大骨节病病区乃当村学龄前儿童甲状腺激素水平调查

目的检测大骨节病区学龄前儿童甲状腺激素水平，探讨大骨节病的发病因素。方法纳入大骨节病区金川县河西乡乃当村1-6岁学龄前儿童，询问生活史、病史，查体并采血检测血清甲状腺激素水平。结果共采集到14名儿童的血标本，其中57．14％（8／14）儿童的TT3水平低于正常值，85．71％（12／14）儿童的FT3水平低于正常值，14名儿童TT3、FT3平均值均低于正常平均值，差异均有统计学意义（P〈0．00001）；但14名儿童TT4、FT4和TSH水平均在正常参考值范围内。结论大骨节病病区乃当村大部份学龄前儿童存在低T3血症，可能是KBD软骨病变的始动病因。建议将低T，血症作为评估大骨节病预防效果、早期监测和诊断临床前期或亚临床期的指标。

Thyroid Hormone Concentrations in Preschool Children in Kashin-Beck Disease Endemic Area

Objective To determine the thyroid hormone concentrations in preschool children in the Kasin- Beck disease (KBD) endemic area so as to explore the etiology of KBD. Methods Children of 1-6 years old in Naidang village, Jinchuan county, Sichuan Province, China were included. Physical examination was performed, personal history and medical history were collected, and blood samples were drawn for the determination of thyroid hormones. Results Blood samples were successfully collected from 14 children. Of them, 57.14% showed decreased TT3 levels, and 85.71% demonstrated decreased FT3 levels. All children showed significantly lower TT3 and FT3 average levels than the reference average value (P<0.000 01). The TT4, FT4 and TSH levels were within the normal range. Conclusion Most children in the KBD endemic area showed lower T3 levels, which may act as a key factor for cartilage hypogenesis. It is suggested that a decreased TT3 level be one of the indicators for the assessment of KBD preventative effect, early monitoring and diagnosis of preclinical or subclinical stage of KBD.