摘要
目的 探讨亚临床甲状腺功能异常的早期诊断和确定筛查对象 ,分析一般人群中TSH、甲状腺自身抗体 (TAA)、年龄和性别间的关系。方法 对西安地区某单位全体职工 2 0 5 6人进行血清TSH、总甲状腺素 (TT4)、总三碘甲酰原氨酸 (TT3 )、甲状腺球蛋白抗体 (TGAb)和甲状腺微粒体抗体 (TMAb) 5项指标检测 ,排除甲状腺疾病家族史、怀孕、服用性激素及锂剂等影响因素后确定亚临床甲状腺功能异常的患病率。结果 未诊断组中 (即研究总体中去除有甲状腺疾病史和家族史、怀孕、服用性激素、锂剂等药物者 )甲减患病率为 8.0 % ,甲亢患病率为 6.0 % ,其中 95 %以上为亚临床甲状腺功能异常。TSH值随年龄增长而增高 ;60～ 69岁组TSH值达峰 ,女性和男性的TSH值中位数分别达 2 .47mU /L和 3 .3 1mU/L ;TSH值性别间差异不显著。TSH值明显异常时 (TSH≥ 10mU /L或≤ 0 .13mU/L) ,仅有 <2 0 %个体TT3和 (或 )TT4值超出正常值。TAA阳性存在明显的性别间差异 ,女性较高 (P <0 .0 5 ) ,但各年龄组间分布较一致。TAA阳性率与TSH值有相关性 ,当TSH值明显异常时TAA阳性率也显著增高。结论 一般成年人群中亚临床甲状腺功能异常的患病率较高 ,应重视亚临床甲状腺功能异常的早期诊断和防治。
Objective To explore the early diagnosis of subclinical thyroid dysfunction and the interrelations among TSH, thyroid autoantibodies (TAAs), age and sex. Methods A total of 2056 adult members of a company in Xi′an area were included in this study. Fasting blood was collected in the morning for measurement of TSH, TT 4, TT 3, thyroglobulin antibody (TGAb) and thyroid microsome antibody (TMAb). The history of thyroid diseases, pregnancy, sex hormones and lithium intakes in the population were inquired individually. The undiagnosed subjects (the unidentified group) was determined by excluding those who were pregnant or had been diagnosed thyroiddiseasesbefore,or androgen,estrogenor lithium agents takers. Results The hypothyroidism and hyperthyroidism were found to be 8.0% and 6.0% respectively in the unidentified group, and over 95% of them had subclinical thyroid dysfunction. TSH value increased with aging and reached the peak level in 60-69 age group. The median TSH values were 2.47 mU/L and 3.31 mU/L in female and male populations respectively in 60-69 age group. This trend did not change when those with positive TAA were excluded. When the TSH values were significantly abnormal (TSH≥10 mU/L or ≤0.13 mU/L), TT 3 and/or TT 4 values were abnormal in less than 20% of the subjects. There was significant sex difference of positive TAA distribution, being higher in female (P< 0.05). The prevalence of TAA was not related with age, but was correlated with TSH variation. Conclusion The prevalence of subclinical thyroid dysfunction in adult population is high, so more attention should be paid to its early diagnosis and prevention.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2004年第6期490-493,共4页
Chinese Journal of Endocrinology and Metabolism
基金
陕西省攻关项目 (2 0 0 1K1 0G9)
