庆元县地方性甲状腺病的流行、控制与消除

目的 调查庆元县地方性甲状腺病(简称地甲病)流行情况,评估预防控制效果。方法 采用逐村逐户登记检查方法,普服碘油丸和碘盐。结果 庆元地区人群甲状腺肿大率为39.13％,患病率3.66％;7～14岁儿童甲状腺肿大率达58.22％,患病率为6.02％;尿碘抽查均值为20μg/g肌酐。结论 庆元县是严重地方性碘缺乏病地区,经十余年防治,已达基本控制地甲病标准。     

城,乡10岁儿童甲状腺体积与环境碘含量的研究

碘缺乏病(IDD)是外环境缺碘,机体不能摄入足够的碘而导致的一系列疾病。地方性甲状腺肿(简称地甲肿)是碘缺乏病的一种,地甲病主要通过尿碘和甲状腺肿大率来诊断。长期以来,尿碘作为碘摄入量的判断标准已被人们接受,而且其测定方法也确立,触诊法诊断甲状腺肿大常受一些主观和客观条件限制,故其精确度和准确度受到影响。本文用B超测定甲状腺体积,并初步探讨环境碘含量与甲状腺体积的关系。     

丰县地方性甲状腺肿流行情况调查

丰县地方性甲状腺肿流行情况调查丰县卫生防疫站徐枫地方性甲状腺肿（下简称地甲病）是一种严重危害人民健康的常见地方病，为摸清地甲病在我县的流行情况，在全县范围内进行了甲状腺肿大率、患病率以及水碘、尿碘调查，结果报告如下：１调查方法１．１布点：采用“５·５...     

大雁矿区地方性甲状腺肿调查报告

本文对大雁矿区中、小学生地方性甲状腺肿（简称地甲病）的流行因素做了初步调查分析。结果：７～１４岁儿童甲状腺肿大率为２８．６０％；小学生骨龄延迟者占２８．３７％；中、小学生尿碘检测结果３８．４５±１３．５２μｇ／Ｌ；居民饮用水水碘检测结果６．３３８±０．８０μｇ／Ｌ。另外，大雁居民饮用水来自牙克石水系。以上调查可以说明：大雁矿区为地甲病流行区，其流行原因为环境贫碘所致。从而，结束了大雁是非病区的历史。     

常州地区食盐加碘对人群甲状腺疾病谱的影响评估

目的以碘缺乏纠正状况和住院甲状腺疾病谱的变化对全民食盐加碘有关影响作出评估。方法对人群作碘营养状况与甲状腺肿调查,甲状腺疾病住院病历采用回顾性研究方法搜集。结果居民合格碘盐食用率达95％以上。社区居民甲状腺疾病年住院率暂时性上升最高达54．5／10万,住院甲状腺疾病占总疾病比重亦呈暂时性上升,女性和≥40岁组是受影响的主要人群,甲状腺功能亢进症占甲状腺疾病的比例由平均13．6％增加到34．7％。结论全民食盐加碘消除碘缺乏病的同时其他影响客观存在,碘缺乏的纠正所产生的效益远远超过其他影响的损失。     

我国高碘地方性甲状腺肿研究进展（上）

我国高碘地方性甲状腺肿研究进展（上）陈豪敏，胡新建综述傅宝珊审校高碘地方性甲状腺肿（以下简称高碘地甲病）的发现和证实是６０年代Ｓｕｚｕｋｉ等在日本北海道工作的成就。［１］７０年代未期以来，我国学者对高碘地甲病进行了广泛深入的调查研究，在各个方面的研究...     

检测水碘、盐碘和尿碘含量测定人体碘代谢水平

<正> 缺碘易致“地方性甲状腺肿”和“地方性克汀病”,补碘可予防和治疗这些疾病的发生和发展。而如何掌握补碘程度指标,则甚为重要。现将我县历年有关碘测定资料加以整理分析,以寻求适宜的盐碘浓度,为巩固和提高“地甲病”的防治效果提供科学依据。     

未实施碘盐防治的社区人群甲状腺疾病的调查

目的 研究未实施碘盐防治的社区人群甲关腺疾病的患病率。方法 辽宁省盘山社区1103名14周岁以上居民参加甲状腺疾病的普查,内容包括填写调查表、接受体格检查、测定血清指标及测定尿碘浓度、进行甲状腺B超检查。结果 盘山社区甲亢与甲低患病率分别为16．3‰和2．7‰;亚临床甲亢与亚临床甲低患病率分别为37．7‰和9．1‰;甲状腺自身抗体阳性率10．9％;B超诊断甲状腺肿大经20．7％,其中弥漫性甲状腺肿占16．8％,结节性甲状腺肿占3．9％。结论 自身免疫参与碘缺乏地区甲状腺肿的发生,而且可能是亚临床甲亢与亚临床甲低的主要病因。     

碘缺乏病的危害

1概述 碘是人体所必需的一种微量元素。甲状腺有浓集碘以合成甲状腺激素的功能，而甲状腺激素在各个器官系统的代谢、生长和发育成熟中起着十分重要的作用。碘缺乏病是由于自然环境碘缺乏造成机体甲状腺激素不足所表现的一组疾病的总称，包括地方性甲状腺肿（简称地甲肿）、地方性克汀病（简称地克病）和地方性亚临床克汀病（亚克汀）等，可造成单纯性聋哑、胎儿流产、早产、死产和先天畸形等。     

2012-2013年无锡市甲状腺疾病发病分析

摘要:目的　分析无锡市甲状腺疾病发病现状,为合理补碘提供科学依据。方法　对2012-2013年新发甲状腺疾病资料进行分析,计算发病率等指标。结果　居民年均发病率65.17/10万,男性发病率为38.73/10万,明显低于女性91.22/10万;发病率居前三位的主要病种为结节性甲状腺肿、甲状腺功能亢进和甲状腺功能减退,女性各病种发病率均明显高于男性,以甲状腺炎为最高;以5～14岁发病率为最低,0～4岁以甲状腺功能减退为主,5～14岁为甲状腺功能亢进和甲状腺炎,15～34岁为甲状腺功能亢进和结节性甲状腺肿,35～59岁为结节性甲状腺肿、甲状腺功能亢进和甲状腺恶性肿瘤,60岁～为结节性甲状腺肿、甲状腺功能减退和甲状腺功能亢进;城区发病率显著高于农村。结论　应加强人群碘营养状况与甲状腺疾病之间动态变化的监测,开展科学补碘。     

Goitre prevalence and the state of iodine nutrition in the sundarban delta of north 24-parganas in West Benegal

The main objective of this study was to assess the iodine nutritional status among school children (6-12 yrs) of Sundarban delta in North 24-Parganas district of West Bengal in eastern India. A total of 2050 children were clinically examined for goiter and 240 urine samples were analyzed for iodine and thiocyanate respectively; iodine content in 48 water samples and 210 salt samples were also measured. Results indicate that the studied region is clinically severely goiter endemic having goiter prevalence 33.1 % (grade 1: 30.4 %; grade 2: 2.7%),median urinary iodine level 200 mug/l indicating no biochemical iodine deficiency, 65.2 % salt samples contain recommended level of iodine and the iodine content in drinking water is sufficient while mean urinary thiocyanate level was 0.708+/-0.38 mg/dl. In spite of the consumption of adequate iodine, the existing goiter prevalence may be for the consumption of dietary goitrogens/antithyroid substances that possibly come through food and water.     

浙江省会城市儿童碘营养状况研究分析

通过对浙江省会杭州市 8～ 10岁学龄儿童供碘前的甲状腺肿大率、尿碘、智商 ( IQ)的系统调查 ,结果甲状腺肿大率 10 .0 2 % (触诊法 )和 15.60 % ( B超法 ) ,尿碘中位数 70 .0 1μg/L,平均智商 ( 112 .14± 13.73)。该研究提示 :杭州市儿童碘营养不足 ,呈轻度碘缺乏状态。说明碘缺乏不仅存在于农村 ,城市也可发生 ,应实施并巩固全民食盐加碘以消除缺碘对人群造成的危害。     

Assessment of iodine deficiency in district Bikaner,Rajasthan

The prevalence of iodine deficiency in the Bikaner district of Rajasthan, India, was estimated in a 1995 pilot project involving 527 children 6-12 years of age recruited from three high schools. Goiter, as detected by palpation, was present in 20.5% of these children. A goiter prevalence above 5% is considered indicative of endemic iodine deficiency. According to urine analyses, 3% of children had severe iodine deficiency (urinary excretion levels under 2 mcg/ml), 9% had moderate deficiency (2.0-4.9 mcg/ml), 18% had mild deficiency (5.0-9.9 mcg/ml), and the remaining 70% had adequate iodine levels (10 mcg/ml and above). 32% of families were using salt with no iodine content; another 8% consumed salt with less than 15 ppm of iodine. These findings indicate that iodine deficiency is a serious public health problem in this district and suggest a need to strengthen monitoring of the quality of salt procured.     

成安县部分高碘乡镇停供碘盐前后甲状腺肿流行病学调查

目的研究高碘地区居民停止食用碘盐对甲状腺肿的影响。方法随机抽取2个高碘乡8～10岁儿童用B超法诊断地方性甲状腺肿,同时检测居民的食用碘盐情况。结果停供碘盐前儿童甲状腺肿大率为10.57%,停供碘盐后1年时儿童甲状腺肿大率为5.36%,差异有统计学意义(χ2=4.84,P0.05)。停供碘盐前与停供碘盐后1年时,碘盐覆盖率差异有统计学意义(χ2=104.53,P0.01)。结论该县属水源性高碘地区,居民应食用无碘盐。     

Experience with iodine prophylaxis in the province of Bolzano

Since 1981 in the province of Bolzano a "free-choice" iodine prophylaxis with iodinated dietary salt has been implemented. An epidemiological survey carried out in 1982 in 3109 schoolchildren living in this region showed an incidence of endemic goiter grade 1B-3 (WHO classification) of 23.6 +/- 14.0% and an urinary iodine excretion of 10.2 +/- 8.0 micrograms/l (colorimetric analysis) compared to the values of 39.6 +/- 17.7 micrograms/l found in a similar population of schoolchildren living in a non goitrous urban area in Northern Italy (Padua). This program of iodine prophylaxis was advertised through the local mass media. A further epidemiological survey, performed in the whole province in the year 1990, involving 1046 schoolchildren, randomly selected, showed an average goiter incidence of 1.6 +/- 1.3% and a urinary iodine excretion of 137.1 +/- 104.4 micrograms/l (ICP-MS analysis) in comparison to the values of 182.6 +/- 131.7 micrograms/l seen in the schoolchildren of the town of Padua. During the period of iodine prophylaxis the content of iodine in the commercially available iodinated dietary salt was also estimated. In 1990 the average content was 31.0 mg/kg and in 1997 was 27.1 mg/kg. These data therefore confirm the usefulness of iodinated salt in the prophylaxis of endemic goiter.     

西安市碑林区2006年碘缺乏病调查结果

目的了解西安市碑林区碘缺乏病防治现状，完善可持续防治策略，为今后制定该区碘缺乏病的防治措施提供可靠依据。方法用触诊法对全区所有学生进行甲状腺肿大患病调查。随机抽取320份居民用户食用盐，用直接滴定法测定碘盐含量。随机采取尿样132份，用砷铈接触法测定尿碘含量。结果该区在校学生甲状腺肿大率为1．20％，其中7～15岁人群肿大率为2．08％。碘盐合格率为99．06％。尿碘中位数为204．5μg／L。结论该区已达到国家消除碘缺乏病的标准，人群碘营养水平处于基本适宜状态。     

European project of structural funds: eradication of endemic goiter and iodine deficiency disorders in Southern Italy

Iodine deficiency disorders and endemic goiter are still present in the population of Southern Italy, where the use of iodized salt is not widely diffused because of a lack of information and health education on this problem. The aim of this project financed by the "structural funds" (objective 1) of the European Union, is to eradicate endemic goiter and iodine deficiency in the population of Southern Italy. The project comprises various subsequent steps. Initially, the grade of iodine deficiency (measuring urinary iodine excretion) and the prevalence of endemic goiter (measuring thyroid volume by echography) will be evaluated in the whole schoolchildren population aged 12-14. In addition, a widespread promotional campaign on the mass media (newspaper, TV, etc.) will be performed in order to implement the use of iodized salt. Subsequently, the effect of this campaign to promote the use of iodized salt will be verified evaluating the increase of urinary iodine excretion and the decrease of enlarged thyroid volumes in the schoolchildren population.     

National Institute of Hygiene in Warsaw: an initiator of iodine prophylaxis

A well defined goiter area in Southern Poland has been known since 19th century. An iodine prophylaxis program initiated by the National Institute of Hygiene was realized in Krakow province and introduce at the level of 5 mg KI/kg of table salt in 1935. The program brought positive health results; the percentage of goitrous inhabitants of Southern Poland decreased. The goiter prophylaxis was suspended during the Second World War. After the war in the years 1945-46 epidemiological studies confirmed high incidence of goiter, especially in the Carpathian region. As the result of these investigations KI salt supplementation started in 1947. High goiter incidence was still noted, that is why the KI supplementation was intensified from the level of 3 to 30 mg/kg. Observed cases of severe iodine deficiency disorders disappeared and goiter in Southern Poland became mild. The National Institute of Hygiene carried out in early 90's investigations on the KI content in market samples of fortified salt. The results of these studies showed that the technological process of salt iodization was not proper; the concentration of KI in salt samples collected in Krakow province, i.e. territory of endemic iodine deficiency in the environment--was lower then recommended. Also the observed unsatisfactory clinical results of the iodine prophylaxis forced to correct the preventive action.     

Epidemiologic investigation on the prevalence of goiter and urinary excretion of iodine in the school population of the province of Reggio Emilia

The prevalence of goiter was evaluated in a sample from the schoolchildren population of Reggio Emilia district. 1020 children underwent physical examination of thyroid gland and thyroid ultrasonography for determination of thyroid volume. Urinary iodine excretion (UIE) was measured in 837/1020 (82.1%). Iodine content was measured in water samples collected from 65 wells and 12 springs all around the district. The prevalence of goiter according to thyroid gland palpation was 26.2%. Thyroid volume was 4.74 +/- 1.87 ml, and the median UIE value 85 micrograms/l. According to the UIE classes as defined by WHO, 57.8% of all subjects showed a UIE less than 100 micrograms/l. In 57 out of 65 wells and in all the 12 springs examined, iodine was completely absent. In the remaining 8 wells, only iodine traces were found. Based on the results of physical examination of the thyroid gland, Reggio Emilia district should be regarded as an endemic goiter area. Nevertheless, thyroid volume measurement by ultrasound indicates that goiter prevalence may be markedly overestimated by palpation. The high prevalence of subjects featuring an increased thyroid volume, the low median UIE value and the poor iodine content in the local reservoirs of drinkable water suggest the opportunity for iodine prophylaxis in the Reggio Emilia district.     

Thyroid size and goiter prevalence after introduction of iodized salt: a 5-y prospective study in schoolchildren in Côte d'Ivoire

BACKGROUND: The long-term goal of salt iodization is elimination of iodine deficiency and reduction of the goiter rate to < 5% in school-aged children. Normalization of the goiter rate probably indicates disappearance of iodine deficiency disorders as a public health problem. However, thyroid size may not return to normal for months or years after correction of iodine deficiency. OBJECTIVE: We described the time course and pattern of changes in thyroid size and goiter rate in response to the introduction of iodized salt in an area of severe endemic goiter. DESIGN: In a 5-y prospective study, we measured thyroid size by ultrasonography and urinary iodine and thyroid hormone concentrations in schoolchildren 6 mo before the introduction of iodized salt and annually for 4 y thereafter. RESULTS: Four years after the introduction of iodized salt and normalization of the median urinary iodine concentration, mean thyroid size had decreased 56% (P < 0.0001). However, 29% of the children remained goitrous, with a significant age shift in the distribution of goiter. At baseline, the goiter rate was significantly higher in younger (age: 5-9 y) than in older (age: 10-14 y) children (P < 0.0001). At 2, 3, and 4 y after salt iodization, the goiter rate was significantly higher in the older than in the younger children (at 4 y: 52% compared with 19%), and the difference increased with time (P < 0.0001). CONCLUSION: The goiter rate in school-aged children may remain sharply elevated for up to 4 y after successful introduction of iodized salt, primarily because of persistent goiter in older children.