摘要
甲状腺功能减退症(简称甲减),是多种原因引起的甲状腺激素合成、分泌或生物效应不足所致的一组内分泌疾病。仅有血清促甲状腺激素(TSH)水平轻度升高,而游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))水平正常,患者无甲减症状或仅有轻微甲减症状,称为亚临床甲状腺功能减退症(简称亚临床甲减)。普遍食盐加碘干预措施在我国已实施20年,虽然碘缺乏症得到了有效控制,但摄入过量碘的风险一直存在争议。本研究主要关注亚临床甲减的流行病学特征,探讨碘摄入量与亚临床甲减的关系。利用中国知网和PubMed中英文数据库,以“亚临床甲状腺功能减退”“碘”和“促甲状腺激素”为关键词,主要检索2015-2021年相关文献。纳入标准:(1)甲减与亚临床甲减的流行病学特征;(2)亚临床甲减的病因及其转归;(3)碘摄入量与亚临床甲减的关系。剔除标准:(1)年份较远的综述类文献;(2)文章质量较差、语序较乱的文献。最终纳入39篇文献。结果显示,长期过量碘摄入影响甲状腺功能,所致甲状腺疾病患病率明显上升,其中亚临床甲减患病率呈增加趋势。通过实施以全民食盐加碘为主的综合防治措施,人群碘营养状况总体得到改善,但是仍然需要加强碘摄入量监测评估,进一步加强和完善消除碘缺乏病的长效工作机制,指导相关部门做好科学补碘工作,控制和制订因人而异、因地而异的碘摄人量。同时,应重视亚临床甲减的临床和流行病学研究,提出符合我国特点的预防、筛查和治疗策略。
Hypothyroidism(hypothyroidism for short)is a group of endocrine diseases caused by insufficient synthesis,secretion or biological effects of thyroid hormones.Only the serum thyroid stimulating hormone(TSH)level is slightly elevated,while the free triiodothyronine(FT_(3))and free thyroxine(FT_(4))levels are normal,the patients have no hypothyroidism symptoms or only slight hypothyroidism symptoms,which is called subclinical hypothyroidism(subclinical hypothyroidism for short).Universal salt iodization intervention has been implemented in China for 20 years.Although iodine deficiency disorders have been effectively controlled,the risk of excessive iodine intake has been controversial.This study focused on the epidemiological characteristics of subclinical hypothyroidism,and explored the relationship between iodine intake and subclinical hypothyroidism.Using the Chinese and English databases of CNKI and PubMed,the relevant literatures from 2015 to 2021 were mainly searched with the keywords"subclinical hypothyroidism","iodine"and"thyroid stimulating hormone".Inclusion criteria:(1)Epidemiological characteristics of hypothyroidism and subclinical hypothyroidism;(2)The etiology and outcome of subclinical hypothyroidism;(3)The relationship between iodine intake and subclinical hypothyroidism.Exclusion criteria:(1)Review literature with a long history;(2)Documents with poor quality and disordered word order.Finally,39 literatures were included.The results showed that long-term excessive iodine intake affected thyroid function,resulting in a significant increase in the prevalence of thyroid diseases,of which the prevalence of subclinical hypothyroidism was increasing.Through the implementation of comprehensive prevention and control measures focusing on universal salt iodization,the iodine nutritional status of the population had been improved in general.However,it was still necessary to strengthen the monitoring and evaluation of iodine intake,further strengthen and improve the long-term working mechanism for eliminating iodine deficiency disorders,guided relevant departments to do a good job in scientific iodine supplementation,and controled and formulated iodine intake that varies from person to person and from place to place.At the same time,we should pay attention to the clinical and epidemiological research of subclinical hypothyroidism,and put forward the prevention,screening and treatment strategies in line with the characteristics of our country.
作者
韩永刚
HAN Yong-gang(Department of Environmental Health,Binhai New Area Centers for Disease Control and Prevention of Tianjin,Tianjin 300450,China)
出处
《社区医学杂志》
CAS
2022年第8期471-474,共4页
Journal Of Community Medicine
关键词
亚临床甲状腺功能减退
碘
促甲状腺激素
综述文献
subclinical hypothyroidism
iodine
thyroid-stimulating hormone
review literature
