低碘地区食盐加碘后人群碘营养状况调查

Investigation of the lodine nutrition status among the population in Chongqing after iodine supplementation

目的 :通过对正常成人和甲状腺肿伴甲亢患者的尿碘对比分析 ,掌握食盐加碘后重庆市区正常成人和甲状腺肿伴甲亢患者的碘营养状况。方法 :随机选取重庆市 4个区共 6个市级或中心医院门诊 4 2 3名正常成人和 5 76名甲状腺肿伴甲亢患者。所有调查对象接受有关甲状腺疾病的调查 ,体格检查 ,测定血清TT3 、TT4、TSH ,测定尿碘浓度。比较两个组人群尿碘中位数和尿碘频数分布。结果 :重庆市食盐加碘后正常成人和甲状腺肿伴甲亢患者的尿碘中位数分别为 2 4 7μg/L和 2 2 4 μg/L ,均明显高于重庆市食盐加碘前的水平 ;甲状腺肿伴甲亢患者的尿碘水平与正常成人无明显差异 (P >0 .0 5 )。有 4 7%正常人尿碘值介于 10 0 μg/L～ 2 0 0 μg/L ,17%甲状腺肿伴甲亢患者的尿碘值介于 10 0 μg/L～ 2 0 0 μg/L ,尿碘 <10 0 μg/L的患者占 33% ,尿碘 >2 0 0 μg/L的患者占 5 0 % ,即甲状腺肿伴甲亢患者的尿碘频数分布中尿碘低值和尿碘高值所占比例较大 (P <0 .0 1)。 结论 :合理补充碘盐能够纠正重庆市居民的碘缺乏状态 ,目前重庆市处于低碘性甲状腺肿伴甲亢和高碘性甲状腺肿伴甲亢的并存状态。

Objective:To evaluate iodine nutrition status in Chongqing after the program of iodized salt supplementation by appraising and analysing the urinary iodine of healthy subjects and patients with goiter and hyperthyroidism.Methods:423 healthy subjects and 576 patients with goiter and hyperthyroidism were randomly choosed from the clinic of College of Clinical Medicine in Chongqing Medical University and Chongqing University.They were respectively questioned about thyroid disorders,and received necessary physical examination.Their sera were measured for TT 3,TT 4,TSH.The urinary iodine was examined by spectrophotometer.Results:The median value of urinary iodine after iodine supplementation were 247μg/L and 224μg/L in normal subjects and patients respectively,which were higher than those before iodine supplementation,while a slight but insingnificant difference between normal subjects and patients were found ( P >0.01).The value of urinary iodine in 47% of normal subjects and 17% of patients were between 100μg/L and 200μg/L.The value of urinary iodine in 53% of patients were over 200μg/L and 33% of patients were lower than 100μg/L.Conclusion:The iodine deficiency is corrected by the supplementation of iodized salt,however,both higher and lower intake of iodine exist among the patients with goiter and hyperthroidism.