碘摄入量不同地区人群甲状腺自身抗体的流行病学研究

为了研究不同碘摄入量人群的甲状腺自身抗体的变化以及甲状腺自身抗体阳性人群甲状腺功能的变化 ,我们在三个不同碘摄入量的农村社区盘山、彰武和黄骅进行甲状腺疾病入户问卷调查共 16 2 87人 (≥ 14岁 ) ,对其中的 376 1人进行体格检查并采血、尿标本及甲状腺B超检查。检测全部尿样的尿碘含量 ;所有血清标本均应用固相化学发光酶免疫分析方法测定甲状腺过氧化物酶抗体 (TPOAb )和甲状腺球蛋白抗体 (TGAb )及血清第三代TSH水平。结果显示盘山、彰武和黄骅社区的尿碘中位数分别为 10 3 15 μg/L、 374 76 μg/L和 6 14 6 1μg/L (P <0 0 1)。我们发现盘山、彰武和黄骅社区TPOAb和TGAb阳性率均无显著差异 (P >0 0 5 )。在TPOAb阳性的人群中 ,黄骅和彰武社区出现临床或亚临床甲状腺功能减退的比率明显高于盘山社区 (P <0 0 1)。虽然三社区TPOAb和TGAb阳性率无显著差异 ,但是高碘社区存在甲状腺自身免疫异常者发生甲状腺功能减退的危险性显著增加 ,特别是甲状腺自身抗体呈高水平的患者

The Comparative Screening for Thyroid Autoantibodies in Areas with Different Iodine Intakes

The aim of this study is to investigate the prevalence of positive thyroid autoantibodies in inhabitants with different iodine supply and to investigate the TSH levels in the groups with positive antibodies A cross sectional study was conducted in three rural communities in Pansan,Zhangwu and Huanghua in which there were different iodine intakes,and 4 343,7 714 and 5 230 inhabitants were questioned about thyroid disorders as well as 1 103,1 584 and 1 074 of them were examined in these three areas respectively The examinations included third generation TSH,TPOAb and TGAb in sera,iodine determinations in urine and B ultrasound on thyroid It was found that the median urinary iodine(MUI) value was 103 15 μg/L in Panshan,374 76 μg/L in Zhangwu and 614 61 μg/L in Huanghua,but there was no any difference in the positive rates of TPOAb and TGAb antibodies It concludes that the inhabitants with positive TPOAb in the areas with high iodine intakes are more likely to have hypothyroidism,although there is no difference in the prevalence of positive TPOAb or TGAb antibodies among these three communities