【摘要】 目的检测甲状腺功能亢进症（以下简称甲亢）和亚临床甲状腺功能亢进症（以下简称亚临床甲亢）患者的尿碘水平变化,探讨甲亢和亚临床甲亢患者碘营养状态的变化及意义。方法选取甲亢患者251例为甲亢组、亚临床甲亢患者242例为亚临床甲亢组、健康人群130例作为对照组。取空腹静脉血标本5 m L,采用化学发光免疫法测定各组甲状腺功能五项指标,包括促甲状腺激素（TSH）、游离三碘甲腺原氨酸（FT₃）、游离甲状腺素（FT₄）、总甲状腺素（TT4）、总三碘甲腺原氨酸（TT₃）。采集一次性晨尿10 m L,采用尿碘定量检测试剂盒AR型测定各组尿碘水平,以尿碘水平中位数（MUI）评价碘营养状态。结果甲亢组、亚临床甲亢组尿碘水平均高于对照组（P均<0.05）,甲亢组、亚临床甲亢组尿碘水平差异无统计学意义（P>0.05）。甲亢组、亚临床甲亢组不同碘营养状态者的分布差异均有统计学意义（P均<0.01）,均以碘过量和碘超量状态构成比最多、碘缺乏状态构成比最少。甲亢组、亚临床甲亢组不同碘营养状态者的血清FT₃、FT₄、TT₃、TT4、TSH水平差异均无统计学意义（P均>0.05）。甲亢组碘缺乏、碘超量和碘过量者的尿碘量与血清FT₃、FT₄、TT₃、TT₄水平均呈明显相关性,亚临床甲亢组碘过量和碘缺乏者的尿碘量与血清FT₃、FT₄均呈明显相关性（P<0.05或0.01）。结论亚临床甲亢患者处于碘过量状态,甲亢患者处于碘超量状态,但同时都存在高碘与低碘并存现象,长期碘摄入过量在甲亢和亚临床甲亢疾病的发生发展过程中起了非常重要的作用。更多还原

【Abstract】 Objective To detect the change in the urine iodine of hyperthyroidism patients and subclinical hyperthyroidism patients and to explore the change and significance of iodine nutrition status on the pathogenesis of hyperthyroidism and subclinical hyperthyroidism. Methods Totally 251 hyperthyroidism patients（ hyperthyroidism group）,242 patients with subclinical hyperthyroidism（ subclinical hyperthyroidism group）,and 130 subjects of healthy controls（ control group）were selected. The venous blood（ 5 mL） of empty stomach was extracted to detect the serum levels of thyroid stimulating hormone（ TSH）,free triiodothyronine（ FT₃）,free thyroxine（ FT₄）,total triiodothyronine（ TT₃） and total thyroxine（ TT₄） by chemiluminescence immunoassay. The disposable morning urine（ 10 m L） was collected. Iodine level in each group was detected by AR type of urine iodine quantitative test kit. Iodine nutritional status was evaluated with median of urine iodine levels（ MUL）. Results The levels of iodine urine in the hyperthyroidism group and subclinical hyperthyroidism group were higher than that of the control group（ P < 0. 05）. There was no significant difference in the urinary iodine level between the hyperthyroidism group and subclinical hyperthyroidism group（ P > 0. 05）. The distributional difference in patients with different iodine nutrition between the hyperthyroidism group and subclinical hyperthyroidism group was statistically significant（ P < 0. 01）. There was no significant difference in serum levels of FT₃,FT₄,TT₃,TT₄ and TSH in patients with different iodine nutrition between the hyperthyroidism and subclinical hyperthyroidism（ all P > 0. 05）. The urinary iodine levels were significantly correlated with FT₃,FT₄,TT₃,and TT₄ in patients with in sufficient iodine intake,more than adequate iodine intake,and excessive iodine intake in the hyperthyroidism group; the urinary iodine levels in patients with in sufficient iodine intake and more than adequate iodine intake in the subclinical hyperthyroidism group were significantly correlated with serum FT₃ and FT₄（ P < 0. 05 or P < 0. 01）. Conclusions The patients with subclinical hyperthyroidism are in excessive iodin intake and the patients with hyperthyroidism are in more than adequate indine intake,and the excess and deficiency of iodine intake exist together. Long-term exlessive iodine intake plays a very important role in the progress of hyperthyroidism and subclinical hyperthyroidism.更多还原