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目的了解新疆住院维吾尔族(简称维族)和汉族患者的甲状腺功能与碘营养状态的特点。方法纳入2015年1~5月在新疆维吾尔自治区人民医院内分泌科住院的患者1 098例,其中汉族620例,维族478例,所有患者均完善甲状腺功能及尿碘检测,了解维族、汉族患者各甲状腺功能组的分布情况,以及各甲状腺功能亚组自身抗体阳性率上的差异,并分析总体和各亚组促甲状腺激素(TSH)的受影响因素及其在碘营养状态上的差异。结果住院维族、汉族患者尿典在各甲状腺功能组分布情况(甲亢组/甲减组/甲功正常组)组间比较差异无统计学意义(P>0.05),且维族、汉族患者的尿碘中位数(MUI)均处于碘足量范围(MUI维:167.5μg/L,MUI汉:159.2μg/L),组间比较差异无统计学意义(P>0.05);总样本的TSH与甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)滴度呈正相关(偏相关系数分别为0.109、0.136);根据甲状腺功能分层,临床甲功异常组与亚临床甲功异常组组间自身抗体阳性率比较差异无统计学意义(P>0.05),但均显著高于甲功正常组(P<0.01);临床甲亢组患者的碘营养状态构成(碘缺乏/足量/超足量/过量)与甲功正常组比较差异有显著统计学意义(P<0.01);此外,各甲状腺功能异常亚组MUI(MUI甲亢:132.9μg/L,MUI亚甲亢:158.4μg/L,MUI甲减:146.3μg/L,MUI亚甲减:165.1μg/L)与甲功正常组的MUI(MUI正常:165.1μg/L)比较差异均无统计学意义(P>0.05);而不同甲状腺功能亚组的TSH受影响因素不同。结论住院维族、汉族患者的MUI处于碘足量状态,民族间甲状腺功能异常的分布情况相似,临床甲亢患者的碘缺乏比例较正常组高,这与甲亢患者低碘饮食的干预可能有关。TSH的水平在不同亚组中受影响因素不同,有待扩大样本控制混杂因素后进一步证实。
Objective To understand the characteristics of thyroid function and iodine nutrition in hospitalized Uighur (Uighur) and Han patients in Xinjiang. Methods A total of 1 098 inpatients were admitted to Department of Endocrinology, People’s Hospital of Xinjiang Uyghur Autonomous Region from January to May 2015, including 620 Han patients and 478 Uighurs. Thyroid function and urinary iodine were detected in all patients. The thyroid Functional groups and the differences in the positive rates of autoantibodies in thyroid function subgroups and to analyze the influencing factors of total and sub-thyroid-stimulating hormone (TSH) and their differences in iodine nutrition status. Results There was no significant difference in the distribution of urinary code between Uygur and Han patients in each thyroid function group (hyperthyroidism group / hypothyroidism / normal thyroid dysfunction group) (P> 0.05), and urinary iodine in Uygur and Han patients (MUI dimension: 167.5μg / L, MUI Han: 159.2μg / L). There was no significant difference between the two groups (P> 0.05). The total sample of TSH and thyroid There was a positive correlation between titers of TPOAb and TGAb (partial correlation coefficients 0.109, 0.136, respectively). According to the thyroid function stratification, clinical thyroid dysfunction group and subclinical thyroid dysfunction group (P> 0.05), but both of them were significantly higher than that of normal thyroid function (P <0.01). The iodine nutrition status of patients with clinical hyperthyroidism (iodine deficiency / adequate / (MUI hyperthyroidism: 132.9μg / L, MUI hyperthyroidism: 158.4μg / L, MUI (MUI hyperthyroidism: MUI hyperthyroidism: 158.4μg / L, MUI Hypothyroidism: 146.3μg / L, MUI subclinism: 165.1μg / L) was not significantly different from normal MUI group (MUI normal: 165.1μg / L) 5); and different thyroid function subgroup TSH affected by different factors. Conclusions The MUI in hospitalized Uygur and Han nationality is in iodine sufficient state, and the distribution of thyroid dysfunction among ethnic groups is similar. The proportion of iodine deficiency in clinical hyperthyroidism patients is higher than that in normal group, which may be related to the intervention of low iodine diet in patients with hyperthyroidism. The level of TSH in different subgroups is affected by different factors, to be further confirmed by the expansion of sample control confounders.