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[河北省高水碘地区儿童甲状腺功能异常情况调查]

[Investigation of thyroid function abnormalities in children in high water iodine areas of Hebei province].

作者信息

Chen Wen, Sang Zhong-Na, Liu Hua, Shen Jun, Zhao Na, Tan Long, Wei Wei, Zhang Gui-Qin, Wen Song-Chen, Zhang Wan-Qi

机构信息

School of Public Health, Tianjin Medical University, Tianjin 300070, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2012 Feb;46(2):148-51.

Abstract

OBJECTIVE

To understand the level of thyroid function and the prevalence of the thyroid diseases of children in high water iodine areas.

METHOD

Two primary schools were selected by purposive sampling from Haixing county, Hebei province in April 2010. A total of 371 children were selected from six classes by cluster sampling in the schools. Morning-urine and venous blood (5 ml) were collected to measure the levels of urinary iodine, free triiodothyronine (FT(3)), free thyroxine (FT(4)) and sensitive thyroid-stimulating hormone (sTSH) in serum and to evaluate the iodine status and thyroid function of children.

RESULTS

The median urinary iodine of the children was 1032.08 µg/L. Overall, 96.2% (357/371) of the children's urinary iodine were ≥ 300 µg/L and 68.5% (254/371) were ≥ 800 µg/L. The level of FT(3) and FT(4) were (6.28 ± 0.81) pmol/L and (16.37 ± 2.72) pmol/L, respectively. The median of sTSH was 4.01 mU/L. The FT(4) among boys ((16.63 ± 2.60) pmol/L) was significantly higher than that among girls ((15.99 ± 2.85) pmol/L) (P < 0.05). Overall, 44 subjects were diagnosed as thyroid disease (11.9%), 25 were subclinical hypothyroidism (57% of the total patients), 4 were hypothyroidism (9%), 10 were hyperthyroidism (23%) and 5 were subclinical hyperthyroidism (11%). In the urinary iodine of 200 - 799 µg/L, the prevalence of thyroid disease and hypothyroidism were 6.3% (7/111) and 14.6% (27/254), respectively. When urinary iodine ≥ 800 µg/L, the prevalence of thyroid diseases and hypothyroidism were 3.6% (4/111) and 8.3% (21/254), respectively.

CONCLUSION

Most of the children in high water iodine areas had excessive iodine intake. Levels of the children's thyroid hormone were within the normal range. The prevalence of thyroid disease were high, in these areas and the thyroid disease were mainly the subclinical hypothyroidism.

摘要

目的

了解高水碘地区儿童甲状腺功能水平及甲状腺疾病患病率。

方法

2010年4月采用目的抽样法从河北省海兴县选取两所小学。通过整群抽样从这两所学校的六个班级中选取371名儿童。采集晨尿和静脉血(5ml),检测尿碘、血清游离三碘甲状腺原氨酸(FT(3))、游离甲状腺素(FT(4))和敏感促甲状腺激素(sTSH)水平,评估儿童碘营养状况及甲状腺功能。

结果

儿童尿碘中位数为1032.08µg/L。总体上,96.2%(357/371)的儿童尿碘≥300µg/L,68.5%(254/371)的儿童尿碘≥800µg/L。FT(3)和FT(,)水平分别为(6.28±0.81)pmol/L和(16.37±2.72)pmol/L。sTSH中位数为4.01mU/L。男孩的FT(4)水平((16.63±2.60)pmol/L)显著高于女孩((15.99±2.85)pmol/L)(P<0.05)。总体上,44名儿童被诊断为甲状腺疾病(11.9%),其中25名为亚临床甲状腺功能减退(占全部患者的57%),4名为甲状腺功能减退(9%),10名为甲状腺功能亢进(23%),5名为亚临床甲状腺功能亢进(11%)。尿碘在200~799µg/L组中,甲状腺疾病和甲状腺功能减退患病率分别为6.3%(7/111)和14.6%(27/254)。尿碘≥800µg/L时,甲状腺疾病和甲状腺功能减退患病率分别为3.6%(4/111)和8.3%(21/254)。

结论

高水碘地区多数儿童碘摄入过量。儿童甲状腺激素水平在正常范围内。该地区甲状腺疾病患病率较高,且甲状腺疾病主要为亚临床甲状腺功能减退。

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