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巴西工业区的慢性自身免疫性甲状腺炎:一项 15 年调查。

Chronic autoimmune thyroiditis in industrial areas in Brazil: a 15-year survey.

机构信息

Rua Dr. Gabriel dos Santos, 405 -20° Andar, São Paulo, SP, CEP: 01231-011, Brazil.

出版信息

J Clin Immunol. 2012 Oct;32(5):1012-8. doi: 10.1007/s10875-012-9703-2. Epub 2012 May 30.

Abstract

PURPOSE

To investigate whether there is an increased incidence of chronic autoimmune thyroiditis (CAT) in individuals living in the vicinity of industrial plants that manufacture petroleum byproducts in the state of São Paulo, Brazil.

METHODS

Between 1989 and 2004, 6,306 patients of both sexes, from 5 to 78 years old were divided in two groups according to their home location: Group 1: 3,356 residents living near industrial plants that manufacture petroleum byproducts (Region A), and Group 2: 2,950 residents living far from Region A in an area with predominantly steel industries (Region B). For all patients, we measured the serum levels of antithyroglobulin antibody, antithyroperoxidase antibody, triiodothyronine, thyroxine, free thyroxine and thyrostimulating hormone. Sonographic scans of the thyroid gland were also conducted.

RESULTS

The proportion of patients with CAT coming from Region A increased from 2.5 % (5 patients with CAT/200 total patients) in 1992 to 57.6 % (106 patients with CAT/184 total patients) in 2001. This striking increase was highly significant (p < 0.001). Similar findings were not observed in Region B. The difference in the number of patients with CAT between 1989 and 2004 coming from Region A and Region B was highly significant (p < 0.001), with 905 CAT patients (83.95 %) in Region A and 173 CAT patients (16.05 %) in Region B.

CONCLUSION

Our results showed a striking increase in the incidence of CAT in residents in the vicinity of large industrial plants that manufacture petroleum byproducts compared with residents living near steel industries, which opens the field to new areas of research.

摘要

目的

研究巴西圣保罗州生产石油副产品的工业企业附近人群慢性自身免疫性甲状腺炎(CAT)的发病率是否增加。

方法

1989 年至 2004 年间,根据住所将 6306 名 5 至 78 岁的男女患者分为两组:组 1:3356 名居住在生产石油副产品的工业企业附近的居民(A 区);组 2:2950 名居住在远离 A 区、以钢铁工业为主的地区的居民(B 区)。对所有患者均检测抗甲状腺球蛋白抗体、抗甲状腺过氧化物酶抗体、三碘甲状腺原氨酸、甲状腺素、游离甲状腺素和促甲状腺激素水平,并进行甲状腺超声检查。

结果

1992 年 A 区 CAT 患者占比为 2.5%(200 例患者中有 5 例 CAT),2001 年增至 57.6%(184 例患者中有 106 例 CAT),差异有统计学意义(p<0.001)。B 区 CAT 患者比例未见明显变化。1989 年至 2004 年 A 区和 B 区 CAT 患者数量差异有统计学意义(p<0.001),A 区 CAT 患者 905 例(83.95%),B 区 CAT 患者 173 例(16.05%)。

结论

本研究结果表明,与居住在钢铁企业附近的人群相比,生产石油副产品的大型工业企业附近人群 CAT 的发病率显著增加,为进一步研究开辟了新领域。

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