Péter Ferenc
Budai Gyermekkórház-Rendelóintézet, Endokrinológiai részleg, Budapest.
Orv Hetil. 2002 Dec 29;143(52):2867-73.
Author gives information to the home tendencies of incidence of some important thyroid disorders in childhood mainly on the basis of his studies done with his coworkers. Results are compared with the standpoints raised since Chernobyl accident. It is verified on the basis of cca one million neonatal TSH screening that the frequency of congenital hypothyroidism in Hungary corresponds to those of European countries in the last 17 years. Changes connected with Chernobyl has not occurred. It deals with incidence of Graves' disease as the main form of hyperthyroidism relying upon TSH receptor antibody positivity. The yearly distribution of the 176 proved cases shows a slow increasing trend in the same period of time (17 yrs). In this radiation does not play a role. The paper treats of the topic of iodine deficiency with of high priority. Author draws the attention again to the fact that the iodine nutrition in significant part of the population is behind of optimum in harmony with the results of some other national studies also according to their own three thousand urinary iodine tests and more than four thousand thyroid sonographies. This iodine deficiency should be regarded as a potential risk from the viewpoint of radiation hazard! While enlargement of thyroid was often found by sonography, the formation of nodules only rarely in contrast to those of the Chernobyl area. The frequency of thyroiditis, especially in puberty increases too, but the degree of it falls far behind from those of published around of Chernobyl. The incidence of differentiated thyroid carcinoma--according to the available data--moderately increases as well, without any connection between the residence and the geographical distribution of radiation pollution. The epidemiological, clinical, and histological characteristics of the Hungarian children are similar to the so-called sporadic (non-radiation induced) form and different from the cases of the Chernobyl area.
作者主要基于与同事的研究,给出了儿童期一些重要甲状腺疾病发病率的国内倾向信息。将结果与切尔诺贝利事故后提出的观点进行了比较。基于约100万例新生儿促甲状腺激素筛查证实,匈牙利先天性甲状腺功能减退症的发病率在过去17年中与欧洲国家相当。与切尔诺贝利相关的变化并未发生。本文依据促甲状腺激素受体抗体阳性情况,探讨了格雷夫斯病作为甲状腺功能亢进主要形式的发病率。176例确诊病例的年度分布在同一时期(17年)呈缓慢上升趋势。在这方面,辐射不起作用。本文高度重视碘缺乏这一主题。作者再次提请注意,根据他们自己的三千例尿碘检测和四千多次甲状腺超声检查结果,以及其他一些国内研究结果,相当一部分人群的碘营养状况未达到最佳水平。从辐射危害的角度来看,这种碘缺乏应被视为一种潜在风险!虽然超声检查经常发现甲状腺肿大,但与切尔诺贝利地区相比,结节的形成却很少见。甲状腺炎的发病率,尤其是在青春期也有所增加,但其程度远低于切尔诺贝利周边地区报道的程度。根据现有数据,分化型甲状腺癌的发病率也适度增加,且居住地点与辐射污染的地理分布之间没有任何关联。匈牙利儿童的流行病学、临床和组织学特征与所谓的散发性(非辐射诱发)形式相似,与切尔诺贝利地区的病例不同。