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目的调查海南省地方性甲状腺肿流行病学特点,并分析其干预措施。方法采取流行病学的调查方法对海南省2010年~2015年间的1200例地方性甲状腺肿患者的发病特点和发病趋势以及临床表现,并依据流行病特点进行制定干预措施。结果男性500例(比例41.7%),女性700例(58.3%),男性地方性甲状腺肿发病率明显的低于女性,数据比较差异有统计学意义(P<0.05)。地方性甲状腺肿患者的年龄分布比较广泛,年龄段为16~20、21~30、31~40、41~50、51~60、61~70、71~77,构成比分别为7.4%、10.1%、12.1%、14.1%、16.0%、17.2%、23.1%。2010年、2011年、2012年、2013年、2014年、2015年中地方性甲状腺肿发生率分别为31.7%、22.8%、18.2%、14.3%、8.7%、4.3%。B超检查地方性甲状腺肿主要分型为弥漫性肿、结节性肿、甲状腺瘤、胶质性肿和甲状腺癌,构成比分别为54.3%、30.1%、9.0%、4.8%、1.8%。地方性甲状腺肿临床分度表现为Ⅰ度、Ⅱ度和Ⅲ度以及Ⅳ度,构成比分别为91.3%、5.7%、2.1%、1.0%。地方性甲状腺肿患者饮用水含碘量为86-1895μg/L。其中,乡镇地区、县级地区、市级地区的饮用水含碘量分别为(1217.5±2311.7)、(756.3±99.6)、(174.7±21.6)μg/L,且市级地区饮用水含碘量明显的低于乡镇地区、县级地区饮用水含碘量,数据比较差异有统计学意义(P<0.05)。结论海南省地方性甲状腺肿患者流行病学特点相对比较明显,其发病可能与患者的生活水平以及碘摄入量有着关联,可以依据临床特征进行制定干预措施,改善海南省地区地方性甲状腺肿发病状况。
Objective To investigate the epidemiological characteristics of endemic goiter in Hainan Province and analyze the intervention measures. Methods Epidemiological survey method was used to analyze the onset, trend and clinical manifestations of 1200 cases of endemic goiter from 2010 to 2015 in Hainan Province. Interventions were made according to the characteristics of the epidemic. Results There were 500 males (41.7%) and 700 females (58.3%). The prevalence of endemic goiter in males was significantly lower than that in females (P <0.05). The age distribution of patients with endemic goiter is relatively extensive, the age range is 16 ~ 20,21 ~ 30,31 ~ 40,41 ~ 50,51 ~ 60,61 ~ 70,71 ~ 77, the constituent ratios were 7.4%, 10.1 %, 12.1%, 14.1%, 16.0%, 17.2%, 23.1%. The prevalence of endemic goiter in 2010, 2011, 2012, 2013, 2014 and 2015 were 31.7%, 22.8%, 18.2%, 14.3%, 8.7% and 4.3%, respectively. B ultrasound examination of endemic goiter mainly divided into diffuse swelling, nodular swelling, thyroid tumors, gliosis and thyroid cancer, the constituent ratios were 54.3%, 30.1%, 9.0%, 4.8%, 1.8%. The clinical grade of endemic goiter showed Grade I, Grade II and III and Grade IV, with the proportions of 91.3%, 5.7%, 2.1% and 1.0% respectively. Endemic goiter patients with drinking water iodine 86-1895μg / L. Among them, the iodine content of drinking water in township, county and municipal areas were (1217.5 ± 2311.7), (756.3 ± 99.6) and (174.7 ± 21.6) μg / L, respectively, and the iodine content of drinking water in municipal areas Significantly lower than the township areas, county-level drinking water iodine content, the difference was statistically significant (P <0.05). Conclusion The epidemiological characteristics of endemic goiter in Hainan Province are relatively obvious. The incidence may be related to the patient’s living standard and the iodine intake. Interventions may be made based on clinical features to improve the incidence of endemic goiter in Hainan Province situation.