沿海产盐区碘缺乏病防治模式研究与应用

目的 探讨我国沿海产盐地区碘缺乏病防治策略和干预措施,以解决沿海产盐区严重干扰可持续消除碘缺乏病的非碘盐问题.方法 1995年开始在非碘盐问题较严重的沿海产盐区厦门市,针对不同区域、不同阶段、不同人群,系统地采取了普及碘盐与特需人群强化补碘相结合、碘盐配给与健康促进相结合、查堵私盐与盐田废转相结合、碘盐质量跟踪监测与碘盐加工工艺改进相结合等综合干预策略和措施.结果 1997年碘盐加工厂出厂碘盐合格率由1995年的89.50%迅速提升至96.17%,并在2000年以后保持在99.00%以上水平.销售点碘盐合格率由1996年的87.33%上升到1998年的96.33%,以后逐年上升,2003年后保持在99.00%以上.城市、郊区和农村的碘盐覆盖率由1995年的0.92%、0、0上升到2000年的100.00%、99.00%、89.00%,2001年后居民碘盐覆盖率保持在93.00%以上.1995年城市、郊区、农村儿童甲状腺肿大率为16.44%(228/1387)、20.57%(266/1293)、24.93%(651/2611),1996年以后儿童甲状腺肿大率逐年下降,城市、郊区、农村儿童甲状腺肿大率分别在1999、2001、2005年以后下降并控制在5.00%以下.1995年城市、郊区、农村儿童的尿碘中位数分别为137.50、102.12、94.66μg/L,从1997年起儿童的尿碘中位数已全部达到100.00 μg/L以上,以后均稳定在120.00 μg/L以上.2007年市区、郊区和农村儿童尿碘中位数分别达到271.10、240.40、198.10μg/L.1997年碘缺乏病防治知识知晓率为74.00%(444/600),2000年后全市小学生碘缺乏病知识知晓率保持在95.00%以上.结论 建立的沿海产盐区可持续消除碘缺乏病的工作模式是成功的,实施应用可行,干预技术行之有效,为非碘盐问题地区推行全民食用加碘食盐、实现可持续消除碘缺乏病提供了可借鉴的模式和经验.

Study and application about a modality preventing iodine deficiency disorders in coastal salt-produced areas

Objective To discuss the strategy and intervention measures of the iodine deficiency disorders (IDD)control in coastal salt.producing areas so as to shoot the problem of non-iodized salt causing IDD.Methods Accordinng to different areas,periods and crowds,eomplicatd measures and strategies were taken such as supply of iodized salt to peopie in special need while universalizaion of iodized salt,health promotion,private salt factory censu8 and close.iodized salt quality monitoring and promotion of technology of iodized salt producion in Xiamen, where the probiem of non-iodized salt Was serious since 1995.Results Iodized salt manufactured Was qualified in a increased rate from 89.50% in 1995 to 96.17% in 1997,stablized at 99.00%since 2000.Qualified iodized salt sold in the shops waft increased from 87.33%in 1996 to 96.33%in 1998.Popularization covered by iodized salt in urban areas increaased from 0.92%in 1 995 to 100.00%in 2000,and it Was increased from 0 to 99.00%in suburban area8 and increased from 0 to 89.00%in rural areas.Since 2001 iodized salt covered up 93.00%of the people.The rate of child goitre in urban,suburban and rural areas respectively Wag 16.44%(228/1387), 20.57%(266/1293) and 24.93%(651/2611).Moreover,beginning from 1996,it reduced tO below of 5.00%respectively in 1999,2001 and 2005.The median of urinary iodine of children in urban,suburban and rural areas respectively was 137.50, 102.12,94.66 μg/L in 1995,since 1997 it reached 100.00μg/L and kept at 120.00μg/L In 2007 the median of urinarv iedine of children respectively was 271.10,240.40,198.10μg/L in urban,suburban and rural areas.The pereentage of awareness of IDD knowledge was 74.00%(444/600)in students in 1997 and reached 95.00% since 2000.Conclusion The paRern of eliminating iodine deficiency dis ease in Xiamen has successful established,which works efficiently and sets an example for iodized salt supplement in non-iodized salt areas and continually eliminating the iodine deficiency disease.