摘要目的:探讨碘营养水平与甲状腺疾病的关系。方法:选取2016 - 2018年在山东省地方病防治研究所就诊的299例甲状腺疾病患者作为病例组，根据病情分为Graves病组（GD组，137例），慢性淋巴细胞性甲状腺炎组（HT组，90例）和甲状腺结节组（72例），选取同时期在查体中心体检的无甲状腺疾病史、甲状腺彩超检查和甲状腺功能均正常的健康体检者75例作为对照组。采集晨尿，采用砷铈催化分光光度法检测尿碘；抽取空腹静脉血，采用电化学发光法检测血清促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT 3）、游离甲状腺素（FT 4）、甲状腺球蛋白抗体（TgAb）及甲状腺过氧化物酶抗体（TPOAb）水平。 结果:4组尿碘中位数比较差异有统计学意义（ H = 42.530， P < 0.05），其中GD、HT组尿碘中位数（326.79、341.91 μg/L）均高于甲状腺结节和对照组（235.01、187.32 μg/L， P均< 0.05）。GD组TSH、FT 3、FT 4水平与对照组比较，差异均有统计学意义（ P均< 0.05）。HT组TgAb和TPOAb阳性率均高于GD、甲状腺结节和对照组（ P均< 0.05），GD组TgAb和TPOAb阳性率均高于甲状腺结节和对照组（ P均< 0.05）。 结论:GD和HT患者的碘营养过量，高碘摄入可能导致GD和HT的发生。甲状腺相关功能检查结合实验室尿碘检测可简便、快捷地诊断甲状腺疾病。

abstractsObjective:To investigate the relationship between iodine nutrition level and thyroid disease.Methods:Totally 299 patients with thyroid disease who were treated at Shandong Provincial Institute for Endemic Disease Prevention and Control from 2016 to 2018 were selected as case group which was further divided into Graves' disease group (GD group, 137 patients), chronic lymphocytic thyroiditis group (HT group, 90 patients) and thyroid nodule group (72 patients). At the same time, 75 healthy people with no history of thyroid disease, normal thyroid color ultrasound and thyroid function were selected as control group. Morning urine was collected and urinary iodine was detected by arsenic cerium catalytic spectrophotometry. Fasting venous blood was extracted, and serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid globulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) were detected by electrochemiluminescence method. Results:The difference of median urinary iodine in the 4 groups was statistically significant ( H = 42.530, P < 0.05). The medians urinary iodine in GD and HT groups (326.79, 341.91 μg/L) were higher than those of thyroid nodule group and control group (235.01, 187.32 μg/L, P < 0.05). The levels of TSH, FT 3 and FT 4 in GD group were compared with those of control group, and the differences were statistically significant ( P < 0.05). The positive rates of TgAb and TPOAb in HT group were significantly higher than those in GD, thyroid nodule and control groups, and the positive rates of TgAb and TPOAb in GD group were higher than those in thyroid nodule and control groups ( P < 0.05). Conclusions:GD and HT patients have excessive iodine nutrition, and high iodine intake may lead to the occurrence of these thyroid diseases (GD and HT). Thyroid function test combined with laboratory urinary iodine test can be used to diagnose thyroid diseases simply and quickly.