2008年广西沿海地区碘缺乏病重点人群碘营养状况调查

Objective To investigate the nutrition status of the focus groups of iodine deficiency in the 5 coastal counties(districts)in Guangxi in 2008 to propose corresponding prevention and control measures.Methods In the 5 coastal counties(districts)in Guangxi,including Haicheng,Tieshangang,Yinhai districts and Hepu county in Beihai city,Qinnan district in Qinzhou city,the rates of iodized salt coverage,qualified iodized salt and consumption of qualified iodized salt had always been below the average level of Guangxi.In the study,6 towns were randomly picked in Hepu district,and 3 towns were randomly picked in each of the other 4 coastal counties(districts).Two administrative viRages were randomly picked in each town.Forty children ages 8 to 10 and 10 women of child-beating age from 18 to 42 which included 5 pregnant and lactating women,were picked from each administrative village.Arsenic-cerium catalyzed spectrophotometry(WS/T 107-2006)Was used to determine the urinary iodine.Results In total,1437 urine samples of the children Were picked.The median of the children's urinary iodine Was 191.0μg/L,with 1.4%(20/1437)of the children's urinary iodine<20 μg/L,and 5.4%(77/1437)<50 μg/L, and 20.3%(292/1437) < 100 μg/L. The medians of the children's urinary iodine were 134.5 - 220.0 μg/L.In Haicheng and Hepu, the medians of the children's urinary iodine were higher than 200 μg/L(220.0,209.5 μg/L, respectively). The medians of the children's urinary iodine in the other 3 counties(districts) were within the suitable range between 100 and 200 μg/L(134.5,162.4,199.3 μg/L, respectively). The medians of the 8- and 9-year-old ehildren's urinary iodine (192.3,206.7 μg/L, respectively) were higher than that of the 10-year-old children's(157.2 μg/L, χ2 = 19.644,41.997, all P < 0.017). Totally, 365 urine samples of the women were picked.The medians of the women's urinary iodine in the 5 counties were 88.2 - 195.6 μg/L, with 195.6 μg/L in Haicheng and 156.5 μg/L in Hepu, and 88.2 μg/L in Tieshangang, which was the lowest and below 100 μg/L. The median of the childbearing-age women's urinary iodine was the highest(152.6 μg/L). The median of the lactating women's urinary iodine was the second (131.9 μg/L). The median of the pregnant women's urinary iodine was the lowest (89.4 μg/L) and below 100 μg/L. Only 6.7%(2/30) of the pregnant women's urinary iodine were within the suitable range between 150 and 250 μg,/L. Conclusions In the 5 coastal counties(districts) in Guangxi, 8 to 10-year-old children had good nutrition levels while childbearing-age and lactating women were within the suitable range. As a whole, the pregnant women had insufficient iodine nutrition. We propose that the iodine nutritional status of pregnant women is monitored routinely, with further prevention, control measures, health publicity and education necessary to improve iodized salt coverage.     

2008年广西沿海地区碘缺乏病重点人群碘营养状况调查

Objective To investigate the nutrition status of the focus groups of iodine deficiency in the 5 coastal counties(districts)in Guangxi in 2008 to propose corresponding prevention and control measures.Methods In the 5 coastal counties(districts)in Guangxi,including Haicheng,Tieshangang,Yinhai districts and Hepu county in Beihai city,Qinnan district in Qinzhou city,the rates of iodized salt coverage,qualified iodized salt and consumption of qualified iodized salt had always been below the average level of Guangxi.In the study,6 towns were randomly picked in Hepu district,and 3 towns were randomly picked in each of the other 4 coastal counties(districts).Two administrative viRages were randomly picked in each town.Forty children ages 8 to 10 and 10 women of child-beating age from 18 to 42 which included 5 pregnant and lactating women,were picked from each administrative village.Arsenic-cerium catalyzed spectrophotometry(WS/T 107-2006)Was used to determine the urinary iodine.Results In total,1437 urine samples of the children Were picked.The median of the children's urinary iodine Was 191.0μg/L,with 1.4%(20/1437)of the children's urinary iodine<20 μg/L,and 5.4%(77/1437)<50 μg/L, and 20.3%(292/1437) < 100 μg/L. The medians of the children's urinary iodine were 134.5 - 220.0 μg/L.In Haicheng and Hepu, the medians of the children's urinary iodine were higher than 200 μg/L(220.0,209.5 μg/L, respectively). The medians of the children's urinary iodine in the other 3 counties(districts) were within the suitable range between 100 and 200 μg/L(134.5,162.4,199.3 μg/L, respectively). The medians of the 8- and 9-year-old ehildren's urinary iodine (192.3,206.7 μg/L, respectively) were higher than that of the 10-year-old children's(157.2 μg/L, χ2 = 19.644,41.997, all P < 0.017). Totally, 365 urine samples of the women were picked.The medians of the women's urinary iodine in the 5 counties were 88.2 - 195.6 μg/L, with 195.6 μg/L in Haicheng and 156.5 μg/L in Hepu, and 88.2 μg/L in Tieshangang, which was the lowest and below 100 μg/L. The median of the childbearing-age women's urinary iodine was the highest(152.6 μg/L). The median of the lactating women's urinary iodine was the second (131.9 μg/L). The median of the pregnant women's urinary iodine was the lowest (89.4 μg/L) and below 100 μg/L. Only 6.7%(2/30) of the pregnant women's urinary iodine were within the suitable range between 150 and 250 μg,/L. Conclusions In the 5 coastal counties(districts) in Guangxi, 8 to 10-year-old children had good nutrition levels while childbearing-age and lactating women were within the suitable range. As a whole, the pregnant women had insufficient iodine nutrition. We propose that the iodine nutritional status of pregnant women is monitored routinely, with further prevention, control measures, health publicity and education necessary to improve iodized salt coverage.     

2007年重庆市云阳县和璧山县8～10岁儿童尿碘水平分析

Objective To determine the urinary iodine level of people in Yunyang and Bishan County of Chongqing and explore into its influencing factors. Methods Using multistage cluster stratified simple random sample method, Yunyang and Bishan County were chosen as research spots, then thirty children aged 8-10 in each 3 primary school of the 2 counties were selected using stratified randomization sampling method to inspected their urine and household salt for iodine and the iodine content in drinking water. Results Five hundred and seventy-one urine samples were inspected and the urinary iodine median was 261.47 μg/L. 5.78% (33/571) and 37.48%(214/571) of samples had an urinary iodine median less than 100 μg/L and more than 300 μg/L. The urinary iodine median of Yunyang County was higher than that of Bishan (H = 7.42, P < 0.01). The iodine salt coverage rate, the qualified rate and edible qualified iodine salt rate respectively were 99.64%(554/556), 94.22% (522/554) and 93.88% (522/556) in 556 samples of family table salt. Eighty-seven samples of drinking water were inspected, resulting an averaged iodine content of 8.81 and 2.97 μg/L, respectively in the 2 counties. Conclusions The 2 counties are all the area of iodine deficiency. The urinary iodine level, although meeting the demand of eliminating iodine deficiency diseases, is a little bit higher given that iodized salt of present doage has been taken for a long time. The content of iodized salt should be adjusted accordingly.     

2007年重庆市云阳县和璧山县8～10岁儿童尿碘水平分析

Objective To determine the urinary iodine level of people in Yunyang and Bishan County of Chongqing and explore into its influencing factors. Methods Using multistage cluster stratified simple random sample method, Yunyang and Bishan County were chosen as research spots, then thirty children aged 8-10 in each 3 primary school of the 2 counties were selected using stratified randomization sampling method to inspected their urine and household salt for iodine and the iodine content in drinking water. Results Five hundred and seventy-one urine samples were inspected and the urinary iodine median was 261.47 μg/L. 5.78% (33/571) and 37.48%(214/571) of samples had an urinary iodine median less than 100 μg/L and more than 300 μg/L. The urinary iodine median of Yunyang County was higher than that of Bishan (H = 7.42, P < 0.01). The iodine salt coverage rate, the qualified rate and edible qualified iodine salt rate respectively were 99.64%(554/556), 94.22% (522/554) and 93.88% (522/556) in 556 samples of family table salt. Eighty-seven samples of drinking water were inspected, resulting an averaged iodine content of 8.81 and 2.97 μg/L, respectively in the 2 counties. Conclusions The 2 counties are all the area of iodine deficiency. The urinary iodine level, although meeting the demand of eliminating iodine deficiency diseases, is a little bit higher given that iodized salt of present doage has been taken for a long time. The content of iodized salt should be adjusted accordingly.     

2007年重庆市云阳县和璧山县8～10岁儿童尿碘水平分析

Objective To determine the urinary iodine level of people in Yunyang and Bishan County of Chongqing and explore into its influencing factors. Methods Using multistage cluster stratified simple random sample method, Yunyang and Bishan County were chosen as research spots, then thirty children aged 8-10 in each 3 primary school of the 2 counties were selected using stratified randomization sampling method to inspected their urine and household salt for iodine and the iodine content in drinking water. Results Five hundred and seventy-one urine samples were inspected and the urinary iodine median was 261.47 μg/L. 5.78% (33/571) and 37.48%(214/571) of samples had an urinary iodine median less than 100 μg/L and more than 300 μg/L. The urinary iodine median of Yunyang County was higher than that of Bishan (H = 7.42, P < 0.01). The iodine salt coverage rate, the qualified rate and edible qualified iodine salt rate respectively were 99.64%(554/556), 94.22% (522/554) and 93.88% (522/556) in 556 samples of family table salt. Eighty-seven samples of drinking water were inspected, resulting an averaged iodine content of 8.81 and 2.97 μg/L, respectively in the 2 counties. Conclusions The 2 counties are all the area of iodine deficiency. The urinary iodine level, although meeting the demand of eliminating iodine deficiency diseases, is a little bit higher given that iodized salt of present doage has been taken for a long time. The content of iodized salt should be adjusted accordingly.     

2007年重庆市云阳县和璧山县8～10岁儿童尿碘水平分析

Objective To determine the urinary iodine level of people in Yunyang and Bishan County of Chongqing and explore into its influencing factors. Methods Using multistage cluster stratified simple random sample method, Yunyang and Bishan County were chosen as research spots, then thirty children aged 8-10 in each 3 primary school of the 2 counties were selected using stratified randomization sampling method to inspected their urine and household salt for iodine and the iodine content in drinking water. Results Five hundred and seventy-one urine samples were inspected and the urinary iodine median was 261.47 μg/L. 5.78% (33/571) and 37.48%(214/571) of samples had an urinary iodine median less than 100 μg/L and more than 300 μg/L. The urinary iodine median of Yunyang County was higher than that of Bishan (H = 7.42, P < 0.01). The iodine salt coverage rate, the qualified rate and edible qualified iodine salt rate respectively were 99.64%(554/556), 94.22% (522/554) and 93.88% (522/556) in 556 samples of family table salt. Eighty-seven samples of drinking water were inspected, resulting an averaged iodine content of 8.81 and 2.97 μg/L, respectively in the 2 counties. Conclusions The 2 counties are all the area of iodine deficiency. The urinary iodine level, although meeting the demand of eliminating iodine deficiency diseases, is a little bit higher given that iodized salt of present doage has been taken for a long time. The content of iodized salt should be adjusted accordingly.     

2007年重庆市云阳县和璧山县8～10岁儿童尿碘水平分析

Objective To determine the urinary iodine level of people in Yunyang and Bishan County of Chongqing and explore into its influencing factors. Methods Using multistage cluster stratified simple random sample method, Yunyang and Bishan County were chosen as research spots, then thirty children aged 8-10 in each 3 primary school of the 2 counties were selected using stratified randomization sampling method to inspected their urine and household salt for iodine and the iodine content in drinking water. Results Five hundred and seventy-one urine samples were inspected and the urinary iodine median was 261.47 μg/L. 5.78% (33/571) and 37.48%(214/571) of samples had an urinary iodine median less than 100 μg/L and more than 300 μg/L. The urinary iodine median of Yunyang County was higher than that of Bishan (H = 7.42, P < 0.01). The iodine salt coverage rate, the qualified rate and edible qualified iodine salt rate respectively were 99.64%(554/556), 94.22% (522/554) and 93.88% (522/556) in 556 samples of family table salt. Eighty-seven samples of drinking water were inspected, resulting an averaged iodine content of 8.81 and 2.97 μg/L, respectively in the 2 counties. Conclusions The 2 counties are all the area of iodine deficiency. The urinary iodine level, although meeting the demand of eliminating iodine deficiency diseases, is a little bit higher given that iodized salt of present doage has been taken for a long time. The content of iodized salt should be adjusted accordingly.     

河北省低碘盐覆盖率地区重点人群碘营养状况调查

Objective To investigate the iodine nutrition status of the target population living in the areas with low coverage rate of iodized salt and to provide a basis to prevent and control iodine deficiency. Methods The investigation was carried out in the areas with coverage rate of iodized salt lower than 80%, including 7 counties (city, district). Three townships(sub-district office) were sampled in each county and two elementary schools in each township(sub-district office). Urinary iodine level was measured for 40 children aged from 8 to 10 years old in each elementary school. Drinking water iodine was collected and determined in their living villages. Twenty salt samples were tested for iodine in salt from 20 house which had fertile women, and urine iodine of 10 fertile women were tested in each village. Results Sixty-two water samples were determined and the water iodine was ranged from 5.8 to 272.7 μg/L, of which 3 water samples were equal and more than 150 μg/L. Eight hundred and seventy-two salt samples were collected. The coverage rate of iodized salt was 70.74%(585/827) and the coverage rates were below than 80% in 5 counties (city, district). A total of 1660 children' urine samples were collected, the content of urine iodine ranged from 10.0 to 1088.0 μg/L and the urine iodine median was 173.7 μg/L. Four hundred and thirty-seven urine samples were collected from the fertile women and the urine iodine median was 179.1 μg/L. The iodine level of children and women was the highest in Dongguang County(251.8,273.8 μg/L) while that of Hejian County (130.8,118.7 μg/L) was the lowest. Conclusions Although the iodine nutrition of children and fertile women is appropriate in areas with low coverage rate of iodized salt, we presume from the results that the possibility of iodine deficiency in pregnant and lactating women exists in Hejian and Anping.     

2007年西藏自治区碘缺乏病高危地区重点人群调查分析

Objective To propose prevention and control strategy against iodine deficiency disorders to prevent new cases of endemic cretinism from occurring. Methods In April and August 2007, all the suspected cretinism patients born after the first of January, 1997 were searched for in 16 counties from Lhasa, Shannan, Nyingchi, Qamdo and Xigaze. Meanwhile, 60 children aged 8-10 years were selected in each of the two rural villages of each county chosen. Goiter was examined using palpation and B-ultrasound, urinary iodine was determined, inteligence quotient(IQ) was tested; 30 women of childbearing age from each village chosen underwent urinary iodine test and household salt semi-quantitative detection. Results No new cases of endemic cretinism had been found; Palpation identified goiter at 4.5% (257/5680) in children, B-ultrasound revealed a rate of 4.7% (258/5433). Median of urinary iodine was 159.4 μg/L, the averaged IQ was 78.3±14.5; women of childbearing age had a median urinary iodine of 70.2 μg/L. The coverage rate of iodized salt was 52.8%. Conclusions Goiter rate in children, urinary iodine level meet the standard set for the elimination of iodine deficiency disorders; however, the low IQ children, low coverage of iodized salt and the level of urinary iodine in women of childbearing age are less than desirable. Iodine deficiency disorders prevention and control need to be strengthened.     

2007年西藏自治区碘缺乏病高危地区重点人群调查分析

Objective To propose prevention and control strategy against iodine deficiency disorders to prevent new cases of endemic cretinism from occurring. Methods In April and August 2007, all the suspected cretinism patients born after the first of January, 1997 were searched for in 16 counties from Lhasa, Shannan, Nyingchi, Qamdo and Xigaze. Meanwhile, 60 children aged 8-10 years were selected in each of the two rural villages of each county chosen. Goiter was examined using palpation and B-ultrasound, urinary iodine was determined, inteligence quotient(IQ) was tested; 30 women of childbearing age from each village chosen underwent urinary iodine test and household salt semi-quantitative detection. Results No new cases of endemic cretinism had been found; Palpation identified goiter at 4.5% (257/5680) in children, B-ultrasound revealed a rate of 4.7% (258/5433). Median of urinary iodine was 159.4 μg/L, the averaged IQ was 78.3±14.5; women of childbearing age had a median urinary iodine of 70.2 μg/L. The coverage rate of iodized salt was 52.8%. Conclusions Goiter rate in children, urinary iodine level meet the standard set for the elimination of iodine deficiency disorders; however, the low IQ children, low coverage of iodized salt and the level of urinary iodine in women of childbearing age are less than desirable. Iodine deficiency disorders prevention and control need to be strengthened.     

我国碘缺乏病高危地区重点调查结果分析

目的 调查我国碘缺乏病高危地区新发地方性克汀病(地克病)和地方性甲状腺肿(地甲肿)的流行现况,了解高危地区碘盐覆盖率较低的原因,有针对性地提出防治对策.方法 以县为单位,在西藏、青海、新疆、甘肃、宁夏、四川、海南、重庆、云南、广西、内蒙古11个省份的碘盐监测盲区(高危县)采取单纯随机抽样方法选择调查乡,在其他高危县按照典型调查原则以乡为单位选取调查点,进行10岁以下新发地克病病例搜索;对8～10岁儿童采用B超法检测甲状腺大小,采用中国瑞文测验(农村修订版)检测智商;对育龄妇女开展人户调查和采集家中盐样,盐碘测定采用半定量法,统计居民户碘盐覆盖率;采集8～10岁儿童和育龄妇女尿样,尿碘测定采用砷铈催化分光光度法;全部结果采用Epi Iinfo 6.0软件进行分析.结果 在101个高危县中搜索出地克病线索病例4122人,其中确诊地克病249例.儿童甲状腺肿大(甲肿)率为8.28%(4434/53 541),44个县儿童甲肿率在5%～20%,5个县儿童甲肿率在>20%～30%,3个县儿童甲肿率>30%.儿童智商均值为85.44,智商<70的儿童占16.52%(8713/52 745).儿童尿碘中位数为154.69;μg/L、尿碘<50μg/L的比例为17.26%(9069/52 558),有25个县的儿童尿碘中位数<100μg/L;育龄妇女尿碘中位数为107.14μg/L、尿碘<50μg/L的比例为27.50%(3722/13 534),有46个县家庭主妇尿碘中位数<100μg/L.居民户的碘盐覆盖率为77.85%(13 150/16 891),西藏、海南、青海碘盐覆盖率较低,分别为52.80%(1585/3002)、44.72%(631/1411)、72.82%(1850/2506).西藏、四川、海南、甘肃、青海居民户中>10%的人认为购买碘盐不方便,有71.39%(7652/10 719)的家庭食用土盐,土盐每公斤的平均价格(0.30～1.20元)低于碘盐(1.20～3.00元).结论 碘缺乏病高危地区存在发生地克病和地甲肿的危险,应在这些地区开展碘缺乏病监测,降低碘盐价格,提高碘盐覆盖率,对特需人群要尽快实施应急补碘,建立消除碘缺乏病的长效机制.     

2010年福建省碘缺乏病高危地区重点调查结果分析

目的 调查福建省碘缺乏病高危地区新发地方性克汀病(简称地克病)、地方性甲状腺肿流行现况及防治措施落实情况,为制订有针对性的防治策略措施提供科学依据.方法 2010年,在碘盐监测覆盖率较低的秀屿区、翔安区、平潭县、东山县各抽取3个乡(镇),进行10岁以下新发地克病病例搜索;在每个乡(镇)抽取2所小学,每所小学抽取40名8～ 10岁儿童进行甲状腺B超检查,同时采集尿样,用砷铈催化分光光度法测定尿碘;在小学所在村抽取20名18 ～40岁育龄妇女,采集食用盐样和尿样,用半定量法测定盐碘,砷铈催化分光光度法测定尿碘.结果 病例搜索未发现新发地克病及疑似地克病病例;8 ～ 10岁儿童总体甲状腺肿大率为3.6％ (37/1027),但东山县为5.4％( 13/240),超过国家消除碘缺乏病标准(＜5％);8～10岁儿童和18～40岁育龄妇女的尿碘中位数分别为175.3、152.7 μg/L;碘盐覆盖率为82.7％ (382/462).结论 福建省碘缺乏病高危地区未发现新发地克病及疑似地克病病例,人群尿碘中位数处于适宜水平.     

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.     

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.     

云南省彝良县碘缺乏病高危监测结果分析

目的了解云南省碘缺乏病高危地区新发地方性克汀病、地方性甲状腺肿流行现况、人群碘营养状况及防治措施落实情况,查找影响我省高危地区碘盐覆盖率的原因,研究并提出有针对性的防治策略和措施。方法 2008、2010年在碘盐覆盖率<80%的彝良县抽取3个乡实施高危地区监测,监测内容包括搜索疑似地克病病例,检测8～10岁儿童甲状腺容积,检测8～10岁儿童和育龄妇女的尿碘浓度,入户调查和采集家中盐样进行半定量检测,调查被监测乡、村实施碘盐供应、碘油投服等防治措施情况。结果 2008、2010年两次监测都未发现疑似地克病;育龄妇女尿碘中位数分别为184.14μg/L、247.12μg/L,儿童尿碘中位数分别为204.72μg/L、282.96μg/L;2008与2010年结果比较,碘盐覆盖率由84.17%上升至99.17%,儿童和育龄期妇女尿碘中位数均有明显升高,8～10岁儿童甲肿率(触诊法)由19.34%下降至6.25%。结论我省高危地区碘缺乏病监测、防治措施及时有效,今后应不断巩固碘缺乏病防治成果;该地区居民碘营养已处于超适宜状态,应适当下调盐碘含量。     

2007年西藏自治区碘缺乏病高危地区重点人群调查分析

目的 掌握西藏自治区碘缺乏病防治工作现况,提出有针对性的防治对策,杜绝新发地方性克汀病(简称地克病)的发生.方法 2007年4-8月在拉萨、山南、林芝、昌都、日喀则5个地区的16个县,搜索所有1997年1月1日以后出生的疑似克汀病患者,在每个乡选择2个村,每个村选取60名8～10岁儿童,采用触诊法和B超法进行甲状腺检查、尿碘测定、智商测查;每个村选择30户育龄妇女进行尿碘测定,并对其家中食盐进行半定量检测.结果 调查未发现新发克汀病患者.触诊法检查,8～10岁儿童甲状腺肿大(简称甲肿)率为4.5%(257/5680);B超法检查,甲肿率为4.7%(258/5433).8～10岁儿童尿碘中位数为159.4μg/L,智商为78.3±14.5;育龄妇女的尿碘中位数为70.2μg/L;碘盐覆盖率为52.8%.结论 儿童甲肿率、尿碘水平达到了消除碘缺乏病标准;但是儿童智商偏低,育龄妇女尿碘水平较低,碘盐覆盖率较低,碘缺乏病的防治工作需要加强.     

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.     

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.     

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.     

广西2011年碘缺乏病监测结果分析

目的了解广西碘缺乏病防治工作现况,为制定预防控制策略提供科学依据。方法采用PPS法抽取30个县、区开展病情监测;在未开展病情监测的79个县、区进行人群碘营养监测;在全区109个县、区开展系统地饮用水水碘监测。结果病情监测,碘盐覆盖率为99.43%,合格碘盐食用率为93.54%,8~10岁儿童甲肿率为0.33%,尿碘中位数236.60μg/L,孕妇和哺乳妇女尿碘中位数均为131.00μg/L;人群碘营养监测,8~10岁儿童尿样7 838份,尿碘中位数241.77μg/L,〈50μg/L的比例为2.76%,〉300μg/L比例33.50%;饮用水水碘监测,全区4 968份居民生活饮用水水碘检测,〈10μg/L占84.74%,10~150μg/L占14.94%,〉150μg/L占0.32%。结论广西属于缺碘地区,普及碘盐防治碘缺乏病的效果得到进一步夯实,人群碘营养总体上在适宜范畴,但处于一种大于需要量的状态,需要对我区食盐加碘含量进行科学调整。