全民食盐加碘与轻病区甲状腺疾病住院率观察

Observation on Universal Salt Iodization and the Hospitalization Rate of Thyroid Disorder

调查全民食盐加碘 (USI)对轻病区甲状腺疾病住院率的影响。甲状腺疾病住院采用回顾性调查方法。USI后社区甲状腺疾病年住院率由 2 1.8 10万上升到 4 5 .0 10万。女性住院率由 34.8 10万上升到 74 .7 10万 ,与男性由 9.7 10万升到 17.2 10万相比 ,危险比由 3.6升到 4 .3。≥ 4 0岁组住院率由 4 6 .6 10万上升到 95 .6 10万 ,与 <4 0岁组由 11.1 10万升到 2 3.1 10万相比 ,危险比均为 4 .1。住院病种构成因甲状腺功能亢进症的增加而发生变化 ,甲亢住院率由 3.3 10万上升到 16 .6 10万 ,为USI前的 5倍。居民食盐碘含量由不足 5mg kg升到4 3.4mg kg ,尿碘由 71.6 μg gCr升到 375 .7μg L。甲状腺疾病住院率的增加是由于USI实施后人群碘状态快速改善和超过适宜范围所致。食盐加碘浓度应当根据各地不同碘来源、食盐消耗量和碘的丢失而加以调整 。

To survey the affect of universal salt iodization(USI) on hospitalization rate of thyroid disorders in mild iodine deficiency. The hospitalization of thyroid disorders was carried out by retrospective study. The annual hospitalization rate of thyroid disorders has increased from 21 8 to 45 0 per 100 000 after USI. Female and male hospitalization rate was increased respective from 34 8 to 74 7 per 100 000 and from 9 7 to 17 2 per 100 000, its risk ratio increases from 3 6 to 4 3. Hospitalization rate of over 40 years and below 40 years of age was increased respective from 46 6 to 95 6 per 100 000 and from 11 1 to 23 1 per 100 000 ,its risk ratio were 4 1. The constitution of thyroid disorders had changed significantly due to the increase of hyperthyroidism. Hospitalization rate of hyperthyroidism was 16 6 per 100 000, a 5 time as compared with before USI. Iodine content of salt in household increases from 5 mg/kg to 43 4 mg/kg. Urinary iodine increases from 71 6 μg/gCr to 375 7 μg/L. The increase of thyroid disorders hospitalization rate because of the rapid improvement and mild iodine excess of iodine status which has followed the implentation of USI. The iodization of salt should be adjusted to recommended iodine intake, based on the amount of iodine from other sources, the daily intake of salt and any losses of iodine. The evaluating criteria should be lay down for different areas where iodine sources differs