云南省孕妇和哺乳期妇女的碘营养水平监测结果分析

目的：监测孕妇和哺乳妇食用新标准食盐[碘含量（18～33 mg／kg ）]的碘营养水平，指导全省碘缺乏病防控工作。方法选取安宁市、牟定县、南涧县、宁洱县、梁河县，每个县（市）选择城区和近城区农村、偏远山区农村各1个乡镇，每个乡镇抽取至少30名孕妇或哺乳妇，检查其甲状腺大小，采集其尿样及其家中的食用盐分别测定尿碘含量和盐碘含量，采集项目点饮用水测定水碘含量，对受检人群进行碘缺乏病健康教育知晓率调查。结果抽取的水样中碘含量中位数为1．59μg／L ；盐碘中位数为23．7 m g／kg ，碘盐合格率为95．9％，合格碘盐食用率为94．8％；尿碘中位数为168．7μg／L ，总体上5个县的尿碘之间具有统计学差异（ P＜0．01）；孕妇和乳妇尿碘中位数分别为175．5μg／L、163．6μg／L ，孕妇＜150μg／L占39．9μg／L ，乳妇＜100μg／L 占22．2μg／L ；孩子半岁后乳妇的平均尿碘高于半岁前的乳妇，二者尿碘中位数构成分布有统计学差异（ P＜0．05）；城区和农村尿碘中位数分别为158．8μg／L、172．5μg／L ，农村高于城区，二者尿碘有统计学差异（ P＜0．01）；甲肿率（B超法）为0．9％。碘缺乏病健康教育知晓率为69.6％。结论孕妇和乳妇尿碘中位数总体适宜，但部分人群存在碘营养不足的健康风险，通过增加食用富碘食品和碘营养制剂增加碘摄入，或者给这些特殊人群供应较高浓度的食用碘盐[碘含量30mg／kg（21～39mg／kg）]，以保障孕期和哺乳期适宜的碘营养水平。

Analysis of the Surveillance Results of Iodine Nutrition Condition among Pregnant and Lactation Women in Yunnan Province

Objective To survey iodine nutrition condition among pregnant and lactating women after intake the new criterion of iodized salt (iodine content is 18-33 mg/kg) ,then to instruct the work of prevention and con‐trol of iodine deficiency disorders in Yunnan province .Methods Selected Anning ,Moudin ,Nanjian ,Ning'er , Lianghe county ,selected 3 village from city ,suburb and rural in each county and then at least 30 pregnant or lacta‐ting women were selected from each village .The urine and salt were collected to measure the iodine content ,deter‐mined the thyroid volume ,collected local drink water and tested iodine content ,investigated the awareness rate a‐bout health education of iodine deficiency disorders .Results Median water iodine content was 1.59 μg/L .The median salt iodine was 23.7 mg/kg ,the quality of iodized salt rate was 95.6% ,qualified iodized salt coverage rate was 94.8% .The median urine iodine (MUI) was 168 .7 μg/L .Urinary iodine has significant difference among the overall 5 counties(P<0 .01) .MUI of pregnant women was 175.5 μg/L and <150 μg/L accounted for 39 .9% ,MUI of nursing women was 163.6 μg/L ,and<100 μg/L accounted for 22 .2% .MUI of less than half a year of breast feeding is higher than that more than half a year of breast feeding nursing women and two median urinary iodine constitute distribution have significant difference (P<0 .05);urban and rural MUI were 158.8 μg/L ,172.5 μg/L respectively ,rural areas was higher than urban areas ,generally urinary iodine from 2 areas has significant difference (P<0 .01);goiter rate which used palpation inspection was 3 .2% and which used ultrasonic inspection was 0 .9% , health education of iodine deficiency disease awareness rate was 69 .6% .Conclusion MUI of pregnant women and nursing women was at the appropriate level ,but part of these population still at health risk of iodine deficiency ,by increasing the consumption of iodine rich food and iodine fortified food to increase iodine intake ,or to supply higher concentrations of iodine content in iodized salt [(30 mg/kg) 21‐39 mg/kg] to these special groups so that security ap‐propriate iodine nutrition during the period of pregnancy and lactation .