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.

A survey of current situation on control of iodine deficiency disorders in the high-risk areas of Gansu province from 2007 to 2009

Objective To investigate the control status of iodine deficiency disorders (IDD) in the highrisk areas of Gansu province,and to provide a scientific basis for development of effective preventive measures.Methods Twelve counties with high-risk areas of IDD in Gansu province were selected into the survey in 2007 -2009.All patients with suspected cretinism born after the first of January,1997 were enrolled in the study from the 12 counties.Meanwhile,three townships were chosen in each of the 12 counties,two villages were taken in each township,40 children aged 8 to 10 in each village primary school were selected to carry out thyroid examination by B-ultrasonography and palpation,urinary iodine(UI) test,and intelligence quotient(IQ) test; 30 women of childbearing age were selected in each village to fill in the questionnaire,and to test their urinary and salt iodine,and the local salt-related situation was investigated.Results In the 12 high-risk counties,7 were diagnosed as new cretinism cases from a total of 120 suspected cases of cretinism.The goiter rate of children aged 8 - 10 by Bultrasound was 6.8％(290/4281 ),5 counties had goiter rates higher than 5％,of which 3 counties had goiter rates higher than 10％.The average IQ of children was 82.38.The median urinary iodine(MUI) of children was 180.34 μg/L,the ratio of UI ＜ 50 μg/L was 11.0％(482/4383).The MUI of women of childbearing age was 175.91 μg/L,the ratio of UI ＜ 50 μg/L was 16.5％(126/762).MUI of women of childbearing age was less than 100.0 μg/L in Xiahe and Dongxiang counties,which were 95.24 μg/L and 66.30 μg/L,respectively.The coverage rate of iodized salt in 8 of the 12 counties was more than 95％,and that of the remaining four counties was ＜ 85％,of which the coverage rates of iodized salt were only 39.2％ (47/120)and 66.7％ (120/180),respectively,in Guanghe and Dongxiang counties.Fourteen point nine percent (206/1380) of the residents complained that iodized salt was not convenient to buy and 87.7％ (1210/1380) complained that the current price of these salts exceeded the accepted range.Only 29.9％(413/1380)of the housewives knew how to prevent IDD.Conclusions Impact factors of IDD in high-risk areas are widespread.The monitoring of IDD in high-risk areas should be strengthened.Effective measures should be taken to ensure adequate iodine nutrition of people at risk.At the same time,iodized salt-based comprehensive prevention measures should be strengthen and a long-term effective control strategy of IDD should be established.