武汉市学龄儿童碘营养状况及甲状腺容积影响因素研究

目的 分析武汉市8~10岁儿童碘营养状况及甲状腺容积影响因素，为评价碘缺乏病防治效果，调整防治策略提供依据。方法 2016-2018年在武汉市13个区按东、西、南、北、中5个片区各抽取1所小学的8~10岁非寄宿学生，采集其随机1次尿样、家中食用盐样进行检测，并对所有儿童进行甲状腺B超检测，测量其甲状腺容积。结果 共抽取武汉市8~10岁儿童2498人，其中男生1273人，女生1225人。全市儿童尿碘中位数为261.00μg/L，甲状腺容积中位数为2.79ml，甲肿率为1.84%（46/2498）。甲状腺容积随尿碘水平升高而增大（〖XC小五号.EPS;P〗=16.815，P=0.001），随年龄增大而增大（〖XC小五号.EPS;P〗=113.974，P＜0.01），与身高（r=0.254）、体重（r=0.302）、体表面积（r=0.304）、体质指数（r=0.253）呈正相关（P＜0.001），同一年龄组甲状腺容积与性别无关（8岁组:Z=-1.953，P=0.051；9岁组:Z=-0.798,P=0.425；10岁组:Z=-1.034,P=0.301），与地区分布有关（〖XC小五号.EPS;P〗=1035.018，P＜0.01）。结论 武汉市学龄儿童碘营养状况总体处于适宜水平，地方性甲状腺肿患病率较低。儿童甲状腺容积受多种因素影响，应持续开展重点人群碘营养监测，持续维持碘缺乏病消除成果。

Iodine nutritional status and influencing factors of thyroid volume of school-age children,Wuhan

Objective To analyze the iodine nutritional status and thyroid volume of children aged 8-10 years old in Wuhan, and to provide a basis for evaluating the effect and adust the policy of prevention and control of iodine deficiency disease. Methods From 2016 to 2018, non-boarding students aged 8～10 years old in 13 districts of Wuhan were selected from each of the five sample areas in the east, west, south, north and middle. A random sample of urine and the cooking salt from their home was collected. All children were tested for thyroid B-ultrasound and their thyroid volume was measured. Results A total of 2498 children aged 8-10 years in Wuhan were selected, including 1273 boys and 1225 girls. The median of urinary iodine of children in the city was 261.00 ug/L, and the median of thyroid volume was 2.79 ml. The goiter rate was 1.84%(46/2498. The Thyroid volume increased with increasing urinary iodine levels(X2=16.815,P=0.001), and increased with age(X2=113.974,P<0.01), positively correlated with height(r=0.254), weight(r=0.302), body surface area(r=0.304)and body mass index(r=0.253)(P<0.001), and the thyroid volume was independent of sex in the same age group(8 years old group:Z=-1.953, P=0.051;9 years old group:Z=-0.798, P=0.425;10 years old group:Z=-1.034, P=0.301), but related to regional distribution(X2=1035.018,P<0.01). Conclusion The iodine nutritional status of school-age children in Wuhan is generally at an appropriate level, the prevalence of endemic goiter is low, and the thyroid volume of children is affected by many factors. It is necessary to continuously carry out iodine nutritional monitoring in key population, so as to maintain the achievement of eliminating iodine deficiency disorders.