摘要
目的 研究补碘对缺碘人群甲状腺功能及甲状腺疾病发病的影响。方法 动态观察了缺碘机体口服碘油前后甲状腺激素水平及其异常值变化和受检者的临床表现。结果 补碘使缺碘人群的甲状腺肿大率和患病率显著下降 ,但早期引起缺碘机体甲状腺激素水平异常变化导致甲状腺功能紊乱 ,后期因缺碘造成的甲状腺功能高代偿状态趋于正常。补碘前TSH和FT3 高于正常值上限的比例均明显多于低于下限的比例 ,FT4低于下限的比例则明显低于高于上限的比例。补碘 3个月TSH和FT3 高于上限的比例均明显下降 ,低于下限的比例则均明显增多 ;6、12个月FT4高于上限的比例显著增多。补碘前临床甲亢、甲减和甲状腺瘤的检出率分别为 0 .11%、0 .0 6%和 0 .17% ,亚临床甲减检出率为 1.4%。 3、6、12个月的流行病学调查均未发现有甲状腺疾病新发病例 ,但是亚临床甲亢的检出率则分别升为 5 .1%、9.4%、6.0 %且多发于成年女性甲状腺肿患者和补碘 12个月内 ,亚临床甲减的检出率分别为 16.5 %、1.6%、2 .4% ,且多发于成年女性和补碘 3个月内。结论 补碘虽未增加缺碘人群临床甲亢或甲减发病率 ,但早期可造成部分机体甲状腺功能紊乱出现亚临床甲亢和甲减发病率一过性升高 ;其检出率与性别、年龄、有无甲状腺肿和补碘时间有关。
Objective To observe the effects of supplying iodine on thyroid function and thyroid disease in iodine deficiency subjects.Methods The levels and abnormal rates of thyroid hormones and clinical symptoms of cases with thyroid disease were observed in inhabitants in iodine deficiency area before and after oral iodized capsule were administrated.Results Supplying iodine for the inhabitants could decrease significantly goiter prevalence,but it caused the abnormal changes of thyroid hormone levels and resulted in the disorders of thyroid function at early period.At last period the status of high compensatory of thyroid function caused by iodine deficiency was nearly normal.Before supplying iodine,the abnormal rates of TSH and FT 3 which exceeded upper limit of normal lower limit was markedly more than that over upper limit.The abnormal rates of TSH and FT 3 over upper limit were decreased markedly,but their rates of under lower limit were all higher than those over upper limit after 3 months.The rates of FT 4 over upper limit for 6 or 12 months after iodine supplement were higher than those before administration.Before supplying iodine the rates of clinical hyper-or hypothyroidism and thyroid adenoma were 0.11%,0.06% and 0.17% respectively.The rate of subclinical hypothyroidism was 1.4%.Each follow-up to the subjects none of clinical thyroid disease with symptom had found for 3,6 or 12 months after iodine supplementation.But the rates of subclinical hyperthyroidism reached 5.1%,9.4% and 6.0% respectively,these cases were all adult women with goiter and happened within 12 months.The rates of subclinical hypothyroidism for 3 check-ups reached 16.5%,1.6% and 2.4% respectively,these cases were all adult women and happened within 3 months.Conclusion Iodine supplement for the subjects with iodine deficiency seems not to increase the incidences of clinical hyper-or hypothyroidism.But it might result in the disorders of thyroid function in some subjects,and might increase significantly the incidences of subclinical hyper-or hypothyroidism of short duration.The rate of subclinical thyroid diseases concerned sex,age,goiter and time and so on.
出处
《中国地方病防治》
2004年第4期200-203,共4页
Chinese Journal of Control of Endemic Diseases
基金
山东省卫生厅基金资助项目 (1 995CA1DK1 )
