齐齐哈尔市富拉尔基区常住居民甲状腺疾病患病现况及碘营养状态调查

目的了解齐齐哈尔市富拉尔基区常住居民甲状腺疾病患病现况及影响因素,并评估碘营养状态与甲状腺疾病之间的关系,为本地区开展甲状腺疾病和碘营养水平监测工作提供科学依据。方法 2017年1月-2018年12月按照整群随机抽样方法,选择在该地居住5年以上、且在3个月内未接受过含碘造影剂检查或者服用乙胺碘呋酮的健康人群为研究对象,依次进行问卷调查、甲状腺彩色多普勒超声检查、甲状腺激素和自身抗体含量及尿碘水平测定。结果本次调查共有2 066名符合条件者被纳入研究,各种甲状腺疾病患病率由高到低依次为:甲状腺结节(20.33%)、亚临床甲减(14.91%)、临床甲减(1.36%)、亚临床甲亢(1.26%)、临床甲亢(0.97%)、甲状腺肿(0.63%)。甲状腺球蛋白抗体(TgAb)阳性率和甲状腺过氧化物酶抗体(TPOAb)阳性率分别为9.73%和8.23%。成人尿碘中位数(MUI)为204.40μg/L,男性和女性MUI分别为210.10μg/L、195.80μg/L,城市及农村人群MUI分别为186.20μg/L、245.70μg/L。单因素分析结果显示,本地区甲状腺疾病的发生与年龄、性别、文化程度、职业、高血糖、高血脂、食用加碘盐、食用富碘水平等有关(P<0.05)。Logistic多因素分析结果显示,女性(OR=6.85)、年龄≥60岁(OR=9.66)、初中及以下学历(OR=2.70)、政府部门人员(OR=3.63)、高血糖(OR=9.05)、高血脂(OR=6.44)是甲状腺疾病患病的危险因素(P<0.05),而经常食用加碘盐(OR=0.59)、经常食用富碘食品(OR=0.48)是甲状腺疾病发生的保护因素(P<0.05)。结论齐齐哈尔市富拉尔基区常住居民甲状腺疾病总体患病率为39.45%,其发病与多因素有关,高龄女性为好发人群。本地区居民碘营养水平处于碘超适宜状态,未发现不同碘水平组人群甲状腺疾病患病率有差别。建议居民定期进行甲状腺疾病筛查、重视加碘盐食用,有利于甲状腺疾病的预防和早期诊治。

Investigation on the thyroid disease prevalence and iodine nutrition status of residents in Fulaerji District,Qiqihar City

Objective To know about the thyroid diseases prevalence among the residents of Fulaerji District,Qiqihar City and the influence factors.To evaluate the relationship between iodine nutritional status and thyroid diseases,so as to provide scientific evidence for the monitoring of thyroid diseases and iodine nutrition level in this region.Methods From January,2017 to December,2018,the cluster random sampling method was adopted to select the healthy people who have lived in this region for over 5 years,have not accepted iodinated contrast medium examination within 3 months or have not taken amiodarone as the study object.Results In total,2 066 people were studied and the result showed that the ranking of various thyroid disease prevalence was as following:thyroid nodules(20.33%),subclinical hypothyroidism(14.91%),overt hypothyroidism(1.36%),subclinical hyperthyroidism(1.26%),clinical hyperthyroidism(0.97%),thyroncus(0.63%).The positive rate of thyroglobulin antibody(TgAb) and the positive rate of thyroid peroxidase antibody(TPOAb) were separately 9.73% and 8.23%.The median urinary iodine(MUI) of the adult was 204.40 μg/L.The MUI of the male and the female was separately 210.10 μg/L and 195.80 μg/L.Meanwhile,the MUI of the urban people and the rural people was separately 186.20 μg/L and 245.70 μg/L.The single factor analysis result showed that in this region,the thyroid disease prevalence was related with the age,gender,education degree,occupation,hyperglycemia,hyperlipidemia,iodized salt consumption and food iodine level(P<0.05).The logistic multivariable analysis result showed that the female(OR=6.85),the age of≥60 years old(OR=9.66),junior middle school or lower education degree(OR=2.70),government officials(OR=3.63),hyperglycemia(OR=9.05),hyperlipidemia(OR=6.44)were the risk factors that may cause thyroid disease(P<0.05).It was found that frequently taking iodized salt(OR=0.59) and the food that had richiodine content could prevent the occurrence of thyroid disease(P<0.05).Conclusion The overall thyroid disease prevalence rate of the residents in Fulaerji District,Qiqihar City is 39.45% and the prevalence is related with various factors.In addition,the elderly female is the group that can get the thyroid disease easily.The iodine nutrition level of the local residents is rational.The thyroid disease prevalence of different people with different iodine level is not greatly different.It is suggested that the residents shall accept thyroid disease exam regularly and shall emphasize the taking of iodized salt,which is benefit for the prevention and early treatment of thyroid disease.