2020年四川省8~10岁儿童甲状腺肿大调查及影响因素分析

Analysis of the prevalence and influencing factors of goiter among children aged 8 to 10 years old in Sichuan Province in 2020

目的 了解四川省8~10岁儿童甲状腺肿大(简称“甲肿”)情况,探讨影响儿童甲状腺容积的相关因素。方法 2020年在四川省21个县(市、区),每个县(市、区)按东、西、南、北、中5个方位各随机抽取1个乡(镇、街道),在所抽取乡(镇、街道)抽取1所小学,每所小学抽取40名8~10岁儿童(年龄均衡,男、女各半),采用B超法对其进行甲状腺容积检测,根据《地方性甲状腺肿诊断标准》计算甲状腺容积并判定是否为甲肿;测量身高、体重,计算体重指数(BMI),分析甲状腺容积与年龄、性别、身高、体重及BMI的相关性;采集1份随机尿样检测尿碘,采用砷铈催化分光光度法检测尿碘。结果 四川省共调查8~10岁儿童4 203名,其中男生2 109名,女生2 094名,检出甲肿儿童79例,甲肿率为1.9%;男生甲肿率为1.8%,女生甲肿率为2.0%,不同性别甲肿率比较差异无统计学意义(χ^(2)=0.36,P>0.05),8、9和10岁儿童甲肿率分别为2.6%、1.5%和1.6%,不同年龄儿童甲肿率比较差异无统计学意义(χ^(2)=5.56,P>0.05);尿碘中位数为203.0μg/L,为碘超适宜量;儿童甲状腺容积与年龄、身高、体重及BMI呈正相关(r=0.192、0.284,0.293、0.144,P均<0.05)。结论 四川省8~10岁儿童甲肿率符合国家控制标准(<5%),除年龄因素外,儿童甲状腺容积受身高、体重及BMI影响也较大,建议在研讨儿童甲肿诊断标准的修订时将身高、体重及BMI纳入考虑范围。

Objective To analyze the prevalence of goiter among children aged 8 to 10 years old in Sichuan Province and to study the related factors affecting the thyroid volume of these children.Methods A town was randomly chosen from the eastern,western,southern,northern and middle areas of each of the 21 counties of Sichuan Province in 2020.One primary school was selected from each town,and 40 children aged 8 to 10 years old were enrolled from each primary school(age and gender were evenly divided).The size of thyroid was measured by type B ultrasound method.The volume of thyroid was calculated and whether there was a goiter or not was determined according to the Diagnostic Criteria for Endemic Goiter.Height and weight were measured,body mass index(BMI) was calculated,and the correlation of thyroid volume with age,gender,height,weight and BMI was analyzed.Random urine samples were collected,and urinary iodine was detected by arsenic-cerium catalytic spectrophotometry.Results There were 4203 children aged 8 to 10 years old,including 2 109 boys and 2 094 girls enrolled into this investigation in Sichuan Province.A total of 79 children were diagnosed with goiter,and the goiter rate was 1.9%.The goiter rate of boys and girls was 1.8% and 2.0%,respectively.There was no significant difference in the goiter rate between boys and girls (χ^(2) =0.36,P>0.05).The goiter rate of children aged 8,9 and 10 years old was 2.6%,1.5% and 1.6%,respectively.There was no significant difference in the goiter rate among different ages (χ^(2)=5.56,P>0.05).The median of urinary iodine in children was 203.0 μg/L,which was at the level of iodine exceeding appropriate content.The thyroid volumes of children aged 8,9 and 10 years old were positively correlated with age,height,weight and BMI(r=0.192,0.284,0.293,0.144,respectively,P<0.01).Conclusions The goiter rate of children aged 8~10 years old in Sichuan Province is within the national control standard(<5%).In addition to age,children’s thyroid volume is also greatly affected by height,weight and BMI.It is recommended that height,weight and BMI should be taken into consideration when study the revision of diagnostic criteria for children′s goiter.