2007-2009年甘肃省碘缺乏病高危地区碘缺乏病防治现状调查

目的 掌握甘肃省碘缺乏病高危地区碘缺乏病防治现状,为制订碘缺乏病的防治策略提供依据.方法 2007 - 2009年选择12个碘缺乏病高危县,在全县范围内搜索所有1997年1月1日以后出生的疑似克汀病患者.在每个县抽取3个乡,在每个乡抽取2个村,在每个村小学,选择40名8～ 10岁儿童进行甲状腺检查、尿碘测定、智商测查;每个村选择30名育龄妇女进行尿碘测定,并对其家中食盐进行半定量检测,同时对当地碘盐相关情况进行调查.结果 12个县中,共搜索到120例疑似克汀病患者,确诊7例.儿童甲状腺B超肿大率为6.8％(290/4281),夏河县、临潭县、卓尼县、舟曲县和东乡县的肿大率均＞5.0％,其中夏河县、临潭县和东乡县均＞10.0％.儿童平均智商为82.38.儿童尿碘中位数为180.34 μg/L,尿碘＜50.00 μg/L的比例为11.0％(482/4383).育龄妇女尿碘中位数为175.91 μg/L,尿碘＜50μg/L的比例为16.5％(126/762).其中夏河县、东乡县育龄妇女尿碘中位数分别为95.24 μg/L和66.30 μg/L.12个县中有8个县的碘盐覆盖率在95.0％以上,其余4个县的碘盐碘盐覆盖率均＜85％,其中广河县和东乡县的碘盐覆盖率仅为39.2％(47/120)和66.7％(120/180).14.9％(206/1380)的群众认为购买碘盐不方便;87.7％(1210/1380)认为目前的碘盐价格超出可接受的范围;29.9％(413/1380)的家庭主妇知道预防缺碘的方法.结论 影响碘缺乏病高危地区防治的因素广泛存在,应加强碘缺乏病高危地区监测,适时采取有效措施,确保重点人群充足的碘营养.同时还应加强以碘盐为主的综合防治措施的落实,建立碘缺乏病防治长效机制.     

2009年甘肃省碘缺乏病调查结果分析

目的 掌握甘肃省碘缺乏病防治现状,为制订碘缺乏病的防治措施提供依据.方法 2009年,在甘肃省14个市(州),每个市(州)抽取1个达标县(市、区、旗),并按东、西、南、北、中5个方位各抽取1个乡(镇、街道),不足5个乡时全部抽取;在所抽取的每个乡(镇、街道),各抽取1个村,进行居民户碘盐情况及碘盐销售网络调查.同时在每个村抽取1所小学,进行儿童尿碘、甲状腺、智商检查及碘缺乏病知晓状况调查.结果 共检测1420份食用盐,加权碘盐覆盖率为99.53%,加权合格碘盐食用率为98.15%.共对1761名8～10岁儿童检测尿碘,中位数为225.87μg/L,在14个县中,有5个县儿童尿碘处于适宜水平,7个县超过了碘适宜水平.2个县处于碘过量水平.共对3051名8～10岁儿童进行甲状腺检查,加权甲状腺肿大率为1.9%,只有红古区儿童加权甲状腺肿大率大于5%,为5.3%.共对2815名8～10岁儿童进行智商检测,平均智商为105.3,除卓尼县和康乐县之外,其余各县儿童智商均在100以上.碘缺乏病知晓调查平均分为3.2分.知道缺碘不聪明的占57.08%(1229/2153),知道缺碘致甲状腺肿大的占71.76%(1544/2153),知道碘盐是最好的防治方法的占68.04%(1465/2153),向家人讲述碘盐好处的占61.82%(1331/2153).共凋查了87个乡(镇)102个村的食盐销售情况,每个乡(镇)都有一个碘盐代销点,每个村至少有1个碘盐零售店,但73.5%(75/102)的零售店无销售许可证.结论 甘肃省碘缺乏病防治取得了显著进展,合格碘盐食用率达到国家消除标准,甲状腺肿大率明显下降,大多数县儿童尿碘处于"大于适宜水平",碘盐销售网络基本健全,但各县碘缺乏病健康教育工作进展不平衡.

Abstract：

Objective To master the status in control of iodine deficiency disorders (IDD) in Gansu province and to provide the basis for development of control strategies. Methods One county which reached the national standardization of IDD elimination was selected randomly from each of 14 cities of Gansu province in 2009, then one town was selected respectively from five directions (east, south, west, north, and central) of the above selected counties. One village was chosen from every town which was selected for investigating household iodized salt and iodized salt sales network. At the same time the thyroid of children was examined, their urinary iodine (UI) was determined, the intelligence quotient(IQ) values of children were measured and health education was surveyed in one primary school which was chosen in each of the selected town. Results A total of 1420 edible salt samples were tested;the weighted iodized salt coverage rate and the weighted qualified iodized salt rate were 99.53% and 98.15 respectively. Urine samples were collected from 1761 children included in the study. The urinary iodine median was 225.87 μg/L. The urinary iodine medians were at optimal levels in five counties, over the optimal levels in seven counties and at excessive levels in two counties. A total of 3051 children aged 8 - 10 were randomly selected for thyroid examination. The weighted thyroid goiter rate(TGR) of children was 1.9%, and TGR was higher than 5% only in Hoaggu county. IQ of 2815 children was tested and the mean IQ was 105.3, except for the country of Zhuoni and Kangle, the mean IQ of other counties were over 100. The average score of health education was 3.2.Children of 57.08% (1229/2153) knew that iodine deficiency could lead to mental retardation, 71.76% (1544/2153) knew that iodine deficiency could cause thyroid goiter, 68.04%( 1465/2153 ) knew that eating iodized salt was the best method for IDD prevention and control and 61.82%(1331/2153) informed their families of the benefits of eating iodized salt. Each town had one agency selling iodized salt and each village had one more retail store with iodized salt, but 73.5%(75/102) of the stores without license for the sales. Conclusions Great progress has been made on the prevention and control of IDD in Gansu province. The qualified iodized salt consumption rate has reached the national standard for IDD elimination, TGR has decreased markedly, the urinary iodine levels in more counties are over the optimal levels and iodized salt distribution network is basically sound. But progress in health education is uneven.     

日照市2010年碘缺乏病防治效果调查分析

目的掌握日照市防治碘缺乏病(IDD)的防治效果及居民碘营养状况,及时发现工作中存在的问题,为因地制宜、科学补碘提供参考依据。方法 2010年对全市所有自然村及居民饮用水供水点进行水碘含量检测;每个县按东、西、南、北、中方位抽取5～9个乡,每个乡抽取4个行政村,每个村抽取8～15户居民食用盐,进行盐碘检测;每个乡抽取1所小学,每所小学抽取60名8～10岁儿童,进行甲状腺检查,其中收集20名(每年龄组各1/3,男女各半)即时尿样,进行尿碘测定。水碘测定采用硫酸铈催化分光光度法,盐碘测定采用直接滴定法,尿碘测定采用砷铈催化分光光度法,儿童甲状腺检查采用触诊法。结果共检测水样3 483份,水碘范围为0.1～89.90μg/L,<10μg/L的水样3 161份,占90.76%;检测盐样1 164份,盐碘中位数29.8 mg/kg,碘盐覆盖率为98.71%(1 149/1 164),碘盐合格率为98.17%(1 128/1 149),合格碘盐食用率为96.91%(1 128/1 164);检查8～10岁儿童1 200名人,甲状腺肿大率为1.25%(15/1 200);检测8～10岁儿童尿样476份,尿碘中位数为150.65μg/L,5年级学生IDD防治知识知晓率为80.47%,及格率为81.32%。结论日照市属于沿海缺碘地区,IDD防治工作取得了明显成效,居民碘营养水平适宜,符合国家消除IDD标准要求,不存在碘缺乏和碘过量的问题。但IDD健康教育工作需亟待加强。     

2006年贵州省安顺市消除碘缺乏病考核评估结果分析

为了确保2006年贵州省安顺市消除碘缺乏病工作通过国家评估组验收,安顺市疾病预防控制中心按照国家评估方案要求组织市级达标考核,现将结果报道如下.     

2009年重庆市人群碘营养状况调查分析

目的 了解重庆市人群碘营养状况,为科学防治碘缺乏病提供科学依据.方法 2009年,在重庆所有40个区(县)中,每个区(县)抽取9个乡(镇),每个乡(镇)中采集40份居民食用盐,采用直接滴定法检测盐碘;每个区(县)按照东、西、南、北、中5个方位各抽取1个乡(镇),每个乡(镇)抽取20名以上8～10岁儿童,采集尿样,用砷铈催化分光光度法测定尿碘.结果 重庆市共抽取居民户食盐14 217份,含碘量中位数为29.2 mg/kg;碘盐覆盖率为98.90%(14 061/14 217),合格碘盐食用率为95.59%(13 590/14 217).共调查8～10岁儿童4050份尿样,尿碘中位数为247.20μg/L;<50μg/L者占4.60%(186/4050),50～99μg/L者占7.28%(295/4050),100～199 μg/L者占26.44%(1071/4050),200～299μg/L者占25.58%(1036/4050),300μg/L以上者占36.10%(1462/4050);各年龄组之间尿碘比较,差异无统计学意义(x2=3.77,P>0.05).以区(县)计算,尿碘中位数100～199μg/L有10个区(县),占25.00%;200～299μg/L有23个区(县),占57.50%;300μg/L以上的有7个,占17.50%;不同区(县)之间尿碘比较,差异有统计学意义(x2=441.95,P<0.01).结论 重庆市人群碘营养充足,同时存在碘过量,需降低食盐加碘量.

Abstract：

Objective To investigate the nutritional status of iodine among residents in Chongqing, and to facilitate scientific prevention and control of iodine deficiency disorders. Methods Select 9 towns in each of the 40 districts (counties) in Chongqing, and collect 40 resident edible salt samples in each of the selected town to detect salt iodine by direct titrimetry. Select 5 towns on the site of the east, west, south, north and middle of every district (county), select 20 children aged 8 to 10 in each of the selected town to collect urine samples and detect urinary iodine by As-Ce catalytic spectrophotometric assay. Results The median of iodine of 14 217 salt specimens by household was 292 mg/kg with a coverage rate of qualified iodized salt of 98.90%( 14 061/14 217). The consumption rate of qualified iodized salt was 95.59%( 13 590/14 217). The median of urinary iodine for 4050 children aged 8 to 10 was 247.20μg/L, of which < 50 μg/L accounted for 4.60%(186/4050), 50-99μg/L accounted for 7.28% (295/4050), 100 - 199 μg/L accounted for 26.44% (1071/4050), 200 - 299 μg/L accounted for 25.58% (1036/4050), 300 μg/L or more, accounted for 36.10% (1462/4050). However, no significant difference was observed between different age groups(x2 = 3.77, P > 0.05). At district (county) level, the median of urinary iodine in 10(25.00%) districts (counties) was 100 - 200 μg/L, that in other 23(57.50%) districts (counties) was 200 - 300 μg/L, and that in other 7(17.50%) districts/counties was greater than 300 μg/L, and statistical significance was observed between different districts/counties (x2 = 441.95, P < 0.01). Conclusions Current iodine nutrition among residents in Chongqing is adequate. While there is excess, need to reduce the amount of salt iodization.     

2011年河南省碘缺乏病病情现况调查

目的 调查河南省碘缺乏病病情防治现状,推动可持续防治策略的完善.方法 2011年,采用按人口比例概率抽样法(PPS)分层抽样,在全省选取30个县,每个县抽取1所小学,每所小学抽取8～ 10岁学生40名,B超检查抽取儿童甲状腺,采用中国联合型瑞文测验(农村和城市修订版)进行智力测定,采集其家中食用盐样,直接滴定法测定盐碘,另采集其中的12名儿童尿样,采用砷铈催化分光光度法测定尿碘,采用3日称量法测算其所在家庭中居民人均食盐摄入量.在每所抽到学校的5年级学生中抽取30名学生,在学校所在乡及相邻的2个乡抽取孕妇和哺乳期妇女各30人,采用统一试卷进行健康教育调查.结果 ①8～ 10岁儿童(1201人)甲状腺肿大率为4.5％(54/1201);智商(1080人)为107.75±16.81;8～10岁儿童(358人)尿碘中位数为201.4 μg/L.②全省盐碘(1200份)中位数为28.6 mg/kg,碘盐覆盖率为98.8％(1186/1200),合格碘盐食用率为93.0％(1116/1200).③居民每日平均食盐摄入量为10.5 g.④全省问卷调查小学5年级学生1084名,平均得分4.2分;问卷调查家庭主妇961名,平均得分4.4分.结论 河南省各项碘缺乏病防治技术指标保持消除碘缺乏病状态,加强健康教育、增强群众防病意识依然是今后的重要工作.     

2000-2008年张家口市影响碘盐防治碘缺乏病因素分析

目的 分析影响碘盐质量的因素(非碘盐和不合格碘盐)与儿童碘缺乏病流行强度、碘营养水平之间的关系,探讨其对碘盐防治碘缺乏病效果的影响.方法 采用回顾性分析的方法,根据张家口市2000-2008年居民户碘盐监测指标(非碘盐率、碘盐合格率、合格碘盐食用率),每年筛选6个县(区),分为非碘盐组(非碘盐率>5%)、不合格碘盐组(碘盐合格率<95%)和对照组(合格碘盐食用率>95%),每组2个县(区),对3个组碘盐监测结果、8～10岁儿童甲状腺肿大率及尿碘水平进行对比分析.结果 2000-2008年共监测居民食用盐12 468份,检查8～10岁儿童甲状腺5655人,采集尿样4404份.非碘盐组历年平均盐碘中位数为30.1 mg/kg,非碘盐率为7.30%(232/3180);不合格碘盐组盐碘中位数为30.9 mg/kg,碘盐合格率为93.10%(3776/4056);对照组盐碘中位数为32.0 mg/kg,合格碘盐食用率为99.27%(5194/5232).非碘盐组、不合格碘盐组、对照组历年平均儿童甲状腺肿大率分别为5.31%(78/1468)、4.84%(92/1902)、2.06%(47/2285),组间比较差异有统计学意义(χ2=72.07,P<0.05),其中非碘盐组儿童甲状腺肿大率明显高于对照组(χ2=8.70,P<0.017),而非碘盐组与不合格碘盐组、不合格碘盐组与对照组比较,差异无统计学意义(χ2值分别为6.83、5.65,P均>0.017).非碘盐组、不合格碘盐组、对照组历年平均儿童尿碘中位数分别为188.20、219.62、262.39μg/L,对照组高于非碘盐组和不合格碘盐组.结论 非碘盐和不合格碘盐对儿童碘缺乏病流行强度和碘营养状况均有影响,特别是非碘盐影响尤为显著.     

2009年湖北省荆门市实现消除碘缺乏病目标考评结果分析

荆门市属于湖北省碘缺乏病病区,按照<〈实现消除碘缺乏病目标县级考核评估方案〉的通知>(卫办疾控发[2008]214号)要求,荆门市血地办抽调荆门市疾控中心、荆门市盐务局等单位领导及专业人员组成荆门市实现消除碘缺乏病目标县级考核评估小组,于2009年9月14-28日,分别对荆门市钟祥、京山、沙洋、东宝、掇刀等5个县(市、区)进行了实现消除碘缺乏病目标的县级考核评估工作.现将考核评估结果报道如下.     

2009年福建省龙岩市实现消除碘缺乏病目标县级考评结果分析

目的 了解福建省龙岩市实现消除碘缺乏病阶段目标10年后的病情现状,评价防治措施效果,为制订防治策略提供依据.方法 按照<福建省实现消除碘缺乏病目标县级考核评估实施细则>的要求,2009年在龙岩市7个县开展组织领导、碘盐管理、监测与防治、健康教育(简称四项管理指标)的检查,以县为单位,每个县按东、西、南、北、中各抽取1个乡,每个乡各抽取1所小学,每所学校抽取8～10岁学生40名,进行甲状腺检查,其中抽取20名学生尿样,进行尿碘测定;以市为单位,在全市的7个县抽取9个乡,每个乡抽取4个行政村,每个行政村抽检8户居民食用盐,进行盐碘检测.儿童甲状腺检查使用触诊法,尿碘测定采用砷铈分光光度法,盐碘测定采用直接滴定法.结果 全市四项管理指标平均得分为94.1分;8～10岁儿童校正甲状腺肿大率为1.9%;尿碘中位数为278.6μg/L,其中＜100μg/L者占4.57%(32/700),100～＜200 μg/L者占24.00%(168/700),200～＜300μg/L者占25.29%(177/700),≥300μg/L者占46.14%(323/700);居民合格碘盐食用率为98.86%,碘盐覆盖率为99.50%,碘盐合格率为99.35%,非碘盐率为0.50%,各项指标均达到国家消除碘缺乏病标准.结论 龙岩市实现消除碘缺乏病阶段目标之后,居民病情稳定,防治成果显著;但人群的碘营养水平有超过适宜量趋势,建议适当下调食盐加碘量.

Abstract：

Objective To understand the current situation of iodine deficient disorder(IDD) 10 years after achieving the stage goal of eliminating IDD in Longyan city and to evaluate the effect of prevention and treatment measures, and to provide the basis for the development of control strategies. Methods There were 7 counties in the city, and each county(city, district) was as a unit to carry out the inspection for organization and leadership,iodine salt management, monitoring and control, health education (referred to as the four management indicators)according to "The County-Level Assessment and Evaluation Implementation Detailed Rules of Realizing the Goal to Eliminate IDD in Fujian Province". According to the east, west, south, north and middle positions in each county,a village and a primary school were selected. Forty 8 to 10 year-old students in each school were randomly selected to check thyroid and among them 20 students were collected urine samples to determine urinary iodine. Nine townships were selected in the 7 counties of the city and among which 4 administrative villages were selected in each township. Eight edible salt samples from each household in each administrative village were collected to test salt iodine. Goiter was examined by palpation, the level of urinary iodine was examined by arsenic and cerium spectrophotometry, salt iodine was detected by direct titration. Results The average score of the four management indicators was 94.1 in Longyan city. The adjusted goiter rate of children aged 8 - 10 years old was 1.9%. The median of urinary iodine was 278.6 μg/L, among which less than 100 μg/L accounted for 4.57%(32/700), 100 -＜ 200 μg/L accounted for 24.00%(168/700), 200 - ＜ 300 μg/L accounted for 25.29%(177/700), and higher than 300 μg/L accounted for 46.14%(323/700). The using rate of qualified iodized salt was 98.86%. The coverage rate of iodized salt was 99.50%, the qualified rate of iodized salt was 99.35%, and the rate of non-iodized salt was 0.50%. All the indicators had reached the national standard to eliminate IDD. Conclusions After achieving the stage goal of eliminating IDD, the disease is stable and the effect of control measures are significantly. But the iodine provided has a trend of more than suitable. Therefore, it is reasonable to reduce the current salt iodine content.     

2009年青海省碘缺乏病高危地区重点人群碘营养水平调查

目的 了解青海省碘缺乏病高危地区重点人群碘营养水平,为制订防治措施提供科学依据。方法 2009年,选择以往调查中非碘盐率＞5％的德令哈市和碘盐覆盖率、合格碘盐食用率≤80％的久治县、乌兰县、囊谦县、杂多县、格尔木市、玉树县、甘德县、称多县、都兰县以及儿童尿碘中位数＜ 100 μg/L的湟源县共11个县（市）作为监测地区。每个县（市）按东、西、南、北、中抽取5个乡（镇）,每个乡（镇）抽取1所学校,每所学校抽取60名学生采集家中食用盐样,采用直接滴定法(GB/T 13025.7-1999)检测盐碘;同时在每个县（市）抽取3个乡（镇）,每个乡（镇）抽取2所学校,每所学校抽取40名8～10岁学生及学校周边20名18 ～40岁育龄妇女采集尿样,采用过硫酸铵消化砷铈催化分光光度法(WS/T 107-2006)检测尿碘。结果 共检测居民户食用盐样3261份,碘盐覆盖率为79.88％,碘盐合格率为95.16％,合格碘盐食用率为76.02％,非碘盐率为20.12％,囊谦县、杂多县、玉树县和格尔木市非碘盐率分别为88.89％、45.05％、43.00％和12.67％。共检测2536名8～ 10岁儿童尿样,尿碘中位数为155.8μg/L,其中尿碘≤50μg/L的占13.6％(346/2536),＞100 μg/L的占67.5％(1711/2536),囊谦县和杂多县儿童尿碘中位数分别为75.1、94.6 μg/L;共检测665名育龄妇女尿样,尿碘中位数为129.7 μg/L,其中尿碘≤50μg/L的占22.7％( 151/665),＞100 μg/L的占59.2％( 394/665),杂多县、囊谦县和称多县育龄妇女尿碘中位数分别为21.0、54.7、72.7 μg/L。结论 青海省碘缺乏病高危地区儿童及育龄妇女存在碘摄入不足,应尽快纠正这些地区儿童和育龄妇女碘营养偏低状况。     

山东省碘缺乏地区重点人群碘营养调查

目的 了解山东省当前盐碘水平状态下,碘缺乏地区重点人群碘营养状况及防治措施落实情况,为今后防治工作提供依据.方法 2007年,在山东省碘缺乏地区选择山区的岱岳、蒙阴,平原的莒县、高密,沿海的招远,共5个县(市、区)作为调查地区,在每个县(市、区)选择1个乡(镇)作为调查点.采用触诊、B超法进行8～10岁儿童甲状腺检查,直接滴定法检测其家中食用盐含碘量;砷铈催化分光光度法检测8～10岁儿童、孕妇、哺乳期妇女、2岁内婴幼儿及20～45岁育龄妇女5种重点人群的尿碘水平.结果 共检查514例8～10岁儿童甲状腺,触诊甲状腺肿大率为1.8%(9/514),B超检查甲状腺肿大率为1.2%(6/514);共检测501份食用盐,盐碘均值为30.95 mg/kg,碘盐覆盖率为94.6%(474/501),合格碘盐食用率为90.4%(453/501);共检测1707份尿样,尿碘中位数为216.7μg/L,8～10岁儿童、孕妇、哺乳期妇女、2岁内婴幼儿及20～45岁育龄妇女尿碘中位数分别为234.0、165.5、162.4、257.5、233.0μg/L.结论 山东省碘缺乏地区重点人群碘营养水平处于适宜或较适宜状态.表明目前盐碘水平能够满足山东省不同碘缺乏地区人群对碘的需求.

Abstract：

Objective To learn the iodine nutritional status of the vulnerable population with different iodine level under the current level of iodized salt in Shandong province and to offer prevention and cure measures.Methods Five groups of vulnerable population including school children aged 8 - 10, pregnant, lactation women, infants and women of childbearing age from mountain areas ( Daiyue, Mengyin counties ) , plain ( Luxian,Gaomi counties ) and coastal (Zhaoyuan county ) of five different iodine deficient areas were investigated in 2007.The thyroids of children aged 8 - 10 were checked by palpation and B ultrasound, their edible salt iodine level was detected by direct titration. The lever of urinary iodine of vulnerable population was examined by arsenic and cerium speetrophotometry. Results The goiter rates of 8 - 10 year-old were 1.8%(9/514) and 1.2%(6/514), respectively by palpation and B-ultrasonic. The mean iodine of 501 edible salt samples was 30.95 mg/kg. The coverage rate of iodized salt was 94.6% (474/501). The rate of qualified iodized salt was 90.4% (453/501). The median of urinary iodine was 216.7 μg,/L. The urinary iodine of school children aged 8 - 10, pregnant, lactation women, infants and women of childbearing age were 234.0, 165.5, 162.4, 257.5, 233.0 μg/L, respectively. Conclusions Current iodine nutritional level is basically appropriate in all groups of vulnerable people. The current iodine content of iodized salt could meet the needs of population from different iodine deficient areas of Shandong province.     

2009年江苏省碘缺乏病病情调查结果分析

目的 调查2009年江苏省碘缺乏病病情现状,对江苏省食盐加碘近15年来可持续消除碘缺乏病防治效果进行评价,为相关政策调整提供科学依据.方法 2009年,在江苏省除去高碘地区外,采用人口比例概率抽样方法(PPS)选取30个县(市、区),在每个县(市、区)抽取40名8～10岁儿童作为调查对象,采用触诊和B超法检测儿童甲状腺肿大情况并测定其尿碘,采集其家中食用盐样测定含碘量,同时进行智商检测.采用问卷对儿童和妇女进行健康教育调查.结果 本次调查共检测1200名8～10岁儿童甲状腺,触诊法和B超法甲状腺肿大率分别为1.70%(20/1200)、1.00%(12/1200),甲状腺容积中位数为1.3 ml;共检测1200份盐样,居民户碘盐覆盖率、合格碘盐食用率分别为97.5%(1170/1200)、94.5%(1134/1200);共检测598名8～10岁儿童尿样,尿碘中位数为325.3 μg/L;598名8～10岁儿童智商为112.4±13.2,智力低下比例占0.5%(3/598);636名学生及149名家庭妇女健康教育知晓率分别为95.9%(1830/1908)、96.4%(431/447).结论 江苏省防治碘缺乏病效果显著,成绩稳固,建议应根据人群碘营养水平适时调整盐碘,监测时应考虑特需人群,可与以县为单位的碘盐监测有机结合开展.

Abstract：

Objective To evaluate the control effect of the policy sustainable elimination of iodine deficiency disorders on the disease status after 15 years salt iodization, and to provide a scientific basis for the relevant policy adjustments. Methods Probability sampling method (PPS) was used to select 30 counties in Jiangsu province(except those iodine excess areas), of each county 40 children aged 8 - 10 were selected as the investigation objects, their thyroids were examined by palpation and B ultrasound, urinary iodine(UI), household salt iodine, and intelligence quotient(IQ) were also investigated. A questionnaire-based health education survey of children and women was also conducted. Results A total of 1200 salt samples were detected and the coverage and qualified rates of iodized salt were 97.5%(1170/1200) and 94.5%(1134/1200), respectively. Five hundred and ninety eight urinary samples of children aged 8 to 10 were detected. The median urinary iodine was 325.3 μg/L. Of 1200 children aged 8 to 10 examined, goiter was 1.70% (20/1200) by palpation and 1.00% (12/1200) by B ultrasound. Average IQ of those 598 children was 112.4 ± 13.2, and the proportion of mental retardation was 0.5% (3/598). The health education awareness were 95.9%(1830/1908) and 96.4%(431/447) for 636 students and 149 family women, respectively. Conclusions The control effect of iodine deficiency disorders is significant in Jiangsu province. Salt iodine concentration should be adapted to people's iodine nutritional status. Iodine nutrition needs of special population such as pregnant, lactation women and infants should be taking into account, and should also be combined with salt iodization status surveillance at county level.     

2007-2009年河北省沧州市碘缺乏病监测结果分析

目的 了解河北省沧州市碘缺乏病防治状况,为防治碘缺乏病提供科学依据.方法 2007-2009年,选择碘盐覆盖率较低的河间市、献县开展碘缺乏病动态监测.监测县(市)按东、西、南、北、中抽取9个乡(镇),每个乡(镇)抽取4个行政村,每个行政村抽检8户居民食用盐样,检测盐碘;每年采集1～3份居民饮用水样,测定水碘;每年抽取8～10岁小学生100名以上,检查甲状腺肿大情况并测定尿碘,选取40名以上学生测定其家中食盐含碘量;抽取50名以上18～40岁育龄妇女,测定尿碘.甲状腺检查采用触诊法;水碘和尿碘检测采用砷铈催化分光光度法;盐碘检测采用直接滴定法.结果 2007-2009年河问市、献县居民户盐碘中位数分别为4.3、15.9,3.6、18.4,4.6、11.7 mg/kg,碘盐覆盖率分别为34.03%(98/288)、78.82%(227/288),29.86%(86/288)、84.72%(244/288)和37.15%(107/288)、49.31%(142/288),合格碘盐食用率分别为27.08%(78/288)、36.46%(105/288),28.13%(81/288)、49.31%(142/288)和37.15%(107/288)、30.90%(89/288).检测饮用水10份,水碘为5.5～34.4μg/L.2007-2009年8～10岁小学生甲状腺肿大率均＜5%,尿碘中位数分别为138.1、176.6、112.0 μg/L,＜100 μg/L的比率分别为31.6%(65/206)、25.0%(52/208)和44.4%(91/205);育龄妇女尿碘中位数分别为167.3、164.2、78.1μg/L,＜100 μg/L的比率分别为28.7%(29/101)、19.2%(20/104)和60.0%(60/100).结论 在碘盐覆盖率较低的地区,人群碘营养水平受到影响,育龄妇女出现碘营养不足.

Abstract：

Objective To understand the situation of iodine deficiency disorders of Cangzhou city, Hebei province, in order to provide the scientific basis for prevention and control of iodine deficiency disorders. Methods From 2007 to 2009, dynamic monitoring of iodine deficiency disorders was carried out in low iodized salt coverage places Hejian city and Xian county. Nine towns were randomly chosen in each county, 4 administrative villages were randomly selected in each town, 8 household salts were tested in each village. Every year, 1 - 3 copies of residents water samples were collected for determination of iodine; more than 100 students age 8 - 10 years old were checked the situation of goiter and urinary iodine, more than 40 students selected were measured iodine content of salt from their home; more than 50 women of childbearing age 18 - 40 years were tested of urinary iodine. Thyroid was examined with palpation; water iodine and urine iodine concentration were measured with arsenic-Ce catalytic spectrophotometry; salt iodine was detected by direct titration. Results From 2007 to 2009,median household salt iodine were 4.3,15.9,3.6,18.4,4.6,11.7 mg/kg in Hejian city and Xian county, respectively,iodized salt accounted for 34.03% (98/288), 78.82% (227/288), 29.86% (86/288), 84.72% (244/288), 37.15%(107/288),49.31% (142/288), respectively, the consuming rate of iodized salt were 27.08% (78/288),36.46%( 105/288 ), 28.13% (81/288 ), 49.31% ( 142/288 ), 37.15 % ( 107/288 ), 30.90% ( 89/288 ), respectively. Ten samples of drinking water were tested, water iodine were 5.5 - 34.4 μg/L. From 2007 to 2009, the goiter rate of students aged 8 - 10 years old was below 5%, the median of urinary iodine were 138.1,176.6,112.0 μg/L, ＜ 100 μg/L ratio were 31.6% ( 65/206 ), 25.0% ( 52/208 ) and 44.4% (91/205 ). The median of urinary iodine of child-bearing age women were 167.3,164.2,78.1 μg/L, ＜ 100 μg/L ratio were 28.7%(29/101 ), 19.2%(20/104) and 60.0%(60/100).Conclusions In areas with low coverage of iodized salt, iodine nutrition level are affected, the child-bearing age     

2007年重庆市与西藏林芝地区碘缺乏病高危地区病情调查结果对比分析

目的 调查重庆市与西藏林芝地区碘缺乏病高危地区病情现状,为制订预防控制方案提供依据.方法 2007年由国家统一制订方案并抽样,重庆市调查城口和巫溪县,西藏林芝地区调查林芝、波密、米林和朗县4个县;林芝县抽查5个乡,其余县抽查3个乡;每个乡抽1所乡小学和2所村小学,以触诊和B超法同时检查8～10岁儿童甲状腺,同时检测尿碘;每个乡抽取2个村,每个村检测30户居民家庭食用盐含碘量,同时检测30名育龄妇女尿碘;搜索克汀病病例.结果 调查居民碘盐,重庆市调查340户,碘盐覆盖率98.82%(336/340);林芝地区调查915户,碘盐覆盖率为66.34%(607/905),重庆市高于林芝地区(x2=139.56,P＜0.01).儿童甲状腺容积触诊和B超检查,重庆市儿童甲状腺肿大率分别为9.27%(89/960)和8.34%(61/731);林芝地区儿童甲状腺肿大率分别为7.80%(102/1308)和5.53%(69/1248),两地触诊法检查肿大率比较差异无统计学意义(x2=1.37,P＞0.05),B超法重庆市高于林芝地区(x2=5.51,P＜0.05);儿童尿碘中位数,重庆市为319.15μg/L,其中城口县为345.75μg/L,巫溪县为281.39 μg/L;林芝地区为189.81 μg/L,其中林芝县为207.81μg/L、波密县为161.12μg/L、米林县为131.83 μg/L、朗县为334.60μg/L;育龄妇女尿碘中位数重庆市为248.42μg/L,林芝地区为121.25μg/L,儿童和育龄妇女尿碘均以重庆市为高;重庆市和林芝地区均未发现新发克汀病病例.结论 重庆市和林芝地区碘缺乏病高危地区儿童甲状腺肿大率降至10%以下,未发现新发克汀病,防治成效显著.重庆市存在碘过量;西藏林芝县和朗县儿童存在碘过量,妇女存在碘不足,其原因有待进一步调查,波密和米林均存在碘不足.重庆市应降低食盐加碘量,林芝地区在进一步调查基础上调整补碘措施.

Abstract：

Objective To investigate iodine deficiency disorders(IDD) in Chongqing and Linzhi, and to provide scientific basis for IDD control and prevention. Methods According to the national program developed in 2007, investigation was conducted in Chengkou and Wuxi county in Chongqing municipality, and Linzhi, Bomi,Milin and Langxian county in Linzhi prefecture. Five towns were sampled in Linzhi county, and 3 in other counties.In each town, one township primary school and two village primary schools were selected to inspect thyroid by B ultrasound and palpation, and urinary iodine of children aged 8 to 10 years was tested in these schools. Meanwhile,2 villages were selected in each town for test of salt iodine level and urinary iodine of childbearing age women and search cretin cases. Results Three hundred and forty families in Chongqing and 915 families in Linzhi were investigated. The coverage of iodized salt in Chongqing was 98.82%(336/340), which was significantly higher than that in Linzhi[66.34%(607/905), x2 = 139.56, P ＜ 0.01]. Goiter rate of children in Chongqing was 9.27%(89/960) by palpation and 8.34% (61/731) by B ultrasound, while goiter rate of children in Linzhi was 7.80%(102/1308) by palpation and 5.53% (69/1248) by B ultrasound. The difference of goiter rate by palpation between Chongqing and Linzhi was not statistically significant (x2 = 1.37, P ＞ 0.05 ). But goiter rate of children by B ultrasound in Chongqing was higher than that in Linzhi (x2= 5.51, P ＜ 0.05). In Chongqing, the median urinary iodine was 319.15 μg/L, and 345.75 μg/L in Chengkou county and 281.39 μg/L in Wuxi county. In Linzhi prefecture, the median urinary iodine was 189.81 μg/L, and 207.81 μg/L in Linzhi county, 161.12 μg/L in Bomi county, 131.83 μg/L in Milin county and 334.60 μg/L in Langxian county. The median urinary iodine in childbearing women were 248.42 μg/L in Chongqing and 121.25 μg/L in Linzhi. The median urinary iodine in Chongqing both in children and women were higher than those in Linzhi. No new cretin case was found in these two areas. Conclusions Goiter rate in high risk areas of IDD in Chongqing and Linzhi has decreased to less than 10%.No new cretin case is found in these areas. It can be concluded that the work of control and prevention is effective.There is excess iodine in Chongqing. In Linzhi county and Langxian county, iodine is excess in children and deficient in women. Further investigation should be conducted to find out the reason. Population iodine is excess in Bomi and Milin counties. The concentration of salt iodine should be decreased in Chongqing. In Linzhi prefecture,adding iodine measures should be adjusted based on further investigation.