摘要目的 分析江苏省连云港市2002-2010年甲状腺疾病住院构成的变化,了解连云港市在实施普遍食盐加碘(USI)过程中碘摄入对甲状腺疾病的影响,为科学防治甲状腺疾病提供流行病学依据.方法 收集2002-2010年连云港市及所属县二级以上医疗机构甲状腺疾病住院患者资料,同时收集连云港市5个县区的居民户碘盐监测结果,分析甲状腺疾病构成的变化,以及甲状腺疾病与碘盐的关系.结果 ①共收集3 559名甲状腺疾病住院患者,男、女性别比为1:3.36.平均年龄为(46.81±14.94)岁,40～ 60岁是高峰年龄.②甲状腺肿大、甲状腺功能亢进、甲状腺炎、甲状腺功能减退和其他甲状腺疾患的构成比分别为41.64％(1 482/3 559)、40.07％(1 426/3 559)、6.83％(243/3 559)、6.21％(221/3 559)和5.25％(187/3 559).③2002-2010年,甲状腺疾病总住院率呈上升趋势(x2=460.12,P＜0.01);甲状腺功能减退、甲状腺肿大、甲状腺功能亢进、甲状腺炎和其他甲状腺疾患的住院率也均呈现上升趋势(x2=50.54、281.91、85.15、19.51、65.01,P均＜0.01).④在住院的甲状腺疾病患者当中,2002-2006年,甲状腺功能亢进的构成比最大,范围为42.03％(124/295) ～ 53.02％(114/215),其次为甲状腺肿大,构成比范围为34.55％(142/411)～39.25％(73/186);2007-2010年,甲状腺肿大的构成比最大,范围为42.11％(232/551)～49.57％(291/587),其次为甲状腺功能亢进,范围为33.05％(194/587) ～ 40.47％(223/551).⑤2002-2010年居民盐碘覆盖率、合格碘盐食用率均呈现上升趋势(x2=183.75、211.99,P均＜0.01).⑥甲状腺疾病总住院率、甲状腺功能减退住院率、甲状腺肿大住院率、其他甲状腺疾患住院率和碘盐覆盖率、合格碘盐食用率之间均存在正相关关系(L=0.83、0.93,0.82、0.87,0.83、0.93,0.74、0.91,P均＜0.05).⑦甲状腺功能亢进与合格碘盐食用率呈正相关关系(rs=0.72,P＜0.05).结论 2002-2010年,连云港市甲状腺疾病住院患者的疾病构成发生了变化,碘摄入对甲状腺疾病住院率的变化有一定影响.

abstractsObjective To analyze the changes in the composition of hospitalization of thyroid disease in Lianyungang City from 2002 to 2010,to learn the impact of iodine intake on thyroid disease in Lianyungang City after implementing universal salt iodization (USI),and to get epidemiologic evidence for prevention and control of iodine deficiency disorders scientifically.Methods Medical reports of the patients with thyroid disease were collected from hospitals at county level and above institutions in Lianyungang City from 2002 to 2010.Monitoring results of household iodized salt were also collected from five counties (districts) in Lianyungang City.The changes in the composition of hospitalization of thyroid disease were analyzed,and the relationship between thyroid disease and iodized salt was studied.Results ① A total of 3 559 patients with thyroid disease were enrolled in the study,the ratio between male and female was 1 ∶ 3.36.Mean age was (46.81 ± 14.94) years old and the peak age was from 40 to 60 years old.② Among the hospitalized patients with thyroid disease,the proportion of goiter patients,hyperthyroidism patients,thyroiditis patients,hypothyroidism and other thyroid disorders was 41.64％ (1 482/3 559),40.07％ (1 426/3 559),6.83％ (243/3 559),6.21％ (221/3 559) and 5.25％ (187/3 559),respectively.③In 2002-2010,the hospitalization rate of thyroid disease showed an upward trend (x2 =460.12,P＜ 0.01),and the hospitalization rates of hypothyroidism,goiter,hyperthyroidism,thyroiditis and other thyroid disorders were all increased year by year (x2 =50.54,281.91,85.15,19.51 and 65.01,all P ＜ 0.01).④From 2002 to 2006,among the patients with thyroid disease,the proportion of hyperthyroidism was the highest,and the range of values was from 42.03％ (124/295) to 53.02％ (114/215).Followed by goiter,and the range of values was from 34.55％ (142/411) to 39.25％ (73/186).From 2007 to 2010,the proportion of goiter became the highest,and the range of values was from 42.11％ (232/551) to 49.57％ (291/587).Followed by hyperthyroidism,and the range of values was from 33.05％ (194/587) to 40.47％ (223/551).⑤From 2002 to 2010,the coverage of iodized salt and the consumption rate of qualified iodized salt both increased year by year (x2 =183.75,211.99,all P ＜ 0.01).⑥There were positive correlations between the hospitalization rates of thyroid disease,hypothyroidism,goiter,other thyroid disorders and the coverage of iodized salt,and the consumption rate of qualified iodized salt (rs =0.83,0.93,0.82,0.87,0.83,0.93,0.74 and 0.91,all P ＜ 0.05).⑦There was a positive correlation between the hospitalization rate of hyperthyroidism and the consumption rate of qualified iodized salt (rs =0.72,P ＜ 0.05).Conclusions There are some changes in the composition of hospitalization of thyroid disease in Lianyungang city from 2002 to 2010.Iodine intake may affect the hospitalization rate of thyroid disease.