Graves病多发家系成员甲状腺自身免疫状况及碘摄入量对其发病率的影响

目的：确定在Graves病（GD）多发家系成员中，甲状腺自身免疫及甲状腺功能异常的发生情况，并研究碘摄入量对GD发病率的影响。方法：对全部家系成员做甲状腺疾病病史询问，体格检查，甲状腺功能及甲状腺自身抗体测定，并测定空腹尿碘含量。结果：GD患者一级亲属的亚临床甲亢，临床甲状，亚临床甲状的患病率分别为5．2％，1．0％和1．4％，这三种疾病患者的甲状腺自身抗体均为阳性，甲状腺功能正常一级亲属的甲状腺自身抗体阳性率为68．6％，尿碘水平500－599ug/L时，GD的发病率显著增高（P＜0．05），。结论：在GD多发家系中，GD患者一级亲属发生甲状腺功能异常的原因均为自身免疫甲状腺病，尿碘水平500－599ug/L是GD发病率增高的危险因素。

Thyroid autoimmunity in members from multiplex families with Graves' disease and effect of iodine intake on its incidence

Objective　To investigate the prevalence of thyroid autoimmunity and thyroid dysfunction in members from multiplex families with Graves' disease (GD), and to evaluate the effect of iodine intake on the incidence of GD. Methods　In addition to history and physical examination, thyroid function, thyroid autoantibodies and fasting urinary iodine were measured for all the subjects. Results　In first-degree relatives of patients with GD, the prevalences of subclinical hyperthyroidism, overt and subclinical hypothyroidism were 5.2%, 1.0% and 1.4% respectively, and thyroid autoantibodies were positive for all these patients. The positive rate of anti-thyroid antibodies was 68.6% in euthyroid first-degree relatives. The incidence of GD increased significantly when the urinary iodine excretion was 500～599 μg/L (P＜0.05). Conclusion　In multiplex families with GD, the pathogenetic causes of all kinds of thyroid dysfunction in first-degree relatives of GD patients are due to autoimmune thyroid diseases. Urinary iodine excretion 500～599 μg/L is a risk factor for higher occurrence of GD