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目的 调查研究目前碘营养状况下成人甲状腺肿大的病因。方法 随机选取 2 0 0 2年第一季度内分泌与代谢病专科门诊甲状腺肿大的初诊患者 10 0例 ,进行甲状腺功能、甲状腺自身抗体以及尿碘物质量浓度测定。结果 其中 4 1例诊断为格雷夫斯病 ,2 5例为慢性淋巴细胞性甲状腺炎 (又称桥本病 ) ,2 3例为单纯性甲状腺肿 ,10例为结节性甲状腺肿 ,1例为亚急性甲状腺炎。各组患者均表现女性占优势 ,结节性甲状腺肿组患者平均年龄明显高于其他各组 (P <0 0 1) ,各组患者尿碘水平分布差异无显著性 (P >0 0 5 )。所有患者中TPOAb与TGAb阳性率分别为 5 2 %与 4 6 % ,甲状腺自身抗体阳性组与抗体阴性组间尿碘的物质量浓度分布亦差异无显著性 (P >0 0 5 )。结论 在目前超足量的碘营养状况条件下 ,碘缺乏已不再是引起甲状腺肿大的主要原因。但长期暴露于高碘下 ,某些易感人群易发生自身免疫性甲状腺疾病。
Objective To investigate the etiopathogenisis of thyroid enlargement in adults under iodine nutrition. Methods A total of 100 newly diagnosed goiter patients with endocrinology and metabolic disease in the first quarter of 2002 were randomly selected for thyroid function, thyroid autoantibodies and urinary iodine. Results Of 41 cases, Graves’ disease was diagnosed, 25 cases were chronic lymphocytic thyroiditis (Hashimoto’s disease), 23 cases were simple goiter, 10 cases were nodular goiter, 1 case Subacute thyroiditis. The average age of patients with nodular goitre was significantly higher than that of other groups (P <0.01). There was no significant difference in the distribution of urinary iodine among all groups (P> 0.05) . The positive rates of TPOAb and TGAb in all patients were 52% and 46%, respectively. There was no significant difference in urinary iodine concentration between thyroid autoantibody positive group and antibody negative group (P> 0.05). Conclusions In the present situation of excessive iodine nutrition, iodine deficiency is no longer the main cause of thyroid enlargement. However, long-term exposure to high iodine, some susceptible populations prone to autoimmune thyroid disease.