江苏省高碘和适碘乡甲状腺功能亢进症的流行病学对比研究

目的 通过对高碘与适碘乡人群甲状腺功能亢进症(甲亢)发病率的流行病学调查,分析高碘与甲亢的发生关系.方法 2006年,在江苏省选择饮用水含碘量较高的沛县孟庄乡(水碘中位数为1284.1μg/L)和饮用水含碘量适宜的邳州市新集乡(水碘中位数为77.9 μg/L),对两乡的所有人群进行甲状腺疾病筛查,对筛查出的可疑者进行检查及确诊,比较两乡甲亢患病率以及与人口学特征分布之间的差异.结果 高碘乡调查17471人,查出甲亢病人26人,患病率为1.49‰,其中男性患病率为0.75‰(7/9264),女性为2.32‰(19/8207);标化患病率为1.48‰.适碘乡调查12 765人,查出甲亢病人27人,患病率为2.12‰,其中男性患病率为0.96‰(7/6823),女性为3.26‰(20/5942);标化患病率为2.02‰.高碘乡甲亢患病率和标化患病率显著低于适碘乡(u值分别为2.88、2.89,P均<0.01).高碘乡女性患病率(2.32‰)低于适碘乡(3.37‰,u=4.03,P<0.01).高碘乡和适碘乡甲亢患病率均以20～50岁年龄组为高(19.36/万～38.96/万).高碘乡甲亢患者中Graves病占50.00%(13/26),显著高于适碘乡29.41%(5/17),χ2=5.853,P<0.01].结论 长期慢性高碘摄入并没有增加甲亢发病危险,与适碘乡相比,高碘乡居民甲亢患病率反而下降,女性患病率高于男性.

Epidemiological comparison of hyperthyroidism between villages with high and with normal iodine intake from drinking water in Jiangsu province

Objective To examine the relationship between hyperthyroidism and excessive iodine intake from drinking water through epidemiological studies in the iodine excess and the iodine normal villages. Methods Mengzhuang village of Pei county and Xingji village of Pizhou city in Jiangsu province, with median water iodine concentration of 1284.1 μg/L and 77.9 μ/L, respectively,were selected in 2006. Thyroid diseases of all local residents in the two villages were assessed clinically to compare the prevalence and the distribution of hyperthyroidism. Results A total of 17 471 residents were recruited from the iodine excess village, 26 of them were diagnosed with hyperthyroidism. The prevalence of hyperthyroidism was 1.49‰, 0.75‰ (7/9264) in male,2.32‰( 19/8207) in female, and the age-standardized prevalence was 1.48‰. A total of 12 765 residents were recruited from the iodine normal village, among them 27 residents were diagnosed with hyperthyroidism. The prevalence of hyperthyroidism was 2.12‰, 0.96‰(7/6823) in male, 3.26‰(20/5942) in female, and the agestandardized prevalence was 2.02‰. The prevalence and age-standardized prevalence was significantly lower in the iodine excess village than those in the iodine normal village (u = 2.88, 2.89; all P < 0.01). The prevalence of hyperthyroidism was lower among females in the iodine excess village (2.32‰) than that in the iodine normal one (3.37‰, u = 2.89, P < 0.01). Residents aged 20 - 50 years had higher prevalence of hyperthyroidism(19.36 -38.96 )/10 000]in the two villages. The proportion of Graves diseases was 50.00% (13/26) in the iodine excessvillage, higher than that in the iodine normal village29.41%(5/17) , χ2 = 5.853, P < 0.01]. Conclusions Chronic excessive iodine intake does not increase the chance of suffering from hyperthyroidism. On the contrary, the prevalence of hyperthyroidism in the iodine excess village decreases significantly compared with that of the iodine normal village. The prevalence is higher among females.