中部地區某國中學生甲狀腺體積和功能及其相關因素之探討

Preliminary Evaluation of Thyroid Volume and Function and Associated Risk Factors among a Junior High School Students in Mid-Taiwan

成人大多數的甲狀腺疾病也會發生在青少年及兒童，有些甲狀腺疾病會潛伏在青少年或兒童時期，有些在早期就已開始發病。因此，本研究的目的是探討國中學生甲狀腺生長的狀況及有關其結構和功能異常的相關因素。研究對象選自台中市某國民中學各年級同學，以隨機集束抽樣方式，各年級選取二班，年齡介於13歲到16之間，於民國92年3月至4月間進行研究，主要的檢查方式是做一般的理學檢查（包括身高、體重）及以甲狀腺超音波做結構與體積上的評估及計算，甲狀腺功能則是抽血檢驗做免疫血清之檢查（包括三碘甲狀腺素、甲狀腺素、甲狀腺刺激素及游離甲狀腺素）及分析尿中碘濃度；甲狀腺異常家族史及飮用水資料則是使用問卷調查的方式。研究對象男、女學生各120名，平均身高爲161.7±7.8公分，平均體重爲57.2±9.3公斤，有甲狀腺家族病史有10.8％，大多是母親或外祖母有過甲狀腺疾患，有11.3％的學生家中無飮用自來水。平均甲狀腺刺激素爲1.5±1.2μ.U/mL，平均甲狀腺體積爲9.2±2.1 cm3，甲狀腺體積異常者有19人佔7.9％。若以甲狀腺刺激素來做早期診斷甲狀腺機能性異常之工具，則甲狀腺機能異常者有30人，佔所有學生的12.5％。經由邏輯斯迴歸分析，未飮用自來水而有甲狀腺體積異常是飮用自來水的10.1倍，有甲狀腺家族史而甲狀腺刺激 素異常是無甲狀腺家族史的22.9倍。青少年甲狀腺體積的異常與是否飮用自來水有關，甲狀腺功能方面的異常則是與家族史有關。

Objective: Most thyroid diseases seen in adults also occur in adolescents and children. 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 illnesses. Materials and Methods: This study examined thyroid volumes, functions and correlated factors of adolescent students aged 13-16 years in junior high school during March and April 2001. The sample consisted of 240 students living in Taichung city without congenital diseases or a drug abuse history. Results: Our objects included 120 boys and 120 girls. Mean of height and weight were 161.7±7.8 cm and 57.2±9.3 kg , respectively. About 10.8% of objects had a thyroid family history, most were the mother and grand mother. 11.3% of them drank ground water. The mean of thyroid stimulating hormone and thyroid volume were 1.5±1.2μU/mL and 9.2±2.1cm3, respectively. The number of students with abnormal thyroid volume and function were 19 (7.9%) and 30 (12.5%), respectively. The odds ratio of abnormal thyroid volume for drinking ground water is 10.1 times higher than drinking no ground water. The odds ratio of abnormal TSH for a thyroid family history is 22.9 times higher than no thyroid family history. Conclusions: 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 family history, especially maternal history of autoimmune goiter.