Lin H D, Lo J G, Ching K N
Department of Medicine, Veterans General Hospital-Taipei, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1991 Mar;47(3):154-60.
We studied the etiology of goiter on outpatient clinic basis with thyroid function test, measuring circulating thyroid autoantibodies and urinary iodine excretion. One hundred patients from endocrine and metabolic clinic with grade I or over goiter according to the WHO classification were included by random sampling after carefully excluding the pure thyroid cyst and thyroid cancer by sonographic examination and fine needle aspiration cytology. Among these 100 studied cases, 23 were classified as Graves' hyperthyroidism (group 1), 19 autoimmune thyroiditis (group 2), 14 simple goiter (group 3), 42 nodular goiter (group 4) and 2 subacute thyroiditis. All four groups of goiter showed female predominance. The mean +/- SD age and 24-hour % RAIU for these four groups were 33.9 +/- 14.5 and 64.3 +/- 24.4; 44.6 +/- 19.5 and 27.3 +/- 11.3; 37.5 +/- 15.9 and 27.5 +/- 9.0; and 47.5 +/- 16.4 and 36.1 +/- 16.7, respectively. Patients with Graves' hyperthyroidism were significantly younger in age than the nodular goiter group and had higher RAIU than the other three groups (p less than 0.05, Kruskal-Wallis ANOVA, multiple comparisons). There was no age or RAIU difference among groups 2-4. The amount of urinary iodine excretion distributed in a very wide range and exhibited no significant difference among four groups. Only 2 subjects had urinary iodine excretion below 50 micrograms iodine/g creatinine but 50% (49.3% of group 2-4) had urinary iodine excretion higher than 300 micrograms iodine/g creatinine. Iodine deficiency is not a real problem at present.(ABSTRACT TRUNCATED AT 250 WORDS)
我们在门诊基础上，通过甲状腺功能检查、检测循环甲状腺自身抗体和尿碘排泄来研究甲状腺肿的病因。在通过超声检查和细针穿刺细胞学仔细排除单纯甲状腺囊肿和甲状腺癌后，随机抽取了100例来自内分泌和代谢门诊、根据世界卫生组织分类为I级及以上甲状腺肿的患者。在这100例研究病例中，23例被分类为格雷夫斯甲亢（第1组），19例为自身免疫性甲状腺炎（第2组），14例为单纯性甲状腺肿（第3组），42例为结节性甲状腺肿（第4组），2例为亚急性甲状腺炎。所有四组甲状腺肿均以女性为主。这四组的平均±标准差年龄和24小时甲状腺摄碘率分别为33.9±14.5和64.3±24.4；44.6±19.5和27.3±11.3；37.5±15.9和27.5±9.0；以及47.5±16.4和36.1±16.7。格雷夫斯甲亢患者的年龄显著低于结节性甲状腺肿组，且甲状腺摄碘率高于其他三组（p<0.05，Kruskal-Wallis方差分析，多重比较）。第2-4组之间在年龄或甲状腺摄碘率上没有差异。尿碘排泄量分布范围很广，四组之间无显著差异。只有2名受试者的尿碘排泄低于50微克碘/克肌酐，但50%（第2-4组的49.3%）的尿碘排泄高于300微克碘/克肌酐。目前碘缺乏并不是一个实际问题。（摘要截断于250字）
