地方性克汀病

在较严重的地方性甲状腺肿流行地区出现的一种地方病。其特征为呆、小、聋、哑，故又称地方性呆小病。可能是因胚胎时期，甲状腺激素供应不足，使患者出生后表现为不同程度的发育迟缓、智力低下，听力、语言障碍，重者有神经运动障碍。有的还有黏液性水肿及其他甲状腺功能低下症等。预防本病首先在于防治地方性甲状腺肿，对育龄妇女可肌注碘油或口服碘剂和甲状腺制剂。婴幼儿一旦发现可疑症状，应尽早持续服用甲状腺制剂。     

硒缺乏与地方性克汀病的抗氧化酶活性,甲状腺功能和形态关系的…

报告了辽宁省缺碘，缺硒的地甲病区３１例地方性汀克病（简称地克病）和３０例病区健康人对照组红细胞硒含量，抗氧化酶及脂质过氧化物水平测定结果，表明地克病患者红细胞硒含量及抗氧化酶活性不低于病区健康人而脂质过氧化物水平则高于病区健康人，病区低硒致地克病患者体贫硒，细胞抗过氧化防御能力下降，可能对地克病患者甲状腺功能和形态引起过氧化损害。     

第三节 甲状腺功能减退症

甲状腺功能减退症（简称甲减症）是指由于不同原因引起的体内甲状腺激素缺乏，机体的代谢和身体的各个系统功能减退而引起的临床综合征，也是较常见的内分泌疾病。各种年龄段均可发生，以女性居多。典型的成年人甲状腺功能减退也称黏液性水肿，由本病引发昏迷者称黏液水肿昏迷。于胚胎期起病者，称克丁病或呆小病。有学者将儿童起病者称为幼儿黏液水肿。     

地方性克汀病诊断新标准发布

<正>2015年1月4日,国家卫生计生委发布推荐性卫生行业标准《地方性克汀病和地方性亚临床克汀病诊断》,该标准自2015年4月1日起施行,原卫生部于1999年发布的旧版诊断标准同时废止。地方性克汀病(地克病)和地方性亚临床克汀病(亚克汀)是由碘缺乏所造成的、以精神发育迟滞为主要特征的神经-精神综合征。新标准明确适用范围限定在我国碘缺乏地区,基本沿用了原来的地克病     

地方性甲状腺肿

我国目前重点防治的一种地方病。主要由地区性缺碘引起，是一种主要的碘缺乏病（IDD）。有些地方，食物和饮水中的致甲状腺肿或影响碘吸收的物质，对本病的发生发展也起一定作用。临床表现主要是甲状腺肿大，轻者无明显症状，重者可压迫邻近器官而产生各种症状，甲状腺功能大多正常。本病多流行于山区、半山区，近年来在某些平原或沿海地区也有发生，但程度较轻，可用1／2万～1／5万的碘盐或肌肉注射碘油防治，口服各种碘剂、甲状腺制剂以及碘酊局部注射等都有明显疗效。巨大、结节型有压迫症状者需手术治疗。     

青岛市市北区2005、2006年碘盐检测结果分析

碘是极为重要的微量元素，是人体合成甲状腺激素的重要元素。碘元素缺乏，不仅能引起地方甲状腺肿和地方性克汀病等疾病，还会影响婴幼儿大脑发育、智利发育以及后期的智商，而碘摄入过多亦会引起碘性甲亢、自身免疫性甲状腺疾病。为防止过高或过低摄入碘而影响居民的身体健康，每年3、4月我们对居民家中食用盐进行一次测碘抽查。     

先天性甲状腺功能减低症病因研究

先天性甲状腺功能减低症（C0ngenital Hypothyroidism，CH），是一种比较常见的内分泌代谢疾病，该病分为2类：散发性和地方性。散发性CH是因先天性甲状腺发育不良或甲状腺激素合成途径中酶缺陷造成；地方性CH多见于甲性腺肿流行地区，由于该地区水、土和食物中碘缺乏所致，而随着我国广泛使用碘化食盐作为防治措施，患病率已明显下降。     

甲减的饮食调理

甲减的全称是甲状腺功能减退症，指甲状腺由于各种原因不能产生足够的甲状腺激素来满足人体的正常需要。常出现怕冷、出汗减少、皮肤干燥、表情迟钝、心率减慢、食欲不振、大便干燥及疲乏无力等临床表现。临床甲减的患病率为1％左右，女性较男性多见，随年龄增加患病率上升。功能减退始于胎儿或新生儿者称呆小病；起于青春期发育前儿童者，称幼年型甲减；起病于成年者为成年型甲减。重者可引起黏液性水肿，更为严重者可引起黏液性水肿昏迷。     

甘肃省地方性克汀病生态流行病学分布特征

目的了解甘肃省不同生态类型区现存地方性克汀病(以下简称地克病)患者的生态流行病学分布特征。方法于2011年,村-乡-县逐级查阅历史地克病病例资料,对1985年普查的历史病例进行核实和登记,同时按照《中央转移支付碘缺乏病防治项目的高危地区监测方案》和WS 104—1999《地方性克汀病和地方性亚临床克汀病诊断》搜索和诊断历史克汀病病区及碘缺乏病高危地区1985年以后出生的地克病患者,建立甘肃省现存地克病数据库。结果 2011年全省现存地克病病例4 715例,地克病患病率为3.74/万;6个生态类型区中,荒漠区无地克病病例,秦岭中山峡谷区和黄土高原丘陵区地克病病例分别占总数的57.5%和33.2%。男、女地克病例的比例分别为70%和30%,不同生态区男性地克病病例比例均高于女性(P0.05);新发地克病7例,其中甘南高原草原草甸区3例,其他生态区各1例;神经型、黏肿型和混合型三种病理类型的地克病病例分别占58.8%,9.8%和31.4%,河西走廊戈壁区和甘南高原草原草甸区100%为神经型,其他生态区神经型病例比例在40%~70%之间。结论甘肃省地克病病例在不同生态类型区分布特征不同,在实施全民食盐加碘防治碘缺乏病的同时,要考虑生态类型区其他因素对碘缺乏病防治的影响。     

A controlled trial of iodinated oil for the prevention of endemic cretinism: a long-term follow-up

A double blind controlled trial designed to examine the effectiveness of intramuscular iodinated oil as a prophylactic for the nervous type of endemic cretinism was begun in 1966 in the highlands of Papua New Guinea. Infants born into the trial between 1966 and 1972 were followed up until 1982. The results showed that if the iodine supplement was given before conception the nervous form of endemic cretinism was prevented. Also a striking difference in the 15-year cumulative survival rate in favour of the test (iodinated oil) group was observed. Measures of motor and intellectual function revealed that children born to mothers given an iodine supplement performed significantly better. This observation shows that iodine deficiency leads to sub-clinical as well as clinical deficits. It also justifies the use of the term iodine deficiency disorder to cover the polymorphic nature of the abnormalities attributable to iodine deficiency.     

Strategy of goitre and cretinism control in Central Africa.

Goitre prevalence in Ubangi Mongala (north-western Za?re) ranges from 27 to 60 per cent in the male population and from 48 to 78 per cent in the female population; the prevalence of cretinism ranges between 0.7 and 7.6 per cent. This severe endemia affects 1.5 million inhabitants and constitutes a major public health problem. If administered to an entire population, single injections of slowly resorbable iodized oil can reduce goitre prevalence substantially, correct the iodine deficiency and restore normal thyroid function for a period of 3 to 7 years, depending on the parameter considered. The cost of programme of endemic goitre prevention based on this method can be estimated at 0.07 US dollars per person and per year of protection. A strategy of goitre and cretinism control in Central Africa, using iodized oil in an attack phase and iodized salt in a follow-up phase, is proposed. The organization of this programme will be dovetailed into other public health activities and will strengthen the basic health service framework.     

Iodine and selenium deficiency associated with cretinism in northern Zaire

Selenium status was determined in an endemic-goiter area and in a control area of Zaire. Compared with the reference values of a noniodine-deficient area, serum selenium in subjects living in the core of the northern Zaire endemic-goiter belt (Karawa villages) was seven times lower in 52 school-children and similarly low in 23 cretins; erythrocyte glutathione peroxidase (RBC-GPX) was five times lower in schoolchildren and still two times lower in cretins (P = 0.004). In a less severely iodine-deficient city of the same endemia (Businga), selenium status was moderately altered. RBC-GPX activity was linearly associated with serum selenium concentration up to a value of 1140 nmol/L and leveled off at approximately 15 U/g Hb at greater selenium concentration. At Karawa villages, selenium supplementation normalized both the serum selenium and the RBC-GPX. This combined iodine and selenium deficiency could be associated with the elevated frequency of endemic myxedematous cretinism in Central Africa.