杨祺 唐兢 吴雯雯 家帅 汤玮 闾倩

摘 要 目的：了解上海某社区成人自身免疫性甲状腺疾病（AITD）患病率及影响因素。方法：采用整群随机抽样的方法抽取上海某社区调查对象381人，其中男性173人，女性208人；平均年龄为（42.62±12.31）岁。收集现场问卷调查、体格检查、实验室检测和影像学检查等数据，分析AITD的患病情况及其影响因素。结果：上海某社区AITD患病率为13.12%，其中男性患病率为8.09%，女性患病率为17.31%，差异有统计学意义（P=0.008）。多因素logistic回归分析结果显示，年龄、BMI、吸烟、饮酒、尿碘水平等影响因素与AITD患病风险未见有统计学意义的相关。结论：AITD是最常见的器官特异性自身免疫性疾病，社区的患病率处于较高水平。

关键词 自身免疫性甲状腺疾病；社区；患病率；影响因素

中图分类号：R581 文献标志码：A 文章编号：1006-1533（2020）14-0034-03

Analysis of prevalence and influencing factors of adult auto-immune thyroid disease in a community in Shanghai

YANG Qi1， TANG Jing2， WU Wenwen2， ZHANG Jiashuai3， TANG Wei4， LYU Qian4

（1. General Practice Department of Tianlin Community Health Service Center of Xuhui District， Shanghai 200233， China； 2. General Practice Department of Changqiao Community Health Service Center of Xuhui District， Shanghai 200231， China； 3. Shanghai Institute of Planned Parenthood Research， and Institute of Reproduction and Development of Fudan University， Shanghai 200231， China； 4. Department of Endocrinology of Changzheng Hospital of Naval Medical University， Shanghai 200003， China）

ABSTRACT Objective： To explore the prevalence and influencing factors of adult auto-immune thyroid disease（AITD） in a community， Shanghai. Methods： Three hundred and eighty-one people from a community in Shanghai were selected by cluster random sampling， and among them there were 173 men and 208 women； the average age was （42.62±12.31） years old. The data of on-site questionnaire， physical examination， laboratory examination and imaging examination were collected to analyze the prevalence of AITD and its influencing factors. Results： The prevalence rate of AITD in a community in Shanghai was 13.12%， of which the prevalence rate of the males was 8.09%， the prevalence rate of the females was 17.31%， and the difference was statistically significant（P=0.008）. Multivariate logistic regression analysis showed that age， BMI， smoking， drinking， urinary iodine level and other factors had no significant correlation with the risk of AITD. Conclusion： AITD is the most common organspecific auto-immune disease， and the prevalence in the community is at a relatively high level.

KEY WORDS auto-immune thyroid disease； community； prevalence； risk factor

成人自身免疫性甲狀腺疾病（AITD）是由遗传因素及环境因素共同作用而引起的自身免疫性疾病，是一组作用于甲状腺的细胞和体液免疫反应综合征，临床疾病以Graves病（GD）和桥本甲状腺炎（HT）最为多见，两者分别以甲状腺功能亢进和甲状腺功能低下为特征。多发生于20～60岁的成年人。有研究结果显示，全球的AITD患病率约为5%，而仅表现为抗甲状腺抗体阳性而无症状的亚临床AITD的比例会更高[1]。本研究旨在分析社区AITD的患病情况及其影响因素，以利于家庭医生开展针对性健康管理。

1 對象与方法

1.1 对象

采用整群随机抽样的方法在上海徐汇区长桥街道18～65岁居民中抽样。首先随机抽取符合条件的家庭，然后通过KISH表从被抽中的家庭选择1名合格的调查对象。……