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。

Surveillance results of iodine deficiency disorders in high-risk areas in Yiliang county,Yunnan province

Objective To understand the occurrence of suspected cretinism cases and the prevalence of endemic goiter and peoples’ nutrition status of iodine.Find out the reason of lower coverage rate of iodized salt in the iodine deficiency disorders(IDD)high-risk areas of Yunnan province,then put forward targeted preventive measures.Methods Selected 3 townships from Yiliang county where the coverage rate of iodized salt was less than 80%.In the selected townships,new cretinism cases were searched and the thyroid volume of children aged 8 to 10 years old were determined.Children aged 8 to 10 years old and child-bearing age women’s urinary iodine(UI)were determined.In the household survey,the salt iodine content was determined using self-quantitative kit.Surveyed the supply of iodized salt,iodized oil administration and prevention measures.Results No suspected cretinism cases were searched both in 2008 and 2010.The median urinary iodine(MUI)of children were more than 100 μg/L,the percentage of UI <50 μg/L was less than 10%.It was showed that the residents of the area does not exist the problem of insufficient iodine nutrition,but non-iodized salt distribute in some areas.The surveillance results in 2008 compared with 2010,the goiter rate of children aged 8 to 10 years old by palpation decreased from 19.34% to 6.25% and the coverage rate of iodized salt increased from 84.17% to 99.17%.Conclusion Timely and effective measures were taken to prevent and control of IDD in high-risk areas of Yunnan province.It is essential to strength the supervision of non-iodized salt and to popularize IDD prevention knowledge,technical training in the remote and poor areas.Emergent iodine fortification measure for high risk region people should be implemented,so as to block the damage of IDD timely and to consolidate the achievement of IDD prevention.