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。     

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.     

慢性肺源性心脏病患者血清甲状腺激素及尿碘水平的临床观察

目的　探讨慢性肺心病患者甲状腺功能及尿碘水平变化。方法　应用放射免疫分析法及恒温消解尿碘分析法检测 ４１ 例不同缺氧程度的慢性肺心病患者及 ２５ 例健康对照组血清 Ｔ Ｔ３、 Ｔ Ｔ４、ｒ Ｔ３、 Ｔ Ｓ Ｈ 及尿碘水平。结果　慢性肺心病患者血清 Ｔ Ｔ３、 Ｔ Ｔ４、 Ｔ Ｓ Ｈ 及尿碘水平降低，以重度缺氧组降低幅度大，ｒ Ｔ３ 水平增高。结论　慢性肺源性心脏病患者血清 Ｔ Ｔ３、 Ｔ Ｔ４、 Ｔ Ｓ Ｈ 水平降低与缺氧程度及碘摄入量不足有关。     

新疆阿克苏地区重点人群碘营养和智力水平调查

目的 了解有新发克汀病患儿的新疆缺碘地区--阿克苏地区拜城和乌什县重点人群的碘营养现状及智力水平.方法 在拜城和乌什县按东、西、南、北4个地理方位,抽取托克逊、温巴什、察尔其,阿合雅、牙满苏、依麻木、亚克瑞克和乌什镇共8个乡镇的10所村小学,每所小学中抽取8～10岁3个年龄组儿童各10名,男女各半,共300名;从上述8个乡镇抽取未口服碘油丸的哺乳妇女及其所生0～2岁婴幼儿104对.调查上述地区碘盐食用情况、8～10岁儿童尿碘和甲状腺肿大(甲肿)率、哺乳期妇女的尿碘和儿童及婴幼儿智力发育情况.盐碘测定采用直接滴定法,尿碘测定采用过硫酸铵消化-砷铈催化分光光度法,甲状腺检查采用触诊法,智力发育水平的测定分别采用中国第2次修订<联合瑞文测验指导书>(CR-TCR2)和丹佛智能发育筛查法(DDST).结果 两县碘盐覆盖率为73.1%(123/182),合格碘盐食用率为641%(118/182),儿童尿碘中位数为103.7μg/L[<100μg/L的比率为47.8%(75/157),<50μg/L的比率为28.0%(44/157)].其中拜城县儿童尿碘的中位数为123.0μg/L[<100μg/L的比率为44.4%(28/63),<50μg/L的比率为33.3%(21/63)],乌什县为100.3μg/L[<100μg/L的比率为50.0%(47/94),<50μg/L的比率为24.5%(23/94)].哺乳妇女尿碘的中位数为143.3μg/L,其中拜城县为119.7μg/L,乌什县为184.6μg/L.儿童甲肿率为14.3%(43/300),其中拜城县为10.8%(13/120),乌什县为16.6%(30/180).儿童平均智商为80.6±11.6,智力落后率为13.0%(39/300,智商≤69),其中拜城县儿童平均智商为83.0±11.6,乌什县为79.0±11.7,智力落后率分别为6.7%(8/120)和17.2%(31/180).婴幼儿智力发育正常所占的比例为78.8%(82/104),可疑比例为12.5%(13/104),发育异常比例为8.7%(9/104).结论 新疆拜城和乌什县重点人群依然存在不同程度的碘营养缺乏,缺碘是导致学龄儿童智力水平下降和婴幼儿脑发育迟滞的主要原因.     

高碘地区居民甲状腺吸碘率及其外周血中甲状腺激素水平

高碘地区居民甲状腺吸碘率及其外周血中甲状腺激素水平张继和李昕明丁萍梁平１９９５年四季度，我科配合市卫生防疫站对高碘地区居民饮用水碘及其尿碘作了调查，同时随机抽样对部分居民甲状腺吸碘功能及其外周血中甲状腺激素水平作了测定，现把结果报告如下。１材料和方法...     

沿海非高碘地区育龄妇女碘营养水平研究

目的探讨沿海非高碘盐地区育龄妇女的碘营养状况,为进一步制定碘缺乏病防治策略提供科学依据。方法收集碘盐覆盖率低的8个市（县）1 161名15～55岁的育龄妇女食用盐样和尿样,采用过硫酸氨消化-砷铈催化分光光度法测定尿碘,采用直接滴定法测定盐碘。结果8个市（县）1 161名妇女碘盐食用率为44.4%,尿碘中位数为120.0μg/L; 其中4.7%妇女尿碘中位数〈25μg/L为重度缺碘,15.5%妇女25μg/L〈尿碘中位数〈50μg/L为中度缺碘,23.1%妇女50μg/L〈尿碘中位数〈100μg/L为轻度缺碘,生育高峰时期的育龄妇女（15～35岁）尿碘水平最低为97.3μg/L。孕妇和哺乳期妇女严重碘缺乏的比例较高,分别为12.2%、11.9%,是非特殊生理时期妇女的2～3倍（χ^2=33.09,P〈0.001）。食用非碘盐的妇女引起严重碘缺乏是食用碘盐妇女的10倍（χ^2=209.52,P〈0.001）。育龄妇女的盐碘含量与尿碘水平有统计学线性相关（t=11.86,P〈0.001）,妇女碘缺乏与生活居住环境无统计学差异。结论育龄妇女,尤其是孕妇和哺乳期妇女,是碘缺乏病防治工作的重点人群,应加强育龄妇女的口服碘油丸强化工作。     

2011年重庆市重点地区人群碘营养水平调查分析

目的了解重庆市实现消除碘缺乏病阶段目标后人群碘营养状况,为科学防治碘缺乏病提供科学依据。方法2011年选择重庆市西部地区的永川、璧山县和东部地区的涪陵、万州区作为监测县,以县为单位,按东、西、南、北、中抽取9个乡(镇),每个乡(镇)抽取4个村,每个村抽取10户居民食用盐。随机抽取1所小学,抽取8～10岁儿童90人采集尿样测定。用砷铈催化分光光度法测定尿碘,直接滴定法监测盐碘。结果共抽取居民户食盐1 440份,碘含量中位数为29.34 mg/kg;不同区县间碘含量比较差异有统计学意义(H=180.52,P<0.01);碘盐覆盖率、碘盐合格率、合格碘盐食用率分别为99.72%、96.73%、96.46%。共调查8～10岁儿童360份尿样,尿碘中位数为297.85μg/L;不同区县间尿碘中位数比较差异有统计学意义(H=30.05,P<0.01)。360份尿碘<50μg/L者占1.11%,50～99μg/L者占6.67%,100～199μg/L者占27.78%,200～299μg/L者占31.11%,300μg/L以上者占33.33%。;尿碘构成比比较,区县间有统计学意义(χ2=39.20,P<0.01),性别、年龄间均无统计学意义(χ2性别=1.94,χ2年龄=4.28,P>0.05)。结论重庆市人群碘营养处于适宜量状态,盐碘水平存在下调的空间。     

新疆阿克苏地区重点人群碘营养和智力水平调查

Objective To investigate the iodine nutritional status of school children, lactating women and infants in iodine deficient areas of Baicheng and Wushi Counties in Xinjiang Autonomous Region. Methods According to the geographic location of east, south, west and north of county, 10 primary schools of 8 townships were selected. In each school, 10 children among each gender and age group from 8 to 10 years old were selected. A total of 300 school children were chosen. One hundred and four infants aged 0-2 years old and their mother were selected in 8 townships. Iodine content in edible salt at household level, the urinary iodine in school children and lactating women, total goiter rate(TGR) and the status of the intelligence quotient (1Q) of school children, the status of psychological development of infants were observed. Direct titration assay for testing the salt iodine, colorimetric ceric-arsenic assay and vitriolic ammonium assimilation were used for testing urinary iodine. The size of thyroid gland was measured by palpation. The Combined Raven Test for Chinese Rural was used to test the IQ. The psychological development of infants was tested by Danver Development Screening Test (DDST). Results The coverage rate of iodized salt at household level was 73.1% (123/182), however, the proportion of households using adequately iodized salt was 64.1% (118/182). The medium of urinary iodine in school children was 103.7 μ/L, with 47.8%(75/157) less than 100 μg/L and 28.0% (44/157) less than 50 μg/L; it was 123.0 μg/L in Baieheng County, with 44.4%(28/63) less than 100 μg/L and 33.3%(21/63) less than 50 μg/L; it was 100.3 μg/L in Wushi County, 50.0%(47/94) less than 100 μg/L and 24.5%(23/94) less than 50 μg/L. The medium of urinary iodine in locating women was 143.3 μg/L, it was 119.7 μg/L and 184.6 μg/L in Baicheng and Wushi Counties, respectively. The total rate of goiter in school children was 14.3%(43/300), it was 10.8%(13/120) and 16.6%(30/180) in Baicheng and Wushi Counties, respectively. The average IQ in school children was 80.6±11.6, it was 83.0±11.6 and 79.0±11.7 in Baicheng and Wushi Counties, respectively. The proportion of mental retardation in school children (IQ≤69) was 13.0% (39/300), it was 6.7% (8/120) and 17.2%(31/180) in Baicheng and Wushi Counties, respectively. In addition, the proportion of psychological development in infants being normal, suspicious and abnormal was 78.8%(82/104), 12.5% (13/104) and 8.7%(9/104), respectively. Conclusion This study confirms the fact that there is also existence of mental retardation in children and infants, caused by iodine deficiency.     

新疆阿克苏地区重点人群碘营养和智力水平调查

Objective To investigate the iodine nutritional status of school children, lactating women and infants in iodine deficient areas of Baicheng and Wushi Counties in Xinjiang Autonomous Region. Methods According to the geographic location of east, south, west and north of county, 10 primary schools of 8 townships were selected. In each school, 10 children among each gender and age group from 8 to 10 years old were selected. A total of 300 school children were chosen. One hundred and four infants aged 0-2 years old and their mother were selected in 8 townships. Iodine content in edible salt at household level, the urinary iodine in school children and lactating women, total goiter rate(TGR) and the status of the intelligence quotient (1Q) of school children, the status of psychological development of infants were observed. Direct titration assay for testing the salt iodine, colorimetric ceric-arsenic assay and vitriolic ammonium assimilation were used for testing urinary iodine. The size of thyroid gland was measured by palpation. The Combined Raven Test for Chinese Rural was used to test the IQ. The psychological development of infants was tested by Danver Development Screening Test (DDST). Results The coverage rate of iodized salt at household level was 73.1% (123/182), however, the proportion of households using adequately iodized salt was 64.1% (118/182). The medium of urinary iodine in school children was 103.7 μ/L, with 47.8%(75/157) less than 100 μg/L and 28.0% (44/157) less than 50 μg/L; it was 123.0 μg/L in Baieheng County, with 44.4%(28/63) less than 100 μg/L and 33.3%(21/63) less than 50 μg/L; it was 100.3 μg/L in Wushi County, 50.0%(47/94) less than 100 μg/L and 24.5%(23/94) less than 50 μg/L. The medium of urinary iodine in locating women was 143.3 μg/L, it was 119.7 μg/L and 184.6 μg/L in Baicheng and Wushi Counties, respectively. The total rate of goiter in school children was 14.3%(43/300), it was 10.8%(13/120) and 16.6%(30/180) in Baicheng and Wushi Counties, respectively. The average IQ in school children was 80.6±11.6, it was 83.0±11.6 and 79.0±11.7 in Baicheng and Wushi Counties, respectively. The proportion of mental retardation in school children (IQ≤69) was 13.0% (39/300), it was 6.7% (8/120) and 17.2%(31/180) in Baicheng and Wushi Counties, respectively. In addition, the proportion of psychological development in infants being normal, suspicious and abnormal was 78.8%(82/104), 12.5% (13/104) and 8.7%(9/104), respectively. Conclusion This study confirms the fact that there is also existence of mental retardation in children and infants, caused by iodine deficiency.     

新疆阿克苏地区重点人群碘营养和智力水平调查

Objective To investigate the iodine nutritional status of school children, lactating women and infants in iodine deficient areas of Baicheng and Wushi Counties in Xinjiang Autonomous Region. Methods According to the geographic location of east, south, west and north of county, 10 primary schools of 8 townships were selected. In each school, 10 children among each gender and age group from 8 to 10 years old were selected. A total of 300 school children were chosen. One hundred and four infants aged 0-2 years old and their mother were selected in 8 townships. Iodine content in edible salt at household level, the urinary iodine in school children and lactating women, total goiter rate(TGR) and the status of the intelligence quotient (1Q) of school children, the status of psychological development of infants were observed. Direct titration assay for testing the salt iodine, colorimetric ceric-arsenic assay and vitriolic ammonium assimilation were used for testing urinary iodine. The size of thyroid gland was measured by palpation. The Combined Raven Test for Chinese Rural was used to test the IQ. The psychological development of infants was tested by Danver Development Screening Test (DDST). Results The coverage rate of iodized salt at household level was 73.1% (123/182), however, the proportion of households using adequately iodized salt was 64.1% (118/182). The medium of urinary iodine in school children was 103.7 μ/L, with 47.8%(75/157) less than 100 μg/L and 28.0% (44/157) less than 50 μg/L; it was 123.0 μg/L in Baieheng County, with 44.4%(28/63) less than 100 μg/L and 33.3%(21/63) less than 50 μg/L; it was 100.3 μg/L in Wushi County, 50.0%(47/94) less than 100 μg/L and 24.5%(23/94) less than 50 μg/L. The medium of urinary iodine in locating women was 143.3 μg/L, it was 119.7 μg/L and 184.6 μg/L in Baicheng and Wushi Counties, respectively. The total rate of goiter in school children was 14.3%(43/300), it was 10.8%(13/120) and 16.6%(30/180) in Baicheng and Wushi Counties, respectively. The average IQ in school children was 80.6±11.6, it was 83.0±11.6 and 79.0±11.7 in Baicheng and Wushi Counties, respectively. The proportion of mental retardation in school children (IQ≤69) was 13.0% (39/300), it was 6.7% (8/120) and 17.2%(31/180) in Baicheng and Wushi Counties, respectively. In addition, the proportion of psychological development in infants being normal, suspicious and abnormal was 78.8%(82/104), 12.5% (13/104) and 8.7%(9/104), respectively. Conclusion This study confirms the fact that there is also existence of mental retardation in children and infants, caused by iodine deficiency.     

2007-2008年内蒙古自治区碘缺乏病高危地区病情及碘营养现状调查

目的 了解内蒙古碘缺乏病高危地区是否存在新发地方性克汀病病例,掌握地方性甲状腺肿(简称甲肿)流行现况及综合防治措施落实情况,为制订碘缺乏病的防治策略提供依据.方法 2007-2008年,在内蒙古历史地克病流行严重的松山区、克什克腾旗、喀喇沁旗,扎赉特旗、卓资县,凉城县、清水河县、和林县、东胜区、准格尔旗、伊金霍洛旗等11个旗(县、区),对10岁以下儿童进行新发地克病病例搜索;每个旗(县、区)选择3～5个乡,每个乡选择3～5个村小学,每所小学选择120～200名8～10岁儿童,进行甲状腺检查、智商和尿碘检测;每个乡选择2个村,每个村选择30个居民户,检测家庭主妇尿碘及家中食用盐含碘量情况.结果 11个项目旗(县、区)共搜索出56例疑似新发地克病病例,无确诊病例.触诊法和B超法检查8～10岁甲状腺,甲肿率分别为5.2%(309/5922)、4.3%(252/5922);8～10岁儿童尿碘中位数为241.5μg/L,尿碘为100.0～300.0 μg/L占65.9%(3901/5920).其中9个项目旗(县、区)的尿碘中位数在200.0～300.0μg/L,尿碘<50.0μg/L所占的比例>5%的旗(县、区)为0,<100.0μg/L所占的比例>10%的有1个.家庭主妇的尿碘中位数为225.6μg/L,<50.0μg/L占2.2%(35/1597).<100.0 μg/L所占比例>10%的旗(县、区)有4个.调查的2109户居民中有97.45%(2055/2109)的存食用碘盐,有2.55%(54/2109)的居民食用无碘盐.结论 调查的11个项目旗(县、区)儿童甲肿率降至10%以下,未发现新发克汀病病例,防治成绩显著;儿童和育龄妇女碘营养水平基本适宜;碘盐覆盖率高、销售网络比较健全、价格合理、购买方便,食盐加碘为主消除碘缺乏病防治措施得到有效的落实,儿童的智力得到有效保护.碘缺乏病健康教育仍然是防治工作中的一个薄弱环节,亟待加强.

Abstract：

Objective To investigate new cases of endemic cretinism in high-risk areas of Inner Mongolia, the prevalence of endemic goiter, the implementation of comprehensive measures, and to provide scientific basis for developing control strategies against iodine deficiency disorders (IDD). Methods In 2007 and 2008, a search for new cretin cases was conducted among children under the age of 10 in 11 historical serious epidemic cretinism prevalent areas of Songshan district, Keshiketeng qi, Kalaqin qi, Zhalaite qi, Zhuozi county,Liangcheng county, Qingshuihe county, Helin county, Dongsheng district, Zhungeer qi and Yinjinhuoluo qi. Three to 5 towns were selected in each qi(county, district) and 3 to 5 village primary schools were selected in each town.One hundred and twenty to 200 children aged 8 to 10 were selected in each school to inspect thyroid by B ultrasound and palpation and to test intelligence and urinary iodine. Two villages were selected in each town and 30 households were selected to determine urinary iodine of housewives and salt iodine. Results A total of 56 cases of suspected cases of endemic cretinism were found from the 11 counties but no case was confirmed. The goiter rate of children aged 8 to 10 was 5.2% (309/5922) by palpation and 4.3% (252/5922) by B-ultrasound. The median urinary iodine of children aged 8 to 10 was 241.5 μg/L, and urinary iodine was 100 to 300 μg/L, accounted 65.9%(3901/5920). Median urinary iodine of the 9 Qis(counties, districts) was in the range of 200 and 300μg/L.Higher than 5% of the 11 Qis(counties, districts) with urinary iodine lower than 50 μg/L was zero. Higher than 10% of the 11 Qis(counties, districts) with urinary iodine lower than 100 μg/L was 1. The median urinary iodine of housewives was 225.6 μg/L, and lower than 50 μg/L accounted for 2.2%(35/1597). Higher than 10% of the 11 Qis(counties, districts) with urinary iodine lower than 100 μg/L was 4. A total of 2109 households were investigated and 97.45%(2055/2109) of them ate iodized salt and 2.55%(54/2109) of them ate non-iodized salt. Conclusions In the 11 investigated counties, goiter rate of children has decreased to less than 10%, and no new cretin was found. It could be concluded that the fulfillment of prevention and control of IDD is effective. The iodine nutrition of children and women of childbearing age is in an adequate level. The coverage rate of iodized salt has maintained at a higher level, the sales network is sound, the salt price is reasonable and salt is easy to get and the children's intelligence is protected effectively. But, the health education about IDD is still weak, need to be reinforced.     

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.     

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     

2008年广西沿海地区碘缺乏病重点人群碘营养状况调查

目的 调查2008年广西沿海5个县(区)碘缺乏病重点人群碘营养状况,提出相应防治措施.方法 在广西碘盐监测中碘盐覆盖率、碘盐合格率和居民合格碘盐食用率一直处于全区低水平的北海市海城区、铁山港区、银海区、合浦县以及钦州市钦南区5个沿海县(区),采用随机抽样的方法,合浦县抽取6个乡(镇),其余县(区)各抽取3个乡(镇),每个乡(镇)抽取2个行政村,每个行政村抽取40名8～10岁学龄儿童及10名18～42岁育龄妇女(要求包括有半数比例的妊娠妇女和哺乳期妇女),用砷铈催化分光光度法(WS/T 107-2006)检测尿碘.结果 共采集8～10岁儿童尿样1437份,尿碘中位数为191.0μg/L,<20μg/L的比例为1.4%(20/1437),<50μg/L的比例为5.4%(77/1437),<100μg/L的比例为20.3%(292/1437);5个县(区)儿童尿碘中位数为134.5～220.0μg/L,其中海城区、合浦县儿童尿碘中位数>200 μg/L(分别为220.0、209.5μg/L),其他3个县(区)儿童尿碘中位数均在100～200μg/L适宜范围内(分别为134.5、162.4、199.3μg/L);8、9岁组儿童尿碘中位数(192.3、206.7μg/L)均高于10岁组(157.2μg/L,χ2值分别为19.644、41.997,P均<0.017).共采集妇女尿样365份,5个县(区)妇女尿碘中位数为88.2～195.6μg/L,其中海城区和合浦县妇女尿碘中位数>150 μg/L(分别为195.6、156.5μg/L),铁山港区妇女尿碘中位数最低(88.2μg/L)且<100μg/L;在妊娠妇女、哺乳期妇女、育龄妇女中,育龄妇女尿碘中位数最高,为152.6μg/L,哺乳期妇女尿碘中位数为131.9μg/L,妊娠妇女尿碘中位数最低(89.4 μg/L)且<100μg/L,仅有6.7%(2/30)的妊娠妇女尿碘水平处于150～250μg/L适宜范围.结论 广西沿海5个县(区)8～10岁儿童碘营养状况良好,育龄妇女和哺乳期妇女尿碘水平在碘营养适宜范围内,妊娠妇女整体上未达碘营养适宜水平.建议将妊娠妇女碘营养监测纳入常规监测,进一步落实碘盐防治措施,加强健康教育宣传,提高碘盐覆盖率.     

不同碘摄入水平对大鼠甲状腺功能影响的实验研究

目的研究不同碘摄入水平对大鼠甲状腺功能的影响。方法将Wistar大鼠分为低碘(LI)组、正常碘(NI)组、5倍、10倍、50倍、100倍高碘(5HI、10HI、50HI、100HI)组,在喂养3、6、12个月后处死,分别检测血清总T4(TT4)、总T3(TT3)、游离T3(FT3)、游离T4(FT4)、反T3(rT3)水平,以及甲状腺组织中T4、T3、rT3水平。结果3个月时血清TT4、FT4、TT3、FT3、rT3以及甲状腺组织中T4、T3、rT3水平,组间比较差异均有统计学意义(F值分别为54．07、67．80、15．51、27．71、19．73、61．51、40．67、53．86,P<0．01);6个月时上述指标组间比较差异均有统计学意义(F值分别为58．80、58．75、19．64、17．22、47．21、46．01、47．22、126．87,P<0．01);12个月时甲状腺组织中T4、T3、rT3水平组间比较差异均有统计学意义(F值分别为20．44、17．69、29．23,P<0．01)。与NI组相比较,LI组血清和甲状腺组织内各激素水平明显降低,而高碘组随着时间的延长和摄入碘量的增加,血清各激素和甲状腺组织内T3水平出现逐渐降低趋势。结论碘缺乏和碘过量均可导致大鼠甲状腺功能低下,而碘缺乏的作用更明显;大鼠对长期高碘摄入比碘缺乏具有更强的耐受性,只有在长期补充过量碘(>50倍正常需要量)才发生甲状腺功能低下。     

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.     

中国部分沿海地区居民碘营养状况调查结果分析

目的 了解我国沿海地区食用碘盐防治碘缺乏病是否导致居民碘摄入过量.方法 采用横断面调查方法,在我国11个沿海省份(自治区、直辖市)中,沿着海岸线从北往南选择辽宁省、上海市、浙江省及福建省4个省(市)进行调查.除上海市调查其所有辖区外,其他的3个省都分城市和农村两个层次,分别调查了5个沿海城市、5个沿海农村,以及3个内陆农村(作为对照点)的外环境水碘、居民合格碘盐食用率、居民人均盐日摄入量以及不同人群的尿碘水平.结果 在4个省(市)共采集居民饮用水水样7552份、居民户盐样7996份和不同人群(成人、哺乳妇女、孕妇和儿童)尿样9873份.除浙江省沿海城市和沿海农村合格碘盐食用率低于90％外,其他3个沿海省(市)调查地区的合格碘盐食用率均大于90％.4个省(市)成人和儿童尿碘中位数均在100～299 μg/L;哺乳妇女尿碘中位数均大于100 μg/L;上海市、浙江省沿海城市和福建省沿海农村孕妇尿碘中位数低于150μg/L.结论 沿海地区居民的碘营养状况总体水平上是适宜的,部分沿海地区孕妇碘营养不足;沿海地区应坚持食盐加碘防治碘缺乏病的措施.     

2009年西宁市碘缺乏病防治效果调查

目的 掌握西宁市基本达到消除碘缺乏病阶段目标后,碘缺乏病的防治效果及人群碘营养状况.方法 2009年调查西宁市7个县(区),每个县(区)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80名8～10岁学生,采用触诊法检查儿童甲状腺肿大情况,采用过硫酸铵消化砷铈催化分光光度法测定儿童尿碘,采用直接滴定法测定学生家中食用盐含碘量.结果 共抽检2919名8～10岁儿童,检出甲状腺肿大31名,甲状腺肿大率为1.06%(31/2919).共检测儿童尿样1078份,尿碘中位数为205.3μg/L,＜20 μg/L的占1.9%(20/1078),＜50 μg/L的占4.5%(48/1078).共检测2079份盐样,盐碘中位数为32.80 mg/kg,非碘盐率为0.87%(18/2079),碘盐覆盖率为99.13%(2061/2079),碘盐合格率为98.64%(2033/2061),合格碘盐食用率为97.79%(2033/2079).结论 西宁市碘缺乏病防治工作取得了明显成效,各项指标均达到国家碘缺乏病消除标准.

Abstract：

Objective To master iodine nutritional status of people after universal salt iodization in Xining that reached the stage goal of elimination iodine deficiency disorders. Methods In the 7 counties investigated of Xining in 2009, 5 towns were randomly selected in each county, and one school was randomly selected in each town, 80 children aged 8 to 10 were randomly selected in each school, and goiter were examined, urinary iodine and salt iodine were tested. Thyroid gland goiter of children was detected by thyroid palpation, children's urinary iodine was tested by As( Ⅲ )-Ce4+ catalytic spectrophotometry, and salt iodine was tested by direct titration. Results A total of 2919 children aged 8 to 10 were examined, 31 goiter was detected, goiter rate was 1.06%(31/2919).One thousand and seventy-eight urine samples were detected, urinary iodine median was 205.3 μg/L, that lower than 20 μg/L accounted for 1.9% (20/1078), lower than 50 μg/L accounted for 4.5%(48/1078). Two thousand and seventy-nine salt samples were detected, median of salt iodine was 32.80 mg/kg, the rate of non-iodized salt was 0.87%(18/2079), the coverage rate of iodized salt was 99.13%(2061/2079), the qualified rate of iodized salt was 98.64% (2033/2061), the consumption rate of qualified iodized salt was 97.79% (2033/2079). Conclusions Prevention and control of iodine deficiency disorders has achieved remarkable results in Xining city, all indicators have reached the national standard to eliminate iodine deficiency disorders.