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目的调查全民食盐加碘前后近20年第二军医大学长海医院甲状腺癌住院构成比的变化,探讨碘摄入和甲状腺癌发病之间的关系。方法对食盐碘化前后长海医院近20年收治的甲状腺疾病患者资料进行统计分析,计算每年的甲状腺癌构成比。依据年份将患者分为4组:1993-1997年间收治甲状腺疾病患者(A组),1998-2002年间收治甲状腺疾病患者(B组),2003-2007年间收治甲状腺疾病患者(C组),2008-2012年间收治甲状腺疾病患者(D组),比较各组间甲状腺癌构成比。结果 1994年立法全民补碘后,甲状腺癌构成比自1993年的11.36%(25/220)降至7.59%(18/237),但其后又逐渐增高,2012年时已达20.76%(318/1 532)。A、B、C、D组甲状腺癌的构成比分别为8.01%(112/1 398)、9.61%(241/2 508)、11.65%(501/4 299)、16.57%(1 101/6 645)。其中A、B(食盐碘化初期)年度段差异无统计学意义(P=0.095),而C、D(长期食盐碘化)年度段较A或B均有所增加(P<0.001)。结论短期补碘对甲状腺癌的发病可能有一定的抑制作用。补碘10年后甲状腺癌检出率明显增高,长期碘盐的摄入也许是原因之一。
Objective To investigate the change of inpatient thyroid cancer hospitalization ratio in Changhai Hospital of Second Military Medical University in the past 20 years before and after the universal salt iodization and to explore the relationship between iodine intake and the incidence of thyroid cancer. Methods The data of patients with thyroid diseases admitted to Changhai Hospital in the past 20 years before and after salt iodization were statistically analyzed, and the annual thyroid cancer composition ratio was calculated. Patients were divided into 4 groups according to years: patients with thyroid disease (group A) were treated during 1993-1997, patients with thyroid disease were treated during 1998-2002 (group B), patients with thyroid disease were treated during 2003-2007 (group C) In 2012, patients with thyroid disease were treated (group D), and the thyroid cancer composition ratio was compared among the groups. Results In 1994, after iodine was added into the whole population, the thyroid cancer composition ratio dropped from 11.36% (25/220) in 1993 to 7.59% (18/237), but then gradually increased. It reached 20.76% (318 / 1 532). The constituent ratios of thyroid cancer in groups A, B, C and D were 8.01% (112/1 398), 9.61% (241/2 508), 11.65% (501/4 299), 16.57% (1 101/6 645) ). There was no significant difference between years A and B (P = 0.095), but C and D (P <0.001) more than A or B in years of salt iodization. Conclusion Short-term iodine supplement may have certain inhibitory effect on the incidence of thyroid cancer. After 10 years of iodine iodine detection rate of thyroid cancer was significantly increased, long-term intake of iodized salt may be one of the reasons.