【摘要】：目的:了解山西地區(qū)人群硒營(yíng)養(yǎng)狀況及甲狀腺功能異常的患病率,同時(shí)探究血清硒水平與甲狀腺功能的關(guān)系,為硒在預(yù)防和治療甲狀腺疾病方面提供更多的理論依據(jù)。方法:本研究為橫斷面研究,選取山西地區(qū)1470例居民進(jìn)行調(diào)查,所有參與者均測(cè)定血清硒含量及TSH、TPOAb、TGAb,TSH升高者加測(cè)FT4,TSH下降者加測(cè)FT4和FT3。比較并分析血清硒水平與各個(gè)指標(biāo)的關(guān)系,不同血硒水平甲功異常的患病率,正常人群與不同類型甲功異常的人群血硒濃度的差異。數(shù)據(jù)分析采用SPSS20.0,正態(tài)分布數(shù)據(jù)多組間比較采用方差分析,非正態(tài)分布的數(shù)據(jù)用非參數(shù)統(tǒng)計(jì)分析,相關(guān)分析采用spearman秩相關(guān),率的比較用c2檢驗(yàn),p0.05差異具有顯著性。結(jié)果:1.山西地區(qū)調(diào)查居民血清硒中位數(shù)為79.38(58.85-128.05)μg/L;2.調(diào)查人群臨床甲減患病率為1.77%,亞臨床甲減患病率為14.08%,臨床甲亢患病率為0.68%(n=10),亞臨床甲亢患病率為0.48%(n=7),TPOAb陽(yáng)性率為10.34%(n=152),TGAb陽(yáng)性率為15.65%(n=230);3.男性血清硒水平為81.78μg/L,女性為76.22μg/L,差異不顯著(p=0.078);隨年齡的增加,硒水平呈下降趨勢(shì);4.血清硒水平與年齡(r=-0.083,p=0.001)、TSH(r=-0.057,p=0.030)呈負(fù)相關(guān);TPOAb陽(yáng)性時(shí),血清硒與TPOAb滴度呈負(fù)相關(guān)(r=-0.257,p=0.002);5.除甲亢以外其他類型甲功異常組人群血清硒水平均低于甲功正常組,甲減組、TPOAb200IU/ml組血硒水平明顯降低,差異具有統(tǒng)計(jì)學(xué)意義,其p值分別為0.008、0.007;6.隨著血清硒水平升高,甲減、TPOAb、TGAb陽(yáng)性的患病率呈下降趨勢(shì),硒水平為60μg/L和≥100μg/L時(shí),甲減及TPOAb200IU/ml的患病率的差異具有顯著性,其p值分別為0.004,0.049。結(jié)論:1.山西地區(qū)硒營(yíng)養(yǎng)狀況處于邊緣硒充足水平;2.個(gè)體硒水平與性別無(wú)關(guān),與年齡存在負(fù)相關(guān),中、老年人血硒含量明顯降低;3.低硒可能是TSH升高的不利因素,并且在甲減的發(fā)生、發(fā)展過(guò)程中起到一定作用;4.硒水平與甲狀腺抗體滴度相關(guān),尤其是與高水平TPOAb關(guān)系更為密切,低硒可能是誘發(fā)或加重甲狀腺異常免疫的原因,而高硒可能對(duì)甲狀腺組織具有一定的保護(hù)作用。
[Abstract]:Aim: to understand the nutritional status of selenium and the prevalence of thyroid dysfunction in Shanxi area, and to explore the relationship between serum selenium level and thyroid function in order to provide more theoretical basis for the prevention and treatment of thyroid diseases. Methods: this study was a cross-sectional study. 1470 residents in Shanxi province were selected for investigation. All the participants measured serum selenium content and FT4 and FT3. in patients with FT4,TSH decrease and TSH,TPOAb,TGAb,TSH elevation. To compare and analyze the relationship between serum selenium level and each index, the prevalence rate of abnormal thyroid function in different blood selenium level, and the difference of blood selenium concentration between normal population and different types of abnormal group. SPSS20.0, normal distribution data were compared with each other by variance analysis, non-normal distribution data were analyzed by non-parametric statistics, spearman rank correlation was used for correlation analysis, and c2 test was used for comparison of rates, there was significant difference between the two groups (p0.05). Results: 1. The median selenium in serum was 79.38 (58.85 / 128.05) 渭 g / L 路L ~ (- 2) 路kg ~ (- 1) 路h ~ (- 1). The prevalence rate of clinical hypothyroidism, subclinical hypothyroidism, clinical hyperthyroidism and subclinical hyperthyroidism was 1.77%, 14.08%, 0.68% and 0.48%, respectively. The positive rate of TGAb was 15.65% (n = 230). 3. The serum selenium level was 81.78 渭 g / L in males and 76.22 渭 g / L in females, and the difference was not significant (p < 0.078), but decreased with the increase of age. 4. The serum se levels in males and females were 81.78 渭 g / L and 76.22 渭 g / L, respectively. There was a negative correlation between serum se level and age (r = 0.083, p0.001), TSH (/ r = 0.057, p = 0.030), and a negative correlation between serum se level and titers of TPOAb (r = 0.257, p = 0.002) when TPOAb was positive (r = 0.257, p = 0.002), and a negative correlation was found between serum se level and TPOAb titers (r = 0.257, p < 0.05). Except for hyperthyroidism, the serum selenium level in the abnormal group was lower than that in the normal group, hypothyroidism group and TPOAb200IU/ml group, and the difference was statistically significant (p = 0.008, 0.007, respectively). With the increase of serum selenium level, hypothyroidism, TPOAb,TGAb positive prevalence rate showed a downward trend. When selenium level was 60 渭 g / L and 鈮，

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