ABSTRACT
Objective To understand the status of endemic cretinism in Southern Xinjiang,and to put forward effective measures for diagnosis,prevention and control of the disease.Methods Follow-up visits were carried out to patients of endemic cretinism that at risk from 2006 to 2009,eliminating death and emigration cases of previous findings,increasing new cases,and all of the patients were conducted epidemiological survey and physical examination.Research contents included the history of patient's general situation,cousin marriage,family history,physical examination including mental retardation,hearing speech disorders in patients with thyroid function,nervous system disorder,thyroid palpation,low performance and cretinism faces,at the same time,a 3 ml venous blood sample was used to determine the thyroid function index.Results Totally 216 cases of endemic cretinism patients from 16 counties of Southern Xinjiang were confirmed,including 122 males and 94 females,aged between 11-20 years old.Neural endemic cretinism patients (167) were in the majority;its main performances were mental retardation,hearing speech disorders and nervous system disorders.Gummy swollen endemic cretinism patients(22) had thyroid hypofunction,but no nervous system disorders.Hybrid endemic cretinism patients (27) had manifestations of the neural and gummy swollen.Thyroid function index inspection results showed that the neural and hybrid endemic cretinism patients triiodothyronine [(2.41 ± 0.48),(2.38 ± 0.38) nmol/L],thyroxine [(118.72 ± 20.92),(120.77 ±21.55) nmol/L],free triiodothyronine [(5.25 ± 0.98),(5.14 ± 0.83) pmol/L],and free thyroxine [(15.81 ± 2.60),(15.58 ±2.99) pmol/L] were higher than those of gummy swollen patients [(1.51 ± 0.73),(39.25 ± 16.95) nmol/L,(3.02 ± 1.05),(6.42 ± 1.99) pmol/L,all P ＜ 0.05],but thyroid stimulating hormone [(2.26 ± 1.04),(2.83 ± 0.91) mU/L] was lower than that of gummy swollen patients [(58.56 ± 24.83) mU/L,P ＜ 0.05].Gummy swollen patients bad typical hypothyroidism,which was conformed to clinical manifestations,and all three types of patients had low thyroid antibody positive rate.Conclusions Southern Xinjiang is the prevalence area of endemic cretinism,the work of prevention and control has a long way to go,in addition to the need to improve the environmental iodine deficiency,it is urgent to improve the level of people's economy.
ABSTRACT
Objective To determine the serum thyroid hormone level of Uygur patients with local Curtin in southern Xinjiang region, to understand the thyroid function of Curtin disease in terms of diagnosis, treatment and prevention and to provide a background information.Methods One hundred and eighty-eight Uygur endemic cretinism were selected as cases [divided into neuval (144), myxedematous (19), mixed type groups (25)], 121 local healthy people as control group, 125 mothers of the case group as mother group from southern Xinjiang region from September 2014 to October 2014, 3 ml venous blood sample was collected of each subject, serum thyroid stimulating hormone (TSH), triiodothyronine (T3), tyroxine (T4), free triiodothyonine (FT3), free tyroxine (FT4), anti-thyroglobulin antibody (A-TG), and thyroid peroxidase antibody (A-TPO) levels were tested.Results There were statistically significant differences of the thyroid function index (T3, T4, FT3, FT4) between the four groups (neural, myxedematous type, mixed type cretinism patients and control groups, F =22.92, 42.58, 38.84, 56.31, 103.29, all P ＜ 0.05).Levels of T3, T4, FT3, FT4 [(2.41 ± 0.48), (118.72 ± 20.92)nmol/L, (5.25 ± 0.98), (15.81 ± 2.60)pmol/L] in neural type patients were significantly higher than those of myxedematous type patients [(1.51 ± 0.73), (39.25 ±16.95)nmol/L, (3.02 ± 1.05), (6.42 ± 1.99)pmol/L], TSH was lower than that of myxedematous type patients [(2.26 ±1.04) vs.(58.56 ± 24.83)mU/L, all P ＜ 0.05];mixed type patients T3, T4, FT3, FT4 [(2.38 ± 0.38), (120.77 ±21.55)nmol/L, (5.14 ± 0.83), (15.58 ± 2.99)pmol/L] were significantly higher than those of myxedematous type patients, TSH was lower than that of myxedematous type patients [(2.83 ± 0.91) vs.(58.56 ± 24.83) mU/L, all P ＜0.05];myxedematous type patients T3, T4, FT3, FT4 were significantly lower than those of control group [(2.53 ± 0.50),(121.93 ± 22.01)nmol/L, (5.49 ± 0.82), (15.93 ± 2.76) pmol/L], and TSH was higher than that of control group [(2.94 ± 1.17)mU/L, all P ＜ 0.05].TSH of neural type patients [(2.05 ± 1.45)mU/L] was lower than that of mother group [(2.27 ± 1.63)mU/L, t =10.57, P ＜ 0.05];T3, T4, FT3, FT4 of myxedematous type patients [(1.81 ± 0.66),(56.73 ± 29.56)nmol/L, (2.97 ± 1.34), (5.95 ± 2.74)pmol/L] were significantly lower than those of mother group [(2.16 ± 0.35), (125.48 ± 24.78)nmol/L, (4.29 ± 0.42), (14.90 ± 2.38)pmol/L], and TSH of mother group [(2.35 ±0.56)mU/L] was lower than that of myxedematous type patients [(57.72 ± 44.69)mU/L, t =7.59, 7.07, 16.07, 10.95,245.23, all P ＜ 0.05].There was no significant difference in comparison of A-TG and A-TPO in the four groups (x2 =1.60, 3.64, all P ＞ 0.05).Conclusion The neural type patients and the mixed type patients have normal thyroid function, the myxedematous type patients have obviously lower thyroid function.