8～10岁儿童甲状腺容积四种校正方法的比较

A comparison of four correction methods for measuring thyroid volume of children aged 8-10

目的 分析比较四种儿童甲状腺容积的校正方法,探讨8～ 10岁儿童甲状腺容积校正的最佳方法.方法 2012、2013年,在吉林和甘肃碘缺乏地区（水碘＜ 10 μg/L）,分别选择10个乡作为调查点,每个乡选择40名8～ 10岁儿童,男女各半,采用超声法检测儿童甲状腺容积,并测量儿童身高、体重.采用体质指数（BMI）、体重和身高、体表面积、身高分别对甲状腺容积进行校正,计算体质指数甲状腺容积（BMIV）、体重身高甲状腺容积（WHVI）、体表面积甲状腺容积（BSAV）和身高甲状腺容积（HVI）,并与原始甲状腺容积相比较,探讨甲状腺容积校正的最佳方法.结果 吉林和甘肃分别检测450、408名8～ 10岁儿童,根据原始甲状腺容积,吉林、甘肃的甲状腺肿大率分别为10.4％（47/450）、0.5％（2/408）.四种校正方法可使不同省份、性别的儿童甲状腺容积的数值差异减少.WHIV和BSAV对不同年龄、身高和体重的儿童出现校正异常的现象.HVI的校正结果最接近正态分布,校正结果与原甲状腺容积相关系数最大（r=0.961）.HVI与原始甲状腺容积分布相似,但数值大小有差距,采用1.7倍HVI后,结果与原始甲状腺容积数值接近,吉林、甘肃儿童甲状腺肿大率分别为9.1％（41/450）、0.5％（2/408）.结论 四种儿童甲状腺容积的校正方法中,1.7倍HVI法最佳,建议进一步验证后推广使用.

Objectives To analyze and compare four correction methods for measuring thyroid volume,and to find out the best one for thyroid volume correction of children aged 8-10.Methods In 2012 and 2013,the project was carried out in iodine deficient rural areas （water iodine below 10 μg/L） of Jilin and Gansu Provinces,10 villages in each province were chosen as survey sites,and 40 children of 8 to 10 years old were chosen from each village,half boys and half girls.Utrasonography was adopted to determine the thyroid volume,and height and weight were measured.The thyroid volume was corrected by Body Mass Indicator（BMI）,weight and height,body surface,and height,separately.Body Mass Indicator corrected Volume （BMIV）,Weight and Height corrected Volume Indicator（WHVI）,Body Surface Area corrected Volume（BSAV） and Height corrected Volume Indicator（HVI） were calculated and compared with their original thyroid volumes to find out the best one.Results Datas of 450 and 408 children were collected from Jilin and Gansu Provinces,separately.According to their original thyroid volumes,goiter rates of Jilin and Gansu were 10.4% （47/450） and 0.5% （2/408）,respectively.All these four methods could decrease the difference between provinces and sexes.Among the four methods,WHIV and BSAV were abnormal for correction of different ages,heights and weights.HVI had the most normalized distribution and stronger correlation with the original thyroid volumes than others（r =0.961）.The HVI corrected results had similar distribution with the original thyroid volume but the data were different.After being adjusted by 1.7 × HVI,the results were close to the original thyroid volumes.Goiters in Jilin and Gansu Provinces,were 9.1%（41/450） and 0.5%（2/408）,respectively,after correction.Conclusion The 1.7 × HVI is the most suitable method for correcting the thyroid volume of children aged 8-10.