甲状腺疾病发病趋势碘缺乏学会北戴河2.ppt

* * Partial List of Environmental Agents That Interfere with Thyroid Function * 甲状腺自身免疫相关影响因素 Thyroid，2010,12 * 小 结 自身免疫性甲状腺疾病发病处于增加趋势； 甲状腺恶性肿瘤处于增加趋势； 射线暴露与二者的增加相关； 甲状腺干扰物的影响值得关注 * Thanks * * * 不同临床情况下血清TSH/FT4的典型关系 * 我国大型妊娠伴甲状腺疾病流行病学调查，纳入4800例妊娠≤20周女性，探讨中国碘充足地区妊娠前半期甲状腺激素不足的流行病学状况。结果临床甲减患病率为0.6%，亚临床甲减为5.27%，低T4血症为2.15%。 * * * 3 妊娠期TPOAb阳性者的亚临床甲减发病率显著高于TPOAb阴性者。妊娠前半期，亚临床甲减中28.86%为TPOAb阳性 Prevalence of thyroid ATAs in the contaminated and noncontaminated Belarusian villages. The prevalence of TPOAbs alone was significantly higher in subjects living in the contaminated Lelchitsy village than in those living in the noncontaminated Braslav village. A slightly, but not significantly, higher prevalence of TgAbs alone and/or with TPOAb was also observed in subjects living in the contaminated village. NS, Not significant. Prevalence of thyroid ATAs in the contaminated and noncontaminated Ukrainian villages. The prevalence of TPOAbs alone was slightly, but not significantly, higher in subjects living in the contaminated Korosten village than those living in the noncontaminated Borispol village. No difference was observed in the prevalence of positive TgAbs alone and/or with TPOAb. NS, Not significant. Prevalence of thyroid ATAs in the contaminated and noncontaminated Russian villages. The prevalence of TPOAbs alone and/or with TgAbs was low and not different in exposed and nonexposed subjects. The prevalence of TgAb alone was significantly higher in the exposed village of Klintsy than in the nonexposed village of Maloarchangelsk. NS, Not significant. 来自斯洛伐克的研究，对严重多氯联苯污染区研究，比较血中多氯联苯在上1/4和下1/4比较，发现TPOAb抗体阳性率显著增加，生活在污染区，有PCBs暴露与不暴露的妇女比较，TPOAb、 TgAb和TRAb阳性率显著增加。 * 小结 甲状腺疾病是妊娠妇女最常见的疾病之一 妊娠期亚临床甲状腺疾病主要有亚临床甲减、低甲状腺素血症、甲功正常的TPOAb阳性及亚临床甲亢 妊娠期亚临床甲状腺疾病显著增加产科并发症，减低后代智力发育水平 积极应用L-T4治疗亚临床甲状腺疾病，可有效降低产科并发症，改善后代智力发育 应对妊娠妇女和计划妊娠的妇女进行亚临床甲状腺疾病的筛查 * Health Rep. 2012 Mar;23(1):7-16. * 北京地区2010年甲状腺癌发病率 《北京市2011年度健康白皮书》 甲状腺癌2010年新发1099例， 占恶性肿瘤新发的2.9%。 发病率从2001年2.7/10万上升到2010年的8.78/10万， 9年间增长225.2%