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本文对实施1/2万碘盐为主的综合性防治措施,地甲病基本控制阶段流行病学规律进行了探讨。通过470962人的病情调查资料分析,显示居民患病率、7—14岁中小学生肿大率较防治前显著降低。罹病程度依然是重1=3.07%>重2=2.22%>轻=1.55%。患病率与年龄的关系,由防治前的少、青、中年患病率最高,改变为患病率随年龄增高而增高。10岁以上各年龄组,男女患病率有显著差异,因此。男女患病率比值应以10岁以上调查对象的统计结果计算,结果分别为重11:2.48、重21:2.98轻1:3.84。现患病人的分型构成与病区类型、年龄、性别有关;分度构成表现为Ⅰ—Ⅱ°病例占现患的绝大部分。4119份尿碘分析表明,居民缺碘巳得到纠正。居民尿碘均值在150—200μg/gCr。各类病区的均值有一定的差别,该差别可能是外环境缺碘程度不同所致。出于碘盐加工不匀,保管不善和碘剂的重复使用,尿碘实际排泄量与理论获碘量不符,尿碘低于25ug/ger 和高于1000ug/ger 者仍占一定比例。病区健康人,生理增大和现患病人的尿碘水平无显著差异。24小时甲状腺摄~(131)碘率显著降低,重1为18.83±8.36%,重2为16.20±10.02%轻为6.77±6.76%。血请 TT_3,TT_4和 TSH 测定结果均在正常范围,无发现甲亢、甲低病例。根据本文研究结果可以预测,在一定条件下,经过一定时期,地甲病流行病学规律仍会发生改变。我们认为,目前大面积的地甲病防治工作,应抓好碘盐质量、碘盐质量监测和病情监测工作。在保证碘盐从加工到食用过程中碘丢失降低到最低程度的情况下,可以考虑降低碘盐浓度。对于现患病人的治疗,弥漫型应根据尿碘水平决定治疗措施,结节、混合型则应手术治疗,不应盲目重复使用碘剂。由于诊断水平和手段的局限,现患病人中有一部分病例属于其他甲状腺疾病,应普及和提高甲状腺疾病的诊断水平,使这部分病人得到及时、合理的治疗。
This article on the implementation of 1/2 million iodized salt-based comprehensive prevention and control measures, the basic control phase of endemic disease epidemiology were discussed. Through the analysis of the data of 470962 people, the prevalence rate of residents, primary and secondary school students aged 7-14 are significantly lower than before. The prevalence remained at 1 = 3.07%> 2 = 2.22%> = 1.55%. Prevalence and age of the relationship between pre-control less, blue, middle-aged highest prevalence, change to prevalence increased with age. The prevalence of men and women in each age group over the age of 10 was significantly different, therefore. The prevalence ratio of men and women should be calculated based on the statistical results of the survey subjects over the age of 10, the results were 11: 2.48 weight, 21: 2.98 light weight 1: 3.84. The current type of patients with the ward constitute the type of ward, age, gender; indexing constitutes the performance of Ⅰ-Ⅱ ° patients accounted for the vast majority of patients. 4119 urine iodine analysis shows that residents have been corrected for iodine deficiency. Urinary iodine average residents in the 150-200μg / gCr. There is a certain difference between the mean values of various wards, which may be due to the different levels of iodine deficiency in the external environment. Out of iodine salt processing uneven, poor storage and iodine reuse, actual urinary iodine output and the theory of iodine content does not match, urinary iodine below 25ug / ger and higher than 1000ug / ger who still account for a certain proportion. Ward health, physical growth and current patients with urinary iodine levels no significant difference. 24 hour thyroid uptake of 131 iodine rate was significantly reduced, weight 1 was 18.83 ± 8.36%, weight 2 was 16.20 ± 10.02% light 6.77 ± 6.76%. Blood TT_3, TT_4 and TSH determination results are in the normal range, no cases of hyperthyroidism, hypothyroidism. According to the results of this study, we can predict under certain conditions, after a certain period of time, epidemiological rules of tomahya will still change. In our opinion, the current large area prevention and treatment of gouty disease should pay attention to the quality of iodized salt, iodized salt quality monitoring and disease monitoring. In ensuring the iodine salt from processing to consumption of iodine in the process to minimize the case of the situation, you can consider reducing iodized salt concentration. For the treatment of patients with prevalent, diffuse type should be based on the level of urinary iodine treatment decisions, nodules, mixed surgical treatment should be, should not be blindly repeated use of iodine. Due to the limitations of the diagnostic level and means, some patients are currently suffering from other thyroid diseases. The diagnosis of thyroid diseases should be popularized and be improved so that these patients can get timely and reasonable treatment.