Wong G W, Kwok M Y, Ou Y
Department of Paediatrics, Chinese University of Hong Kong, Shatin.
Clin Endocrinol (Oxf). 1995 Dec;43(6):697-700. doi: 10.1111/j.1365-2265.1995.tb00537.x.
Childhood Graves' disease has been reported to be rare and epidemiological data on its incidence are limited. In our Paediatric Endocrine Clinic, Graves' disease was the most common thyroid disorder seen. There is no previous epidemiological study on Graves' disease in Chinese children. This study was performed to determine the incidence of childhood Graves' disease in Hong Kong Chinese.
We established a registry of childhood Graves' disease in 1990 at our centre, which has a catchment population of 1,010,000 with 240,000 under 15 years of age. Graves' disease was diagnosed on clinical features, diffuse thyroid gland enlargement, elevated free thyroxine or triiodothyronine levels with suppressed TSH level. All confirmed cases were recorded prospectively. Population data were obtained from the Statistics Department of the Hong Kong Government.
Forty-six Chinese children under 15 years of age had a confirmed diagnosis of Graves' disease during the study period from January 1990 to December 1994. The overall incidence was 3.8/100,000/year with a 95% confidence interval of 1.8-7.3/100,000/year. Incidence was low in children under 4 years. The highest incidence was in girls between 10 and 14 years of age at 15.5/100,000/year. The cumulative incidence for boys and girls of developing Graves' disease during the first 15 years was 11 and 104 per 100,000 respectively.
Our data demonstrate a very high incidence of Graves' disease in Hong Kong Chinese children, with an overall incidence about 5 times that reported in Danish children. A female predominance was found in all three age groups (0-4, 5-9 and 10-14 years) and was particularly striking in the adolescent girls.
据报道，儿童格雷夫斯病较为罕见，其发病率的流行病学数据有限。在我们的儿科内分泌诊所，格雷夫斯病是最常见的甲状腺疾病。此前尚无关于中国儿童格雷夫斯病的流行病学研究。本研究旨在确定香港华人儿童格雷夫斯病的发病率。
我们于1990年在本中心建立了儿童格雷夫斯病登记册，其覆盖人口为101万，其中15岁以下儿童有24万。格雷夫斯病根据临床特征、甲状腺弥漫性肿大、游离甲状腺素或三碘甲状腺原氨酸水平升高且促甲状腺激素水平降低来诊断。所有确诊病例均进行前瞻性记录。人口数据来自香港政府统计部门。
在1990年1月至1994年12月的研究期间，46名15岁以下的中国儿童被确诊为格雷夫斯病。总体发病率为每年3.8/10万，95%置信区间为每年1.8 - 7.3/10万。4岁以下儿童发病率较低。发病率最高的是10至14岁的女孩，为每年15.5/10万。男孩和女孩在15岁前患格雷夫斯病的累积发病率分别为每10万11例和104例。
我们的数据表明，香港华人儿童格雷夫斯病的发病率非常高，总体发病率约为丹麦儿童报道发病率的5倍。在所有三个年龄组（0 - 4岁、5 - 9岁和10 - 14岁）中均发现女性占主导，在青春期女孩中尤为明显。
