This standard specifies the conditions for diagnosing endemic goiter and goiter and the limits for determining the size of goiter. This standard is applicable to epidemiological surveys, evaluation of prevention and treatment effects, and disease monitoring of iodine deficiency; it can also be used as a reference in clinical thyroid examinations. GB 16004-1995 Diagnosis and Grading Standards for Endemic Goiter GB16004-1995 Standard Download Decompression Password: www.bzxz.net

National Standard of the People's Republic of China
Diagnostic and classificatory criteria of endemic goiter1 Subject content and scope of application
GB16004---1995
This standard specifies the conditions for diagnosing endemic goiter and goiter and the limits for determining the size of goiter. This standard is applicable to the epidemiological survey, evaluation of prevention and treatment effects and disease monitoring of iodine deficiency diseases. It can also be used as a reference in clinical examination of the thyroid gland.
2 Diagnostic criteria
2.1 Living in iodine-deficient areas (water iodine lower than 10μg/L, urine iodine lower than 100 μg/L); high iodine areas (water iodine higher than 300μg/L, urine iodine higher than 800 μg/L); or areas where goitrogenic substances exist. 2.2 The thyroid gland is significantly enlarged. When it exceeds the length of the subject's thumb and diseases such as hyperthyroidism, thyroiditis and thyroid cancer are excluded, it can be diagnosed as goiter.
2.3 In the above-mentioned areas, using the PPS sampling method, if the rate of thyroid enlargement in students aged 8 to 10 is greater than 5%, they are diagnosed as endemic goiter.
3 Grading Standard
No palpable or visible thyroid enlargement (invisible or intangible). 3.21 degree
When the neck is in a normal position, the enlarged thyroid can be touched, but it cannot be seen with the eyes (invisible). When the patient swallows, the lump can move up and down the neck. Even if the thyroid does not swell, the presence of thyroid nodules is classified as grade I. 3.3 degree
When the neck is in a normal position, obvious enlargement can be seen in the neck, and when the neck is palpated, the enlarged thyroid can be found at the same time. When the volume of the thyroid is between two levels and it is difficult to determine which level it belongs to, it can be classified as the lower level. The calculation of the thyroid enlargement rate includes the sum of the number of cases in the two levels of grade I and grade I as a percentage of the number of people examined. For a comparison between this standard and the 1978 diagnostic classification and grading standard, see Appendix A (reference). 4 Classification Standards
4.1 Diffuse type
The thyroid gland is uniformly enlarged, and no nodules can be felt on palpation. 4.2 Nodular type
One or several nodules can be felt on the thyroid gland. 4.3 Mixed type
One or several nodules can be felt on the diffusely enlarged thyroid gland. Approved by the State Administration of Technical Supervision on December 15, 1995 4721bzxz.net
Implementation on July 1, 1996 GB 160041995
Appendix A
Diagnostic classification and grading standards 1)
(reference)
Note: 1) The diagnostic classification and grading standards for endemic goiter issued by the Office of the Leading Group for the Prevention and Control of Endemic Diseases of the Central Committee of the Communist Party of China in 1978. A1 Diagnosis
A1.1 Living in an endemic goiter area. A1.2 The thyroid gland is enlarged beyond the end of one's thumb. A1.3 Other thyroid diseases such as hyperthyroidism and thyroid adenoma are ruled out. Urinary iodine is lower than 50μg/gCr, and the thyroid gland absorbs 1311 in an iodine starvation curve, which can be used as a reference indicator. A2 Classification
A2.1 Diffuse type
The thyroid gland is uniformly enlarged and no nodules can be felt. A2.2 Nodular type
One or several nodules can be felt on the thyroid gland. A2.3 Mixed type
One or several nodules can be felt on the diffusely enlarged thyroid gland. A3 Grading
A3.1 Normal
The thyroid gland cannot be seen or felt.
A3.2 Physiological enlargement
When the head is kept in a normal position, the thyroid gland is easy to feel, up to the end of one's thumb, and is characterized by being "touchable". A3.3 Grade I
When the head is in a normal position, the thyroid gland is easy to see, from larger than the end of the thumb to equivalent to 1/3 of the head. The characteristic is "visible".
When the thyroid gland does not exceed the end of the thumb and the nodule can be felt, it is also considered Grade I. A3.4 Grade I
Due to the enlargement of the thyroid gland, the base of the neck becomes obviously thicker, larger than 1/3 of the fist to 2/3 of the head, and the characteristic is "thick neck". A3.5 Grade I
The neck loses its normal shape, and the thyroid gland is larger than 2/3 of the fist to the equivalent of a fist, and the characteristic is "deformed neck". A3.6 Grade N
The thyroid gland is larger than one fist, and often has nodules. Physiological enlargement is not counted in the prevalence rate, but should be counted in the enlargement rate. The relationship between the thyroid grading standard in my country in 1978 and this standard is shown in Table A1: 473
Additional notes:
1978 grading standard
Physiological enlargement
16004-1995
This standard was proposed by the Ministry of Health of the People's Republic of China. This standard was drafted by the Endemic Disease Research Office of Hebei Medical College. The main drafters of this standard were Yu Zhiheng, Zhu Huimin, and Chen Chongyi. This standard
This standard is interpreted by the China Endemic Disease Prevention and Control Research Center, the technical unit entrusted by the Ministry of Health. 474
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