腺疾病患者共 310例 ,其中食盐加碘后 3年半内新发病 183例 ,较前 6年明显增多。②甲状腺疾病谱构成发生了明显改变 ,主要表现在甲状腺功能亢进 (甲亢 )、单纯性甲状腺肿大及甲状腺结节 (B超检查 )患者明显增多。尽管甲状腺结节的发病率仍高居第一位 ,但甲亢的发病率由补碘前的第五位上升至第二位。③近 10年新确诊的甲亢患者 5 5例 ,其中 39例补碘后发病 ,占 70 .91% ;补碘后甲亢平均发病率为 36 .87/10万人年± 5 .40 /10万人年 ,较前增加 3倍 ;补碘后当年甲亢发病率即开始明显升高 ,1997年最高 ,以后仍维持在较高水平 ;补碘后各年甲亢发病相对危险度均有不同程度的升高。结论 随着食用碘盐的应用 ,调查人群甲状腺疾病患者明显增多 ,甲状腺疾病谱构成也发生了明显改变 ,尤其是甲亢发病率明显增高 ,与碘摄入量增多明显相关。

Objective To study the annual incidence of thyroid diseases before and after the increase of iodized salt intake. Method A total of 26 010 persons were examined from mid August to the end of December in 1999. Results ①Three hundred and ten patients of thyroid diseases were identified from 1990 to July 1999. One hundred and eighty three patients were diagnosed after iodine supplementation. ②The constitution of thyroid diseases had changed significantly regarding the increase of hyperthyroidism, simple goiter and thyroid nodule. ③Fifty five patients with hyperthyroidism including 39 patients ( 70.91 %) receiving iodine supplementation were diagnosed. The average annual incidence of hyperthyroidism after iodine supplementation was 36.87 per 100 000 , a three time increase as compared with that before iodine supplementation. The incidence of hyperthyroidism began to show a significant rise in 1996. The year with highest annual incidence was 1997, remaining at high level after supplying iodized salt. Since then the annual relative risk for hyperthyroidism had been increasing. Conclusion The number of patients with thyroid diseases showed a significant increase after mass iodine supplement. At the same time, the spectrum of thyroid diseases had also changed. Iodized salt intake and the incidence of hyperthyroidism showed a significant correlation. However, the typical model of the change of disease patterns incidence needs further study.