影响甲状腺容积相关因素分析

甲状腺肿是碘缺乏病的一种表现形式 ,也是评价碘缺乏病防治情况的指标。为探讨影响甲状腺大小的相关因素 ,以指导今后的工作 ,对我市 172名8～ 10岁在校甲状腺肿学生进行分析 ,结果如下 :1　材料与方法1.1　研究对象　碘缺乏病病情监测中B超法检测甲状腺肿大的 8～ 10岁在校儿童 172人 ,其中男 87人 ,女 85人。1.2　方法　甲状腺容积测量采用 B超法 ,身高和体重采用同一体重称和身高尺。1.3　判定标准　甲状腺肿大的判定采用 GB16 0 0 6— 1995《碘缺乏病消除标准》。2　结果2 .1　甲状腺容积与性别的关系　在被调查的 172名甲状腺肿大儿…     

重庆市普供碘盐5年防治碘缺乏病效果观察

目的 评价重庆市碘盐防治碘缺乏病的效果。方法 用直接滴定法检测居民户盐碘含量；用B超法和触诊法检查8～10岁儿童甲状腺，同时检查儿童尿碘含量。结果 5年碘盐覆盖率为90．08％～98．17％，合格碘盐食用率为83．00％～89．58％；触诊法和B超法检查8～10岁儿童甲状腺肿大率，1999年(23．75％和23．58％)均较1997年(18．33％和17．42％)显著升高，但甲状腺容积呈下降趋势；2002年8～10岁儿童甲状腺肿大率(14．18％和13．50％)和甲状腺容积均显著下降。结论 重庆市普供碘盐防治碘缺乏病2年病情无显著变化，5年效果显著。     

8～10岁儿童甲状腺容积变化分析

吉林省是历史上碘缺乏病流行的重病区。儿童甲状腺肿大是缺碘的主要体征，为了判定甲状腺大小，选用B超法测量甲状腺容积，成为评价碘缺乏危害严重程度的1个重要指标。现将1995～2002年4次全国性监测及1次达标监测的儿童甲状腺容积变化情况进行分析。     

对8～10岁学生甲状腺B超检查方法的探讨

B超可以客观地描述甲状腺真实状况，并具有可靠、可重复、无创伤的优点，在碘缺乏病防治工作中作为判定甲状腺肿大与否的金标准已被肯定和接受。8～10岁学生甲状腺肿大情况是碘缺乏病病情监测和防治效果评价工作的一项重要检查指标，在实际工作中我们根据8～10岁学生的生理解剖特点，采用了一种比国家标准简便的B超检     

B超法和触诊法诊断甲状腺肿大的比较分析

Ｂ超法和触诊法是碘缺乏病监测工作中检查甲状腺肿大的两种方法。为了解两种方法在碘缺乏病防治监测中的应用价值,本文对５２７名学龄儿童甲状腺采用触诊法和Ｂ超法同步诊断的结果进行了如下分析。１　材料与方法１１　调查对象：碘缺乏病区８～１０岁在校儿童。１２　诊断标准：地方性甲状腺肿的诊断及分度标准和儿童少年甲状腺容积正常值,均按１９９６年国家技术监督局和卫生部颁布的国标执行。２　结果２１　触诊法与Ｂ超法诊断结果：共检查８～１０岁学生５２７名,触诊法甲状腺Ｉ度肿大人数６９人,Ⅱ度肿大人数５人,肿大率…     

黑龙江省碘缺乏病监测结果分析

按照《全国碘缺乏病病情监测方案》及全国碘缺乏病监测工作会议的要求 ,我省于 1995、1997、1999年连续开展了 3轮碘缺乏病病情监测工作 ,现将监测结果分析如下 :1　监测结果1.1　 8～ 10岁儿童甲状腺检查　 1995年第 1轮监测我们采用触诊法检查小学生甲状腺 ,检出 度甲状腺肿大 2 92人 , 度甲状腺肿大 36人 ,肿大率为2 3.17%。 1997年第 2轮监测同样触诊法检查小学生甲状腺检出 度甲状腺肿大 10 5人 , 度甲状腺肿大 5人 ,肿大率为 9.17%。 1999年第 3轮监测采用 B超法及触诊法检查小学生甲状腺 ,触诊法检出 度肿大 73人 , 度未检出 ,肿…     

甲状腺体积校正指数作为儿童甲状腺肿大判定指标的可行性研究

甲状腺体积校正指数作为儿童甲状腺肿大判定指标的可行性研究刘德润许瑞霞张纯德贾清珍张永平米尔芳在碘缺乏病（ＩＤＤ）病情判定时，触诊法和Ｂ超法是各国用来检查甲状腺肿大的常用方法，然而在具体检查和判定中，由于各种因素的影响，两法均可产生较大的诊断误差。本文...     

甲状腺峡部厚度对甲状腺触诊和B超诊断的影响

甲状腺峡部厚度对甲状腺触诊和Ｂ超诊断的影响杨小静蔡卫刘汉军谢怀芳评价甲状腺肿目前主要有触诊法和Ｂ超法。但多数文献报道同步完成的Ｂ超肿大率与触诊肿大率不一致。Ｂ超计算甲状腺容积时未包括甲状腺峡部容积在内，甲状腺峡部厚度对甲状腺肿的诊断是否有影响，影响程...     

2004年齐齐哈尔市龙沙区碘缺乏病调查结果分析

为了解和掌握齐齐哈尔市碘缺乏病防治现状,为今后防治碘缺乏病提供科学依据。按照《全国消除碘缺乏病监测方案》的要求,于2004年6月对龙沙区大民镇大民村小学校8～10岁儿童进行了碘缺乏病调查。结果报告如下。1材料与方法随机采集107名8～10岁儿童检测尿样和各自家盐样,同时用触诊法和B超检查儿童甲状腺大小。尿碘测定采用砷铈催化分光光度测定法(WS/T107-1999);盐碘测定采用直接滴定法(CB/T13025.7-1999);甲状腺肿检查,触诊法按(GB16006-1995);B超测量法按(GB16398-1996)。2结果共检查学生107人,触诊法检出甲状腺肿大9人,其中Ⅰ度肿大…     

2017—2021年蚌埠市儿童碘营养状况及甲状腺容积影响因素分析

目的 分析蚌埠市儿童碘营养状况和甲状腺容积影响因素，为蚌埠市儿童科学合理的补碘措施提供理论指导和数据支持。方法 蚌埠市7个地区随机抽取7 000名儿童，进行尿碘含量检测，甲状腺、身高和体重检查。结果 不同年份、不同地区、不同性别间儿童尿碘水平存在统计学差异(P<0.001),不同年龄学生尿碘水平差异没有统计学意义(P>0.05)。不同地区儿童甲状腺容积差异有统计学意义(H=92.101,P<0.001),不同地区儿童甲状腺肿大率差异没有统计学意义(P>0.005)。儿童尿碘浓度水平和体质指数(BMI)、体表面积(BSA)、地区存在正相关，与年龄、性别不存在相关。儿童甲状腺容积和尿碘、年龄、BMI、BSA存在正相关。影响儿童甲状腺容积的独立因素有尿碘、年龄、BSA,影响因素由大至小依次是BSA、年龄、尿碘。结论 总体儿童甲状腺肿大率处于较低水平，总体碘营养为超适宜量水平，但存在儿童缺碘和碘过量问题。影响蚌埠市儿童甲状腺容积的最大独立因素是BSA。     

Does the use of mean or median Z-score of the thyroid volume indices provide a more precise description of the iodine deficiency disorder status of a population?

Endemic iodine deficiency is largely an environmental problem affecting whole populations. Currently, thyroid volume data from a population are analyzed with the sole objective of obtaining an estimate of goitre prevalence using +97th percentile or +2 standard deviations of an appropriate reference as cut-off. This paper proposes an alternative approach to the analysis and presentation of thyroid volume data using Z-scores (standard deviation scores) of the thyroid volume indices such as thyroid volume-for-age or thyroid volume-for-body surface area. The calculation of the summary statistics of the Z-scores, such as mean or median, provides an alternative to the prevalence-based approach for expressing severity of iodine deficiency disorders (IDD). An advantage of the mean or median Z-score is that it describes the thyroid volume profile (and therefore the IDD status) of the entire population directly, unlike goitre prevalence which gives information only about the extremes of distribution. The frequency curve or histogram of the Z-scores provides a complete picture of the whole distribution. Although qualitatively similar conclusions on IDD severity can be drawn from both analytical approaches, only the Z-score system is able to capture adequately the trends or changes in thyroid size over time, and to establish whether a previously iodine-deficient community's thyroid volume profile has returned to 'normal' (as indicated by a distribution that is not significantly different from that of the reference) following intervention. As a continuous variable, Z-scores are particularly useful for the analysis of data from populations where the sample size is relatively small, or where many individuals lie outside the extreme percentiles of the reference population. In view of its advantages in the context of activities based on single and multiple measurements, the Z-score system is to be preferred for the reporting and use of thyroid volume indices. A desirable consequence of this preference is that national goals will be oriented towards an improvement of the overall thyroid volume profile of the population, rather than just a reduction of the number of individuals at the extremes.     

TSH response to TRH in euthyroid insulin-dependent diabetics

Summary In order to establish the exact profile of thyroid function in Insulin Dependent Diabetics (IDD), we have measured T4, T3 basal and TRH stimulated TSH concentrations in 22 IDD. Four patients with positive thyroid antibodies showed increased basal and TRH stimulated TSH concentrations; this situation may be indicative of subclinical hypothyroidism.     

2008年河北省碘缺乏病防治效果调查分析

目的 掌握河北省防治碘缺乏病的效果,及时发现碘缺乏病防治中存在的问题,为防治工作提供科学依据.方法 2008年,根据碘缺乏病的历史病情,在河北省11个市,每个市选择2～3个县(市、区),每县(市、区)选择1个历史上碘缺乏病较重的乡;在每个乡选择2～3所村小学共计抽取100名8～10岁在校学生,采用触诊法检查其甲状腺肿大情况并测定其尿含碘量,同时采集40名学生家中食用盐测定含碘量,在所选取的小学所在村选取50名18～40岁育龄妇女测定其尿含碘量.检测当地饮用水含碘量.结果 共23个县(市、区)采集水样92份,水碘范围为0.21～61.25μg/L.甲状腺触诊检查8～10岁学生2410名,甲状腺肿大率为2.4%(58/2410).检测盐样1312份,碘盐覆盖率为92.4%(1212/1312),碘盐合格率为96.4%(1169/1212),合格碘盐食用率为89.1%(1169/1312),有30.4%(7/23)的县(市、区)合格碘盐食用率低于90%.共采集2191份8～10岁儿童尿样和1000份18～40岁育龄妇女尿样,尿碘中位数分别是185.2μg/L和201.3μg/L.结论 河北省儿童和育龄妇女碘营养总体上处于适宜水平,但武安市可能碘营养不足.在低碘盐覆盖率地区还存在孕妇和哺乳妇女碘营养不足的可能,对这些地区应该加强监测,必要时对他们进行适时补碘措施.     

北京市学龄儿童碘缺乏病流行现状

目的 对北京市自１９９５年实行全民食盐加碘以来的防治效果及病情现状做出评价,以确定今后北京市碘缺乏病防治对策。方法 将１９９５～１９９５年３次病情监测结果进行分析。结果 学龄儿童甲肿率及尿碘中位数均已达到碘缺乏病消除标准。合格碘盐使用率略低于９０％。结论 北京市已提前实现２０００年消除碘缺乏病的目标。为巩固目前所取得的防治效果,应坚持常规碘盐监测工作。建议修订食盐含碘量的国家标准,将生产、加工食盐     

碘缺乏病病区食盐加碘对儿童智力发育的影响

贵州省黔南自治州都匀县石龙乡和平圹县四寨乡、清水乡系地方性甲状腺肿重病区。对三个重病乡居民经用同一产地、同一浓度(1/5万)碘盐防治,十三年后调查结果:石龙、四寨二乡学生甲状腺肿大率降到国家控制地甲病的标准,二乡学生智商水平比加碘前都有显著提高。但清水乡学生甲状腺肿大率居高(47.9％)不下,且在加碘二年或四年学生智商水平都没有显著提高,但清水乡成人尿碘均值均达到国家基本控制地甲病的标准。我们认为清水乡地甲病除缺碘因素外,还应考虑其他致病因素的存在。     

应用加权关联度分析评价我国碘缺乏病防治效果

目的 探求客观定量、准确可行、能反映碘缺乏病防治效果全貌的综合评价方法．方法 采用改进的新方法--加权关联度分析．对1999年全国31个省(市)碘缺乏病监测结果进行评价。结果 根据全国31个省(市)碘缺乏病防治效果的加权关联度值和频数分布、经合理分档得出碘缺乏病防治效果较优的省(市)7个．中等的15个．较差的6个．最差的3个，符合实际情况。结论 加权关联度分析能直观、定量、简明、准确、清晰、科学、全面地反映碘缺乏病防治效果．实用于碘缺乏病防治效果的综合评价。     

Thyroid ultrasound is the best prevalence indicator for assessment of iodine deficiency disorders: a study in rural/tribal schoolchildren from Gujarat (Western India)

OBJECTIVES: (i) To assess the severity of iodine deficiency disorders (IDD), (ii) to determine the aetiology of IDD in Gujarat, (iii) to identify the best prevalence indicator of IDD, and (iv) to compare thyroid volume (TV) results with the WHO International reference. METHODS: Five hundred and thirty schoolchildren (6-15 years) were studied from two districts (Baroda and Dang) and data were collected on dietary habits and parameters such as height, weight, thyroid size by palpation and ultrasonography, urinary iodine (UI), and blood thyroid stimulating hormone (TSH). Drinking water was analyzed for iodine content and food articles for goitrogens. RESULTS: In Gujarat children median UI (interquartile range)=56 (30-96)microg/l, mean TSH=1.71 +/- 2.10mU/l, goiter by palpatio n = 30%, and median TV = 27.8 (23-35)ml. Females had lower median UI (48 (27-82) microg/l) and higher mean TSH levels (2.0 +/- 2.5mU/l) than males. Applying the WHO ultrasonography reference to Gujarat children resulted in an enlarged TV-for-body surface area in almost 100% of subjects. Ninety-nine percent of females and 95% of males had enlarged TV-for-age. Three to eight times larger TV were seen in all subjects as compared with European children. Dang children were severely malnourished. Flavonoids like vitexin, glucosyl vitexin and apigenin were detected in pearl millet. Apigenin was never identified in pearl millet. Dang district water was lacking in iodine content. CONCLUSIONS: IDD is a severe public health problem in Gujarat. Baroda district is a new pocket of IDD. High amounts of dietary flavonoids in Baroda and Dang districts, and lack of iodine in Dang water, account for IDD. TV measurement by ultrasound is the best prevalence indicator of IDD.     

Thyroid ultrasound compared with World Health Organization 1960 and 1994 palpation criteria for determination of goiter prevalence in regions of mild and severe iodine deficiency

OBJECTIVES: In 1994, WHO/International Council for the Control of Iodine Deficiency Disorders recommended replacing the WHO 1960 four-grade goiter classification with a simplified two-grade system. The effect of this change in criteria on the estimation of goiter prevalence in field studies is unclear. In areas of mild iodine deficiency disorders (IDD) where goiters are small, ultrasound is preferable to palpation to estimate goiter prevalence. However, in areas of moderate to severe IDD, goiter screening by palpation may be an acceptable alternative to thyroid ultrasound. To address these two issues, we compared WHO 1960 and 1994 criteria with thyroid ultrasound for determination of goiter prevalence in areas of mild and severe IDD in Morocco. DESIGN: A cross-sectional study of 400 six- to 13-year-old children from two mountain villages (Ait M'hamed and Brikcha) in rural Morocco was carried out. METHODS: Urinary iodine concentration (UI), whole blood TSH and serum thyroxine were measured. Thyroid size was graded by inspection and palpation by two examiners using both WHO 1960 and 1994 criteria. Thyroid volume was determined by ultrasound. Variation between examiners and examination methods was assessed. Sensitivity and specificity of the two classification systems compared with ultrasound were calculated. RESULTS: Median UIs in A?t M'hamed and Brikcha were 183 and 24 microg/l respectively. In Ait M'hamed, using 1960 and 1994 criteria, goiter prevalence was 21 and 26% respectively, compared with 13% by ultrasound. In Brikcha, with 1960 and 1994 criteria, goiter prevalence was 64 and 67% respectively, compared with 64% by ultrasound. Agreement between observers was better with the 1994 criteria than with the 1960 criteria in Ait M'hamed (kappa=0.53 and 0.47 respectively), while in Brikcha observer agreement was similar with the two systems (kappa=0.67). Using either the 1994 or 1960 criteria, agreement with ultrasound was only moderate in Ait M'hamed (kappa=0.41-0.44), but good in Brikcha (kappa=0.55-0.64). Overall, compared with ultrasound, sensitivity increased 3-4% using 1994 criteria, while specificity decreased 4-5%. CONCLUSIONS: The WHO 1994 criteria are simpler to use than the 1960 criteria and provide increased sensitivity with only a small reduction in specificity. Agreement between observers is better with the 1994 criteria than with the 1960 criteria, particularly in areas of mild IDD. Like the 1960 criteria, the 1994 criteria overestimate goiter prevalence in areas of mild IDD, compared with ultrasound. However, the 1994 palpation criteria provide an accurate estimate of goiter prevalence in areas of severe IDD, and may be an acceptable and affordable alternative to thyroid ultrasound in these areas.     

碘缺乏病病区经食盐加碘后甲状腺功能亢进患病率升高的病因分析

目的 探讨在碘缺乏病(IDD)病区经碘盐防治后，甲状腺功能亢进(甲亢)患病率升高的原因及其可能的发病机制。方法 对来自于海陆丰地区(IDD高发区)的甲状腺疾病患者的临床资料进行统计分析，其中包括58例地方性结节型甲状腺肿患者和经^131I治疗的255例甲亢患者。结果 该地区甲亢患者绝大多数是在5年以上患有地方性结节型甲状腺肿的基础上发生的。未合并甲亢的地方性结节型甲状腺肿患者的甲状腺功能、血清甲状腺激素水平及甲状腺过氧化物酶抗体(TPOAb)水平均正常；而合并甲亢者血清甲状腺激素和TPOAb水平明显升高，经^131I治疗后，甲状腺功能恢复正常，但血清TPOAb仍维持高水平。结论 在IDD病区推行碘盐后．甲亢患病率增加的原因是部分原有的地方性结节型甲状腺肿患者在补碘后诱发了甲亢。其可能的发病机制是这部分患者存在甲状腺自身免疫缺陷。     

内蒙古城镇和农牧区、病区和非病区碘盐及碘缺乏病病情分析

目的了解内蒙古城镇、农牧区、病区、非病区碘盐和碘缺乏病现状。方法对１９９７年全区碘缺乏病中期评估资料进行分析。结果精制盐的碘化效果较粉碎盐好,但在内蒙古由于生活习惯,有５０％以上居民食用粉碎盐。城镇碘盐合格率高于农牧区,但因为多数城镇为历史非病区,碘盐普及时间短,故儿童甲肿率仍偏高。结论经过多年防治,病区儿童甲肿率已下降到５％以下,可粗制碘盐的质量尚有待提高。非病区碘盐合格率达到了９０％以上,但需要有可持续性的保障机制