武汉市8 ~ 10岁儿童甲状腺容积校正方法研究

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目的:了解不同甲状腺容积校正方法对武汉市学龄儿童的适用性,探索适宜武汉市学龄儿童的甲状腺容积的校正方法。方法:2019年5 - 8月,在武汉市洪山、汉阳、汉南、江夏、东西湖区,按东、西、南、北、中5个方位划分5个抽样片区,每个片区抽取1所小学,每所小学抽取8 ~ 10岁非寄宿学生40人(性别均衡)作为调查对象,采集随机1次尿样、家庭食用盐盐样检测尿碘、盐碘含量,测量儿童身高、体重、甲状腺容积。同时,采用身高容积指数1(HVI1)、体重身高容积指数(WHVI)、体质容积指数(BMIV)、体表面积容积指数(BSAV)和身高容积指数2(HVI2)对甲状腺容积进行校正。结果:共调查8 ~ 10岁儿童1 000人,其中男生499人、女生501人;8、9、10岁儿童各269、321、410人。尿碘中位数为247.50 μg/L;盐碘中位数为23.20 mg/kg;身高、体重、甲状腺容积分别为140.00(133.00,146.00)cm、31.00(27.00,37.00)kg、2.56(2.13,3.21)ml。共检出甲状腺肿大儿童30人,甲状腺肿大率为3%(30/1 000)。男、女生甲状腺容积分别为2.57(2.16,3.28)、2.56(2.10,3.16)ml,不同性别间比较差异无统计学意义(n U = - 0.981,n P > 0.05)。8、9、10岁儿童甲状腺容积分别为2.31(1.98,2.81)、2.68(2.13,3.30)、2.74(2.28,3.35)ml,不同年龄间比较差异有统计学意义( n H = 47.585,n P < 0.01)。经Spearman相关分析,8、9、10岁儿童原始甲状腺容积与身高、体重均呈正相关( n P均 0.05),与体重呈正相关( n P < 0.01);9、10岁儿童甲状腺容积与身高、体重均呈正相关( n P均< 0.01)。经WHVI校正后,8、9、10岁儿童甲状腺容积与身高、体重均呈负相关(n P均< 0.01)。经BMIV校正后,8、9、10岁儿童甲状腺容积与身高均呈正相关(n P均< 0.01);10岁儿童甲状腺容积与体重呈负相关(n P < 0.05)。经BSAV校正后,9岁儿童甲状腺容积与体重呈正相关( n P < 0.05)。经HVI2校正后,9岁儿童甲状腺容积与体重呈正相关( n P 0.05). The thyroid volumes of children aged 8, 9 and 10 years old were 2.31 (1.98, 2.81), 2.68 (2.13, 3.30) and 2.74 (2.28, 3.35) ml, respectively, and the differences were statistically significant ( n H = 47.585, n P < 0.01). Spearman correlation analysis showed that the original thyroid volume was positively correlated with height and weight in children aged 8, 9 and 10 years old ( n P 0.05), but thyroid volume was positively correlated with weight ( n P < 0.01); thyroid volume was positively correlated with height and weight in children aged 9 and 10 years old ( n P < 0.01). After WHVI correction, the thyroid volumes of children aged 8, 9, and 10 years old were negatively correlated with height and weight ( n P < 0.01). After BMIV correction, the thyroid volume was positively correlated with height in children aged 8, 9, and 10 years old ( n P < 0.01); thyroid volume was negatively correlated with weight in children aged 10 years old ( n P < 0.05). After BSAV correction, thyroid volume was positively correlated with weight in children aged 9 years old ( n P < 0.05). After HVI2 correction, thyroid volume was positively correlated with weight in children aged 9 years old ( n P < 0.01). The thyroid volume obtained by the 5 correction methods were all smaller than the original thyroid volume, and the thyroid volume after BSAV correction was the closest to the original thyroid volume, with a difference of 0.87% - 13.87%.n Conclusions:The thyroid volume of school-age children in Wuhan is affected by age, height, and weight, judgment of goiter should be corrected for these factors. BSAV is relatively independent and stable, it can eliminate the effect of height and weight on thyroid volume. It is initially considered that BSAV is suitable for the correction of thyroid volume in school-age children in Wuhan.
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