2018 年第 9 期 第 13 卷

哈尔滨市人群尿碘含量与甲状腺功能和甲状腺结节的相关性分析

Relation among urinary iodine content, thyroid function and thyroid nodules in residents in Harbin city

作者：陈萍吴东红连立新齐明邵宁郭宝帅赵雪琦李晓阳

英文作者：

单位：150010哈尔滨市第一医院内分泌科（陈萍、吴东红、邵宁），普外科（连立新、齐明、郭宝帅、赵雪琦、李晓阳）

英文单位：

关键词：甲状腺疾病；尿碘；甲状腺结节；甲状腺功能

英文关键词：

• 摘要：

• 【摘要】目的    探讨哈尔滨市人群尿碘含量与甲状腺功能和甲状腺结节的相关性。方法    选择在黑龙江省哈尔滨市5个社区居住10年以上的500名成年居民，均食用含碘盐，根据甲状腺功能的检测结果和甲状腺结节的彩色多普勒超声筛查结果分组，分别比较甲状腺功能正常且无甲状腺结节组（A组）与甲状腺功能异常组（B组）和甲状腺结节组（C组）的尿碘含量，并对尿碘水平与甲状腺功能指标和甲状腺结节的相关性进行分析。结果    500名居民中A组137例、B组197例、C组268例。B、C组中有102例患者为甲状腺功能异常合并甲状腺结节。B、C组的尿碘水平明显高于A组［200（118，252）、204（120，254）μg/L比151（110,195）μg/L］，差异均有统计学意义（均P＜0.01）。A组尿碘水平100~199 μg/L占比最高达71.5%（98/137），B、C组在尿碘＜100、100~199、200~300 μg/L的构成比均呈逐渐增加趋势。B、C组尿碘＜100 μg/L构成比与A组比较差异均无统计学意义（均P＞0.05），100~199 μg/L构成比均低于A组，200~300 μg/L构成比均高于A组，C组尿碘＞300 μg/L构成比高于A组，差异均有统计学意义（均P<0.01）。500名居民尿碘水平与游离三碘甲状腺原氨酸、游离甲状腺素、促甲状腺激素、抗甲状腺球蛋白抗体和抗甲状腺过氧化物酶抗体及甲状腺结节的发生均无相关性（均P＞0.05）。结论    黑龙江省哈尔滨市5个社区居民整体尿碘处于碘营养适宜水平，碘过量摄入会增加甲状腺疾病发生率，尿碘测定有助于指导个体化补碘。

• 【Abstract】Objective    To investigate the relation among urinary iodine level, and thyroid function and the occurrence of thyroid nodules in residents in Harbin city. Methods    A total of 500 adult residents(10 years or more) were selected from 5 communities in Harbin city, Heilongjiang Province. All subjects ate iodized salt in daily diet. According to the results of thyroid function test and thyroid Doppler ultrasound examination, they were divided into normal thyroid function without thyroid nodules group(group A), abnormal thyroid function group(group B) and thyroid nodules group(group C). The relation among urinary iodine level, thyroid function indicators and thyroid nodules was analyzed. Results    There were 137 cases in the group A, 197 cases in the group B and 268 cases in the group C; 102 people had abnormal thyroid function with thyroid nodules. Urinary iodine level in the group B and C was significantly higher than that in the group A［200（118,252）, 204（120,254）μg/L vs 151（110,195）μg/L］（P＜0.01）. In the group A, urinary iodine 100-199 μg/L accounted for 71.5%（98/137）. In the group B and C, rates of urinary iodine＜100, 100-199 and 200-300 μg/L showed an increasing trend. The rate of urinary iodine＜100 μg/L showed no significant difference among the three groups（P＞0.05）. The rate of urinary iodine 100-199 μg/L in the group B and C was significantly lower and the rate of urinary iodine 200-300 μg/L was higher than those in the group A（P<0.01）. The rate of urinary iodine＞300 μg/L in the group C was significantly higher than that in the group A（P<0.01）. There was no correlation of urinary iodine level with the serum levels of free triiodothyronine, free thyroxine, thyroid-stimulating hormone, antithyroglobulin antibody, anti-thyroid peroxidase antibody and the occurrence of thyroid nodule（P＞0.05）. Conclusions    Iodine intake in residents in Harbin city is sufficient. Excessive intake of iodine can increase the incidence of thyroid disease. Measurement of urine iodine helps to guide iodine supply in individuals.