足量碘营养状况下甲状腺肿大原因分析

目的 研究足量碘营养状况下甲状腺肿大原因.方法 完全随机选取2008年6月至2009年6月在山西省地方病防治研究所附属医院甲状腺专科门诊就诊的362例甲状腺肿大的初诊患者,进行甲状腺功能、甲状腺自身抗体测定以及甲状腺体积测量.结果 362例甲状腺肿大患者中,130例诊断为毒性弥漫性甲状腺肿(Graves病),90例诊断为慢性淋巴细胞性甲状腺炎(桥本病),43例诊断为结节性甲状腺肿,41例诊断为原发性甲状腺功能减退症,17例诊断为亚急性甲状腺炎,18例诊断为产后甲状腺炎,23例诊断为单纯性甲状腺肿.各种病患者均表现为女性占优势.结节性甲状腺肿大和原发性甲状腺功能减退症患者平均年龄高于其他患者(P<0.05).甲状腺微粒体抗体(TMAb)和(或)甲状腺球蛋白抗体(TGAb)的l辋性率为65.7%(238例),TMAb的阳性率为60.8%(220例),TGAb的阳性率为58.6%(212例).桥本病和Graves病患者的TMAb、TGAb水平明显高于其他病患者(P<0.05).结论 在目前足量碘营养条件下,各种甲状腺疾病特别是自身免疫性甲状腺疾病成为甲状腺肿大的主要原因.

Abstract：

Objective To study the cause of goiter with non-deficiency iodine. Methods Thyroid hormones and thyroid autoantibodys were determined and thyroid volumes were measured on 362 newly diagnosed outpatients with goiter. Results Among 362 cases of patients, 130 were diagnosed of Graves, 90 of hashimotos, 43 of thyroid nodules, 41 of primary hypothyroidism, 17 of subacute thyroiditis, 18 of postpartum thyroiditis and 23 of simple goiter. There were more females (P < 0.05). Patients with the thyroid nodules and the primary hypothyroidism were more elderly than other patients ( P < 0. 05 ). The positive rate of thyroid autoantibodys was 65. 7% , 60. 8% of TMAb and 58.6% of TGAb. The levels of TMAb and TGAb in both Graves and Hashimoto were higher than those in other groups (P <0.05). The levels of autoantibodys in the simple goiter were the lowest. The volume of thyroid in both Graves and Hashimoto were higher than that in other groups ( P < 0.05 ). The volumes of thyroid were correlated to the level of thyroid autoantibodys (P <0.05). Conclusion The thyroidism, especially the autoimmune thyroid diseases ( AFTD) is the prime reason for goiter with non-deficiency iodine.

Analysis of the cause of goiter with non-deficiency iodine

Objective To study the cause of goiter with non-deficiency iodine. Methods Thyroid hormones and thyroid autoantibodys were determined and thyroid volumes were measured on 362 newly diagnosed outpatients with goiter. Results Among 362 cases of patients, 130 were diagnosed of Graves, 90 of hashimotos, 43 of thyroid nodules, 41 of primary hypothyroidism, 17 of subacute thyroiditis, 18 of postpartum thyroiditis and 23 of simple goiter. There were more females (P < 0.05). Patients with the thyroid nodules and the primary hypothyroidism were more elderly than other patients ( P < 0. 05 ). The positive rate of thyroid autoantibodys was 65. 7% , 60. 8% of TMAb and 58.6% of TGAb. The levels of TMAb and TGAb in both Graves and Hashimoto were higher than those in other groups (P <0.05). The levels of autoantibodys in the simple goiter were the lowest. The volume of thyroid in both Graves and Hashimoto were higher than that in other groups ( P < 0.05 ). The volumes of thyroid were correlated to the level of thyroid autoantibodys (P <0.05). Conclusion The thyroidism, especially the autoimmune thyroid diseases ( AFTD) is the prime reason for goiter with non-deficiency iodine.