中文摘要：

目的研究不同碘氟摄入量人群甲状腺结节和TPOAb阳性的检出率。方法对山东巨野县的适碘低氟、高碘低氟和高碘高氟3个农村地区共396名23岁以上居民进行甲状腺B超检查、TPOAb和尿碘测定。结果适碘低氟组、高碘低氟组和高碘高氟组尿碘中位数（MUI）分别为207.1、383.9和461.7μg/L;甲状腺结节检出率16.5%、22.0%和11.5%,TPOAb阳性率25.9%、33.7%和12.4%。高碘高氟组人群甲状腺结节检出率明显低于高碘低氟组人群（P〈0.05）。各组人群随着年龄的增大,甲状腺结节检出率增高,60岁以上最高,分别为24.4%、29.2%和18.8%,经趋势性卡方检验有显著意义（P〈0.05）。高碘高氟组甲状腺B超正常人群TPOAb阳性率明显低于适碘低氟组和高碘低氟组。结论在水碘200~300μg/L范围内,若水氟自（0.99±0.29）mg/L升至（1.67±0.19）mg/L,无论是甲状腺结节检出率还是TPOAb阳性率均明显降低。

英文摘要：

Objective To investigate the detection rates of thyroid nodules and positive TPOAb in the areas with different iodine and fluoride intakes. Methods Thyroid ultrasound,thyroid peroxidase antibody（ TPOAb） and urinary iodine examination were carried out in 396 adults aged over 23 years old from 3 rural areas in Juye county of Shandong province where the iodine concentration was normal and fluorine was low,the iodine was high and fluorine was low,the iodine and fluorine was high in drinking water. Results The median urinary iodine（ MUI） in the three areas were 207. 1,383. 9 and 461. 7 μg / L. The detection rates of thyroid nodules were 16. 5%,22. 0% and 11. 5% respectively. The positive rates of TPOAb were 25. 9%,33. 7% and 12. 4% respectively. The detection rate of thyroid nodules in the high iodine and fluorine group was lower than that in the high iodine and low fluorine group（ P 0. 05）. The detection rate of thyroid nodules showed an upward trend with the advance of age,the highest above 60 years with 24. 4%,29. 2% and 18. 8% respectively. The trend chi-square test was significantly different（ P 0. 05）. The positive rate of TPOAb in the high iodine and fluorine group was significantly lower than that of the other two groups with the population of the normal thyroid ultrasound. Conclusions Within the water iodine range of 200 ~ 300 μg / L,if water fluoride rises from 0. 99±0. 29 mg / L to 1. 67±0. 19 mg / L,whether the detection rate of thyroid nodules or the positive rate of TPOAb is significantly reduced.