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目的了解乐昌市克汀病老病区与非病区人群尿碘水平及甲状腺结节的分布。方法选择克汀病老病区的乐昌市大源镇和非病区的乐城镇按分层整群方法抽取10~60岁常住居民共648名,进行甲状腺超声检查、盐碘、尿碘含量检测。结果克汀病老病区人群尿碘水平高于非病区人群,尿碘中位数分别为175.9μg/L和138.7μg/L,其中分布于200μg/L及以上的比重高于非病区人群,差异有显著性(P=0.001);克汀病老病区与非病区人群甲状腺结节检出率分别为21.17%和20.10%,差异无显著性。克汀病老病区与非病区人群各年龄组的检出率均以40岁组及以上明显上升,分别为21.12%~38.96%之间和19.77%~38.20%之间,差异均有显著性(分别P=0.000)。结论乐昌市克汀病老病区与非病区人群尿碘中位值均处于适宜水平,甲状腺结节检出率差异无显著性。表明实行食盐加碘为主的综合防治措施对碘缺乏病控制效果明显,目前尚无更多或充分的流行病学依据予以论证碘的过量摄入及其可致其他甲状腺疾病的增高。
Objective To understand the urinary iodine level and the distribution of thyroid nodules in old and non-endemic areas of old patients with cretinism in Lechang. Methods A total of 648 permanent residents aged 10-60 years were selected by Dayun Town of Lechang City and Lecheng Town of non-endemic area in the old endemic area of cretinism. Thyroid ultrasonography, salt iodine and urinary iodine contents were detected . Results The urinary iodine level in the elderly patients with cretinism was higher than that in the non-endemic areas, and the median urinary iodine was 175.9μg / L and 138.7μg / L, respectively. The proportion of urinary iodine distributed in 200μg / L and above was higher than that in non- (P = 0.001). The detection rates of thyroid nodules in old and non-endemic areas of cretinism were 21.17% and 20.10%, respectively, with no significant difference. The detection rate of each age group in the old and the non-ward patients with cretinism were all significantly increased from 40 to 40 years old and above, ranging from 21.12% to 38.96% and from 19.77% to 38.20% respectively, the differences were significant (P = 0.000 respectively). Conclusions The median urinary iodine value of the elderly patients with and without cingulumosis in Lechang City is in an appropriate level, and there is no significant difference in the detection rate of thyroid nodules. It shows that the comprehensive prevention and control measures based on salt iodization are effective in controlling iodine deficiency disorders. There is no more or sufficient epidemiological evidence to prove the excessive intake of iodine and its increase in other thyroid diseases.