高碘地区儿童甲状腺结节的调查分析

The investigation and analysis of thyroid nodules in children of high iodine areas

目的了解高碘地区学龄儿童甲状腺结节的检出率,为高碘甲状腺肿的防治工作提供科学依据。方法对山东省巨野县6-13岁儿童226名和山西省平遥县6-15岁256名儿童进行甲状腺B超检查和尿碘检测。结果本次调查共发现患有甲状腺结节的儿童为6例,检出率1.2%,尿碘中位数为437.7μg/L。尿碘〈100μg/L组学龄儿童的甲状腺结节检出率较高,为6.3%;100-199μg/L组学龄儿童甲状腺结节检出率为2.6%;200-299μg/L组的检出率最低,为0.0%;≥300μg/L组的检出率为1.3%,不同尿碘水平甲状腺结节检出率无统计学意义,χ^2=3.387,P〉0.05。不同年龄甲状腺结节检出率无差异,χ^2=0.194,P〉0.05。儿童的性别之间甲状腺结节检出率无差异,χ^2=0.604,P〉0.05。不同年龄组尿碘中位数无明显差异（H=0.281,P〉0.05）。不同性别儿童尿碘中位数无明显差异（Z=-0.467,P〉0.05）。检出有结节组与无结节组学龄儿童的尿碘中位数分别为324.2μg/L和440.9μg/L,两者之间无统计学意义（Z=-1.688,P〉0.05）。结论高碘地区存在儿童甲状腺结节,儿童甲状腺结节的成因有待进一步研究。

Objective To investigate the detection rate of thyroid nodules of school-age children in high iodine area, so as to provide science basis for high iodine goiter prevention and control. Methods Thyroid ultrasound and urine iodine examination were performed for 226 children aged 6 to 13 years in Juye County in Shandong Province and 256 children aged 6 to 15 in Pingyao County in Shanxi Province. Results Of the 482 school-age children, detection rate of thyroid nodules was 1.2% （6 in 482）, and the median urinary iodine was 437.7 μg/L. The detection rates of ranked groups, 〈 100μg/L, 100 - 199μg/L, 200 299μg/L, ≥300μg/L, were 6.3%, 2.6%, 0.0% and 1.3%, respectively. There was no significant difference in these four groups（χ^2 = 3. 387, P 〉 0.05）. There was no significant difference in age and sex groups（χ^2 = 0. 194, P 〉 0. 05; χ^2 = 0. 604, P 〉 0.05）. There was no significant difference in different age and sex urinary iodine medians （H = 0.281, P 〉0. 05; Z = -0. 467, P 〉 0.05）. Median urinary iodine of children in detected nodules group was 324.2 μg/L, while it was 440.9μg/L in none -detected group（Z =-1. 688, P 〉0.05）. Conclusion Thyroid nodules were identified in the high iodine area. The cause of thyroid nodules of children needs to be further studied.