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.

Statistical analysis of factors affecting the result of using iodized salt in controlling of iodine deficiency disorders in Zhangjiakou from 2000 to 2008

Objective To find out the relation between element (non-iodized salt and iodized salt that below standard) and epidemic strength of iodine deficiency disorders and level of iodine, in order to find out the factors affecting the result of using iodized salt in controlling of this disorders. Methods Retrospective analyses was used in the study. Six counties were selected randomly from Zhangjiakou every year from 2000 to 2008, and these counties were randomly divided into non-iodized salt group (the ratio of non-iodized salt > 5%), iodized salt below standard group (the ratio of qualified iodized salt < 95%) and control group (the ratio of using qualified iodized salt > 95%). The indexes from different groups were compared as well as the ratio of large thyroid syndrome in children aged 8-10 years and the level of iodine in urine. Results The number of iodized salt monitored were 12 468 units from 2000 to 2008. We examined 5655 children's thyroid and collected 4404 urine samples. The median was 30.1 mg/kg for the average of iodized salt and 7.30% (232/3180) for ratio of non-iodized salt in noniodized salt group, while 30.9 mg/kg and 93.10%(3776/4056) in iodized salt below standard group, and 32.0 mg/kg and 99.27%(5194/5232) in control group. Compared the median of the three groups5.31%(78/1468) ,4.84% (92/1902) ,2.06% (47/2285)], we observed significant difference (χ2 = 72.07, P < 0.05), especially the ratio of large thyroid in non-iodized salt group which was apparently higher than that of the control group (χ2 = 8.70, P < 0.017). However there was no significant difference between iodized salt below standard group and non-iodized salt group(χ2 = 6.83, P > 0.017) and control group(χ2 = 5.65, P > 0.017). The median of urinary iodine was 188.20 μg/L in non-iodized salt group, 219.62 μg/L in iodized salt below standard group and 262.39 μg/L in control group, indicated that the index in control group was higher than that of others. Conclusion Both of non-iodized salt and iodized salt below standard have effect on prevalence of child iodine deficiency disorders, especially the non-iodized salt.