孔德明;张家秀;
(8-year follow up investigations)Guiyang Medical College etc.

• 1: 贵阳医学院地方性甲状腺肿和克汀病防治研究组
• 2:天津医学院临床内分泌研究所
• 3:贵州省黔东南州、麻江县、凯里县卫生防疫站

摘要(Abstract)：

从1979年起,在贵州省麻江县河坝公社用1/5万加碘盐对地方性甲状腺肿和克汀病进行了八年防治。结果:防治一年时,成人尿碘几何平均值从14.5μg/gcr 上升到117.5μg/gcr;甲状腺24h 吸~(131)I 率从74.3%降至40.6%。防治二年时,甲状腺肿患病率从31.5%降至5.2%。防治三年时,居民甲状腺激素水平和功能恢复正常,克汀病患病率从3.1%降为0。防治五年时,引产胎儿甲状腺形态和功能正常,大脑发育与非病区同龄胎儿相比已无差异。防治八年时,甲状腺患病率降至1.9%,达到根除本病的水平。
Prior to the using of iodized salt in 1979,investigations had been carried out on the etiology,epidemiology,iodine metabolism,pituitary-thyroid axis f unc tion and clinical features of cretinism,and morphologic and functional changes of the thyroid and cerebral cortex of artificial aborted fetuses in Heba commune, Majiang county,Guizhou province.The results were as follows:The goiter rate was 31.5% and the cretinism was 3.1%.The mean value of urinary iodine of adu- its was 14.5μg/g creatinine;64% of the inhabitants surveyed showed the value tess than 25μg/g creatinine.The 24-hr thyroid I uptake rate was 0.74 (74.3%).The T4 value was 83.2±41.6nmol/L(6.4±3.2μg/dl),T31.92±2.3 nmol(127.9±39.3ng/dl)and TSH19.6±18.9mu/L.Analysis of the thyroid fun- ction types showed that decompensated type and compensated type were 9.5% and 49.0% respectively.The incidence of infant hormonal hypothyroidism and cretinism were 53.8% and 20% respectively.The detection rate of hypot- hyroidism of maternal blood,umbilical cord blood and fetal ventricular blood in the endemic region was around 50%,In the endemic region the goiter rate among 30 fetuses was 43.3% and 6—8th month fetuses showed the brain reta rded in development. The effects of prophylaxis with iodized salt(1:50,000)after one year the inhabitant urinary iodine raised to 117.5μg/gcr,and only 2.2% of those were less than 25μg/gcr.The goiter prevalence was 5.2%,two years after prophyla_ xis and further reduced to 1.9% in 1987.It was showed that the complete eradication of iodine deficiency was therefore feasible within eight yaars.Af- ter using iodized salt for three years,the inhabitant thyroid fuction became normal and not a single case of hypothyroidism or cretinism was detected among 51 and 111 infants respectively.After five years of supplement with iodized salt 14 6—8th month fetal brains and the thyroid glands were studied There was no significant difference between the iodine treated endemic fetuses and the nonendemic ones and the hormonal hypothyroidism in both mothers and fetuses in the endemic area returned to normal after correction of iodine lack in the mothers.

关键词(KeyWords)： 地方性甲状腺肿;克汀病;碘化钠;甲状腺激素;甲状腺机能减退;贵州
Endemic goiter;Cretinism;Iodized Salt;Thyroid hormones;Hypothyroidism;Guizhou

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 孔德明;张家秀;
(8-year follow up investigations)Guiyang Medical College etc.

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