食盐加碘后甲状腺摄 ~（131）I率的变化及其与尿碘的关系

目的：了解食盐加碘后健康人及甲亢患者甲状腺摄131I率的变化及其与24小时尿碘含量的相关性,探讨甲状腺摄131I率与碘营养状况的关系。方法：对比食盐加碘前后健康体检者及甲亢患者甲状腺摄131I率的变化,分析健康体检者甲状腺摄131I率、晨尿碘浓度及经肌酐校正的尿碘含量与24小时尿碘含量的相关关系。结果：健康人及甲亢患者食盐加碘后3、6及24小时甲状腺摄131I率均显著降低;健康体检者甲状腺摄131I率与24小时尿碘含量呈负相关（r=-0.7651,P〈0.001）,晨尿碘浓度与24小时尿碘含量呈正相关（r=0.8231,P〈0.001）,经肌酐校正的尿碘含量与24小时尿碘含量呈正相关（r=0.9054,P〈0.001）。结论：食盐加碘对甲状腺摄131I率有显著影响,应重新确立甲状腺摄131I率的正常范围及甲亢的诊断标准;经肌酐校正的尿碘含量较晨尿碘浓度能更准确地反映碘营养状况;甲状腺摄131I率可作为评估个体碘营养状况的指标,可以稳定地反映近期的碘营养状况。

The Change of Thyroid 131I uptake Rate after USI and its Relationship with Urine Iodine

Objective： To understand the change of thyroid 131I uptake rate after USI （universal salt iodization） and its correlation with urine iodine, and to explore the relationship between thyroid 131I uptake rate and nutrion condition of iodine. Methods： The thyroid 131I uptake rate before and after USI was compared in healthy control and hyperthyroid patients, and the relationships between thyroid 131I uptake rate, morning urine iodine concentration, creatinine corrected urine iodine and 24 h urine iodine were analyzed. Results： The 3, 6 and 24 hour thyroid 131I uptake rate in both healthy controls and patients with hyperthyroidism decreased significantly after USI; the thyroid 131I uptake rate in healthy controls correlates negatively and significantly with 24 hours urine iodine （r=-0.7651, P〈0.001）, morning urine iodine and creatinine corrected urine iodine correlate positively and significantly with 24 hours urine iodine （r=0.8231, P〈0.001 and r=0.9054, P〈0.001 respectively）. Conclusion： The normal range of thyroid 131I uptake rate and the diagnostic standard of hyperthyroidism should be revised after USI; creatinine corrected urine iodine can reflect iodine nutrition condition more precisely than morning urine iodine concentration; the thyroid 131I uptake rate can be used as an indicator to evaluate personnel nutrient condition of iodine and can reflect the recent iodine nutrion steadily.