| 摘要: | 成人大多數的甲狀腺疾病也發生在青少年及兒童。事實上很多甲狀腺疾病潛伏在青少年或兒童時期，甚至已經開始發病。雖然台灣本土的缺碘性甲狀腺腫在三、四十年前非常盛行，曾經造成百分之二十二的學生罹病，但是自從民國五十六年全台全面食鹽加碘後已經降低到百分之四。不過，最近十年間，其他類型的甲狀腺腫有逐漸增加的趨勢。因此，這篇研究的目的是在探討國中青少年甲狀腺生長的狀況及有關其結構和功能異常的相關因素之探討。
本研究的樣本來為台中市立向上國民中學各年級同學，年齡從13歲到16歲（包括一至三年級男女生），於民國八十九年三月至四月間，共有105名學生接受檢查及訪視，主要的檢查方式是以甲狀腺超音波做結構，體積上的評估及計算，而甲狀腺功能則是抽血檢驗做免疫血清之檢查（包括T3，T4，TSH及游離T4）。另外在檢查的同一天並做一般的理學檢查，包括身高、體重、身體質量指數和體脂率，而實驗室方面的檢查還包括尿中碘排泄量，性荷爾蒙等。家族史及飲用水等資料收集，則是使用問卷調查的方式取得。
在結果分析方面，我們發現青少年甲狀腺體積的異常與飲用地下水有關，另一方面，甲狀腺功能方面的異常則是與家族史有關，尤其是母親有罹患自體免疫性甲狀腺腫者。在其他單變項因素之分析中，甲狀腺體積與年級身高成正相關，與碘排泄量成負相關，而甲狀腺功能（甲狀腺刺激素）則與年級成負相關。
總結來看，在青少年，甲狀腺體積異常與飲用地下水有關，而甲狀腺功能異常與家族史有關，這些發現可能對未來青少年甲狀腺疾病的預防計劃及做為更進一步基因層次的研究之參考資料。
Most thyroid diseases seen in adults also occur in adolescents and children. Many thyroid disorders begin from adolescence or childhood. Although the prevalence of endemic goiter due to iodine deficiency is rapidly decreased after supplementation of iodine in salt since 1967, the prevalence of other type of goiter is growing in recent 10 years. The purpose of this study is to evaluate the types of thyroid diseases of adolescents sampled from a municipal junior high school and to find out the risk factors of these thyroid illness.
This study examined thyroid volumes and functions and correlated factors of adolescent students aged 13-16 years in the Taichung Hsiang-Shang junior high shool during March and April 2000. The sample consists of 105 aldolescent students lived in Taichung city without congenital diseases or drug abuse history. Under ultrasonographic examination , the thyroid volumes are calculated. In addition, thyroid functions(T3,T4,TSH,Free T4) are examined with blood sample. Demography wth body height, body weight, BMI, body fat ratio are checked on the same day of examination. Urinary iodine excretion rate , sex hormones study are also performed . Data of family history and drinking history are collected by a self-administered questionnaire.
After analysis, we find the abnormality of thyroid volume is correlated with drinking ground water . On the other hand, the dysfunction of thyroid gland is correlated with famial history, especially maternal history of autoimmune goiter. On univariate analysis, the thyroid volume also correlates with age, body height and iodine concentraion, while the thyrotropin level correlates with age in adolescents.
In conclusion, thyroid volume is correlated with drinking ground water, while thyroid functions is related to family history. These findings could be of help in planning future prevention programs and further genetic study in thyroid diseases in the adolescents. |
