山东省内陆碘缺乏地区甲状腺疾病患者碘营养状况分析

Analysis on iodine nutritional status among patients with thyroid disease in inland iodine deficiency areas,Shandong province

目的分析山东省内陆碘缺乏地区110名甲状腺疾病患者碘营养水平,为因地制宜、科学补碘提供科学依据。方法收集110名于山东省地方病防治研究所就诊患者,患者均来自内陆碘缺乏地区;采集空腹晨尿,采用砷铈催化分光光度法(WS/T 107-2006)检测尿碘含量检验;直接化学发光免疫分析法检测甲状腺功能指标,检测指标包括FT3、FT4、TSH、TGAb、TMAb;所有患者均进行B超检查。结果 110名甲状腺疾病患者的尿碘中位数为136.62μg/L,其中最小值为22.3μg/L,最大值为782.80μg/L。尿碘<100μg/L的占37.27%(41/110),100~199μg/L的占30.91%(34/110),200~299μg/L的占16.36%(18/110),≥300μg/L的占15.15%(17/110)。110名甲状腺疾病患者中,甲亢患者占60.00%(66/110),甲减患者占20.91%(23/110),甲肿患者占10.00%(11/110),甲状腺炎及桥本甲状腺患者占9.10%(10/110)。尿碘<100μg/L的甲亢患者占全部甲亢患者48.48%(32/66),≥300μg/L的甲亢患者占12.12%(8/66);尿碘<100μg/L的甲减患者占17.39%(4/23),≥300μg/L的甲减患者占21.73%(5/23)。结论 110名内陆碘缺乏地区甲状腺疾病患者尿碘水平总体处于适宜状态,但是尿碘水平过低患者所占的比例较大,且患者以甲亢患者居多,还应继续加强碘营养水平和甲状腺功能监测,达到科学补碘,满足不同人群的碘营养需要。

Objective To understand the iodine nutrition level among 110 patients with thyroid disease in the inland iodine deficiency areas of Shandong province,so as to provide scientific basis for scientific iodine fortification. Methods A total of 110 patients, who were treated at the Shandong provincial Institute for Endemic Disease Prevention and Control in 2014-2015, were collected. All of the patients were from inland iodine deficiency areas. Morning fasting urine was collect ed,the arsenic cerium catalytic spectrophotometric method （WS/T 107 2006） was used to detect urine iodine content inspection;Direct chemiluminescence immunoassay testing method was used to detect thyroid function index,testing indexes including FT3,FT4,TSH and TGAb and TMAb;All patients were performed B ultrasonic examination. Results The median amount of urine iodine in 110 patients with thyroid disease was 136.62μg/L,with a minimum of 22.3μg/L, with a maximum value of 782.80 〉g/L. Urine iodine 〈100 μg/L accounting for 37.27% （41/110） ,100-199μg/L accounting for 30.91%（34/110）,200-299 〉g/L for 16.36%（18/110） ,or 15.15% （17/110） of 300 μg/L. Among 110 patients with thyroid disease, the hyperthyroidism accounted for 60.00% （66/110）, and the patients with thyroidism accounted for 20.91% （23/110） ,which accounted for 10.00% （11/110）,and 9.10% （10/110） of thyroiditis and hashimoto thyroid pa tients. Urine iodine 〈100 μg/L of hyperthyroidism accounted for 48.48%（32/66） of total hyperthyroidism,or 12. 12% （8/66） for hyperthyroidism of 300μg/L. Urine iodine 〈100 μg/L was 17.39% （4/23） ,and the number of patients with a greater than 300μg/L was 21. 73%（5/23）. Conclusion The overall iodine levels of 110 urinary iodine deficiency in patients with iodine deficiency from the inland iodine deficiency areas are in a suitable state, but the proportion of patients with low urinary iodine is relatively large,and most of them are patients with hyperthyroidism patients.