CN108827947A - A kind of evaluation method of Iodine nutrition situation in hypothyroidism - Google Patents
A kind of evaluation method of Iodine nutrition situation in hypothyroidism Download PDFInfo
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- CN108827947A CN108827947A CN201810648333.3A CN201810648333A CN108827947A CN 108827947 A CN108827947 A CN 108827947A CN 201810648333 A CN201810648333 A CN 201810648333A CN 108827947 A CN108827947 A CN 108827947A
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Abstract
The present invention relates to a kind of evaluation method of Iodine nutrition situation in hypothyroidism, it will be seen that the relationship that iodine nutrition level and hypothyroidism (hereinafter referred to as clinical first subtracts) and Subclinical hypothyroidism (hereinafter referred to as subclinical hypothyroidism) occur, while can subtract for clinical first and provide theoretical foundation with the early prevention and treatment of subclinical hypothyroidism, early diagnosis and raising curative effect；Include the following steps：(1) Selecting research object；(2) collection of specimens；(3) Samples detection；(4) it diagnoses；(5) statistical procedures.
Description
Technical field
The present invention relates to a kind of evaluation method of Iodine nutrition situation in hypothyroidism.
Background technique
Iodine is the necessary raw material of human body synthetic thyroid hormone, and crowd's iodine nutrition level is answered with crowd's thyroid gland health status
Emphasis as concern.Long-term Iodine intake is excessive or the very few variation that will affect human thyroglobulin function, makes thyroid disease
Disease incidence obviously rise, especially clinical first subtracts the generation with subclinical hypothyroidism in increase trend.Therefore understand clinical first subtract and
The iodine-nutrition of patients with subclinical hypothyroidism, inquires into iodine nutrition level and clinical first subtracts the relationship occurred with subclinical hypothyroidism very
Necessity, while can subtract for clinical first and provide theoretical foundation with the early prevention and treatment of subclinical hypothyroidism, early diagnosis and raising curative effect.
Summary of the invention
The present invention provides a kind of it will be seen that iodine nutrition level and clinical first subtract the relationship occurred with subclinical hypothyroidism, simultaneously
It can subtract for clinical first and provide the Iodine nutrition shape of theoretical foundation with the early prevention and treatment of subclinical hypothyroidism, early diagnosis and raising curative effect
Evaluation method of the condition in hypothyroidism.
A kind of evaluation method of Iodine nutrition situation of the invention in hypothyroidism, includes the following steps：
(1) Selecting research object：It chooses 200~300 or so clinical first and subtracts patient and 200~300 subclinical first
Subtract patient as study group, while choosing 100~200 physical examination of healthy population as a control group；
(2) collection of specimens：Research object empty stomach 8h or more, acquires venous blood 6ml, and centrifugal separation plasma is to be measured；It adopts on the same day
Collect urina sanguinis 10ml, be placed in cleaning vinyl tube, urine iodine detection is carried out in 8h；
(3) Samples detection：Free serum triiodo thryonine, free thyroid are measured using Chemiluminescence immunoassay
Element, total thyroxin, total triiodo thryonine and thyrotropic hormone；
(4) it diagnoses：
A, iodine-nutrition assessment is carried out to research object：100 μ g/L of Medianofurinaryiodine < is iodine deficiency；Medianofurinaryiodine
It is appropriate for iodine between 100~199 μ g/L；It is iodine excess between 200~299 μ g/L of Medianofurinaryiodine；Medianofurinaryiodine >=300 μ
G/L is excessive iodine；
B, the diagnosis of research object：Clinical first subtracts：The symptom or sign subtracted with clinical first while the thyroid gland function having
It can index：Thyrotropic hormone > 4.2mIU/L, free triiodothyronine < 2.8pmol/L and (or) free thyroxine
< 12pmol/L；Subclinical hypothyroidism：Thyrotropic hormone > 4.2mIU/L, free triiodothyronine and free thyroxine
In the normal range；
(5) statistical procedures：Carry out system statistical procedures using SPSS19.0 statistical software, enumeration data withOr
Median indicates that measurement data compares with rank sum test and variance analysis, and the correlativity between each factor is using linear correlation point
Analysis, P < 0.05 show that difference is statistically significant.
Detailed description of the invention
Fig. 1 is the assessment that clinical first subtracts group, subclinical hypothyroidism group and control group iodine-nutrition
Specific embodiment
With reference to the accompanying drawings and examples, specific embodiments of the present invention will be described in further detail.Implement below
Example is not intended to limit the scope of the invention for illustrating the present invention.
A kind of evaluation method of Iodine nutrition situation of the invention in hypothyroidism, includes the following steps：
(1) Selecting research object：In March, 2015~2017 year December is chosen in Cangzhou division of endocrinology of the hospitals of traditional Chinese and western medicine
Medical patient 529 are used as study group, wherein male 203, is classified as two groups by female 326：Clinical first subtracts group 255,
It is middle male 97, female 158, the age 21~70 years old, 42.2 ± 15.1 years old average；Subclinical hypothyroidism group 274, wherein male 105,
It is female 169, the age 20~70 years old, 46.5 ± 17.4 years old average.It is examined headed by all cases are equal, does not receive any treatment, defined
It is diagnosed as clinical first to subtract and subclinical hypothyroidism, excludes the systemic disease for merging Non-thyrogenous.Medical center physical examination is chosen simultaneously
Normal healthy people 130 as a control group, wherein male 58, women 72, the age 21~70 years old, average age 45.3 ±
12.5 years old, liver, kidney, thyroid function, blood routine examination were normal, excluded the systemic disease for having endocrine system and Non-thyrogenous
Disease；
(2) collection of specimens：Research object empty stomach 8h or more, acquires venous blood 6ml, and centrifugal separation plasma is to be measured；It adopts on the same day
Collect urina sanguinis 10ml, be placed in cleaning vinyl tube, urine iodine detection is carried out in 8h；
(3) Samples detection：Free serum triiodo thryonine (FT is measured using Chemiluminescence immunoassay3), free first
Shape parathyrine (FT4), total thyroxin (TT4), total triiodothyronine (TT3) and thyrotropic hormone (TSH), with Germany
Roche Holding Ag Cobase602 fully automatic electric chemical illumination immunity analysis instrument and matched reagent.Urinating Iodine assay selects urine iodine quantitative
Detection kit, reagent are the production of Wuhan all living creatures biochemical technology Co., Ltd, and instrument uses Hitachi, Japan 7600-110 type
Automatic clinical chemistry analyzer；
(4) diagnostic criteria：
A, iodine-nutrition assessment is carried out to research object：By 2001 World Health Organization/United Nations Children's Fund/state
Border controls the standard that IDD(Iodine deficiency disorders) council proposes, 100 μ g/L of Medianofurinaryiodine (MUI) < is iodine deficiency；Medianofurinaryiodine
(MUI) appropriate for iodine between 100~199 μ g/L；It is iodine excess between 200~299 μ g/L of Medianofurinaryiodine (MUI)；It urinates in iodine
Digit (MUI) >=300 μ g/L is excessive iodine；
B, the diagnosis of research object：Clinical first subtracts：The thyroid function for subtracting symptom or sign with clinical first, while having
Index：Thyrotropic hormone > 4.2mIU/L, free triiodothyronine < 2.8pmol/L and (or) free thyroxine <
12pmol/L；Subclinical hypothyroidism：Thyrotropic hormone > 4.2mIU/L, free triiodothyronine and free thyroxine are equal
In the normal range；
(5) statistical procedures：Carry out system statistical procedures using SPSS19.0 statistical software, enumeration data with x ± S or in
Digit indicates that measurement data compares with rank sum test and variance analysis, and the correlativity between each factor uses Liner correlation,
P < 0.05 shows that difference is statistically significant.
The result obtained according to the above method is as follows：
(1) assessment of urine iodide level and iodine-nutrition：Clinical first subtracts poor between group and the urine iodine MUI group of subclinical hypothyroidism group
Different not statistically significant (P > 0.05), compared with the control group difference statistically significant (P < 0.05) (table 1, Fig. 1).It is clinical
It is not statistically significant (P > 0.05) with the iodine-nutrition composition ratio group difference of subclinical hypothyroidism group that first subtracts group.Two groups of patients
Iodine nutrition composition ratio compared with the control group difference have statistics anticipate (P < 0.05), be mainly manifested in iodine in two groups and suffer from right amount
Person accounts for smaller, and iodine deficiency and iodine excess accounting are larger.
The clinical first of table 1 subtracts group, subclinical hypothyroidism group and control group urine iodide level and iodine-nutrition assessment
(2) clinical first subtracts a group comparison for urine iodine number and thyroid function index：Difference urine iodine group clinic first subtracts patients serum
FT3、FT4、TT3、TT4, comparing difference is not statistically significant (P > 0.05) (table 2) between TSH；Urinate iodine number and thyroid function index
Carry out correlation analysis, the urine iodine number and serum FT of iodine deficiency group, iodine excess group and excessive iodine group patient3、FT4、TT3、TT4Have
Correlation does not have correlation (table 3) with serum TSH.
The different urine iodine group clinic first of table 2 subtract the analysis of patient's thyroid function indicator difference
The clinical first of table 3 subtracts group Urinary iodine number compared with thyroid function is index related
(3) comparison of subclinical hypothyroidism group urine iodine number and thyroid function index：Difference urine iodine group patients with subclinical hypothyroidism
Serum FT3、FT4、TT3、TT4, comparing difference is not statistically significant (P > 0.05) (table 4) between TSH；Iodine deficiency group and excessive iodine group
Patient's urine iodide level and serum FT3And FT4Between have a correlation, iodine deficiency group and serum TSH are negatively correlated (table 5).
The different urine iodine group patients with subclinical hypothyroidism thyroid function indicator difference analyses of table 4
5 subclinical hypothyroidism group Urinary iodine number of table is compared with thyroid function is index related
Thyroid gland is one of human body principal endocrine body of gland, and iodine is that thyroid gland synthetic thyroid hormone is essential heavy
Raw material is wanted, since the implementation Universal salt iodization policy of China 1996 (USI), with the improvement of crowd's iodine-nutrition, has been faced
Bed first subtracts and increases year by year with subclinical hypothyroidism illness rate, and influence of the Iodine intake to hypothyroidism becomes medicine again
Boundary's focus of attention problem.Domestic several scholars report that urine iodide levels are related with its thyroid function reduction, Iodine nutrition shortage or
It is excessive easily to increase clinical first and subtract the illness rate with subclinical hypothyroidism, but it is epidemiological study that these are mostly, subtracted with clinical first and
Patients with subclinical hypothyroidism is that research object inquires into iodine nutrition level and the research of thyroid function relationship is less.The intake of human body iodine
Amount is essentially equal with discharge rate, and about 90% iodine is discharged by kidney, when group's urine iodine concentration sample size is sufficiently large, group
Urine iodine MUI can represent the Iodine nutrition situation of the group, be that detection at present and evaluation individual and nutrition status of iodine are most easy to be easy
Capable index.
This method subtracts patient, 274 patients with subclinical hypothyroidism and 130 physical examination of healthy population to 255 clinical first and urinates
Iodine and the detection of thyroid function five indices, clinical first subtracts urine iodine MUI points of group, subclinical hypothyroidism group and control group as the result is shown
It is not 154.5 μ g/L, 148.3 μ g/L and 174.3 μ g/L, comparing difference is not statistically significant (P < 0.05) between each group；Clinical first
Subtract the urine iodine MUI of group and subclinical hypothyroidism group patient lower than physical examination of healthy population, and urinates iodine MUI in 100~199 μ g/L ranges
Interior, patient and physical examination of healthy population group in this research are generally in the appropriate state of iodine, but urine iodide level wider range, individual difference
It is different larger.Clinical first subtracts group and subclinical hypothyroidism group urine iodide level exception person is respectively 61.2% and 68.8%, wherein clinical first
Subtract a group iodine deficiency patient and account for 23.1%, iodine excess and excessive iodine patient account for 38.1%；Subclinical hypothyroidism group lacks patient and accounts for
30.4%, iodine excess and excessive iodine patient account for 38.4%；Control group urine iodide level accounts for 47.7% extremely, hence it is evident that subtracts lower than clinical first
Group and subclinical hypothyroidism group, wherein iodine deficiency person accounts for 16.9%, and iodine excess and excessive iodine person account for 30.8%, this result illustrates this
Regional clinic first subtracts patient and patients with subclinical hypothyroidism iodine to take in excessive or insufficient situation more serious, but physical examination of healthy population
There is a situation where that iodine intake is abnormal, it is particularly evident that iodine takes in excessive phenomenon.Clinical first subtracts group in Iodine nutrition composition ratio and Asia is faced
It is not statistically significant that bed first subtracts group interpatient variation, every group compared with the control group difference it is statistically significant, show two groups
Ratio shared by the iodine deficiency and excessive iodine of patient is higher than control group.Urine iodide level and serum FT3、FT4、TT3、TT4With TSH into
Row correlation analysis show that clinical first subtracts group patient's iodine deficiency, iodine excess and excessive iodine and serum FT3、FT4、TT3And TT4There is phase
Guan Xing, subclinical hypothyroidism group patient iodine deficiency and excessive iodine and serum FT3And FT4There is correlation, iodine deficiency is negatively correlated with TSH, mentions
The morbidity for showing that excessive iodine intake or deficiency and clinical first subtract with subclinical hypothyroidism has specific relationship.
In conclusion iodine deficiency and excessive iodine are that clinical first is caused to subtract the key factor occurred with subclinical hypothyroidism,
This area clinic first subtracts to occupy the majority with patients with subclinical hypothyroidism iodine excess, excessive iodine and the ratio of iodine deficiency person, control group health
Examinee's iodine excess, excessive iodine and the number accounting of iodine deficiency person are quite a few, it is therefore proposed that urine iodine detection is carried out to healthy person, with
The diet guidance of science is just provided, thyroid gland function should be carried out to urine 100 μ g/L of iodine < and the healthy person for urinating 200 μ g/L of iodine >
The screening of energy, so that early prevention and early detection clinic first subtract especially subclinical hypothyroidism；Limitation patient's iodine is taken the photograph into people
As one of remedy measures, it is proposed that urine iodine subtracts a conventional detection with patients with subclinical hypothyroidism as clinical first, for clinical doctor
It is raw adopt an effective measure to control patient's urine iodide level and be in appropriate state foundation is provided, to improving the caused clinic of iodine intake exception
First subtracts with the therapeutic effect of subclinical hypothyroidism and its disease incidence of attenuating with important directive significance.
The above is only a preferred embodiment of the present invention, it is noted that for the ordinary skill people of the art
For member, without departing from the technical principles of the invention, several improvements and modifications, these improvements and modifications can also be made
Also it should be regarded as protection scope of the present invention.
Claims (1)
1. a kind of evaluation method of Iodine nutrition situation in hypothyroidism, which is characterized in that include the following steps：
(1) Selecting research object：It chooses 200~300 clinical first and subtracts patient and 200~300 patients with subclinical hypothyroidism works
For study group, while choosing 100~200 physical examination of healthy population as a control group；
(2) collection of specimens：Research object empty stomach 8h or more, acquires venous blood 6ml, and centrifugal separation plasma is to be measured；Morning is acquired on the same day
10ml is urinated, is placed in cleaning vinyl tube, urine iodine detection is carried out in 8h；
(3) Samples detection：Using Chemiluminescence immunoassay measurement free serum triiodo thryonine, free thyroxine, total
Thyroxine, total triiodo thryonine and thyrotropic hormone；
(4) it diagnoses：
A, iodine-nutrition assessment is carried out to research object：100 μ g/L of Medianofurinaryiodine < is iodine deficiency；Medianofurinaryiodine 100
It is appropriate for iodine between~199 μ g/L；It is iodine excess between 200~299 μ g/L of Medianofurinaryiodine；Medianofurinaryiodine >=300 μ g/L
For excessive iodine；
B, diagnosis research object：Clinical first subtracts：Symptom or sign with subclinical hypothyroidism, while the thyroid function having refers to
Mark：Thyrotropic hormone > 4.2mIU/L, free triiodothyronine < 2.8pmol/L and (or) free thyroxine <
12pmol/L；Subclinical hypothyroidism：Thyrotropic hormone > 4.2mIU/L, free triiodothyronine and free thyroxine are equal
In the normal range；
(5) statistical procedures：Carry out system statistical procedures using SPSS19.0 statistical software, enumeration data withOr middle position
Number indicates that measurement data compares with rank sum test and variance analysis, and the correlativity between each factor uses Liner correlation, P
< 0.05 shows that difference is statistically significant.
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| WO2023102771A1 (en) * | 2021-12-08 | 2023-06-15 | Roche Diagnostics Gmbh | Test result level based analysis |
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| CN106934751A (en) * | 2017-03-22 | 2017-07-07 | 沧州医学高等专科学校 | A kind of investigation of areas with excessive iodine in drinking water healthy population abnormal thyroid function and analysis method |
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| CN106934751A (en) * | 2017-03-22 | 2017-07-07 | 沧州医学高等专科学校 | A kind of investigation of areas with excessive iodine in drinking water healthy population abnormal thyroid function and analysis method |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
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| WO2023102771A1 (en) * | 2021-12-08 | 2023-06-15 | Roche Diagnostics Gmbh | Test result level based analysis |
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Application publication date: 20181116 |