Analysis of a survey results on endemic cretinism in Southern Xinjiang

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 had 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. Key words: Endemic cretinism; Current situation; Thyroid