贵州省碘缺乏病全面监测十年评估

Evaluation of iodine deficiency disorders in Guizhou provine: an overall surveillance for ten years

目的 了解贵州省碘缺乏病 (IDD)的防治现状及 2 0 0 0年实现消除IDD工作的进程情况。方法 分别检测贵州省三个监测点贵阳、都匀、凯里三地区的IDD监测指标 ,并将其结果与 10年前相比较。结果 1999～ 2 0 0 0年 ,贵阳、都匀、凯里三地区 ,(1)居民户食盐碘含量的均值分别为43.6mg/kg、43.2mg/kg及 45 .3mg/kg ,碘盐合格率分别为 97.5 %、95 .8%、97.9%,均较 10年前显著提高 (P均 <0 .0 1) ;(2 ) 8～ 10岁在校儿童尿碘中位数分别为 16 6 .3μg/L、16 7.8μg/L、16 5 .2 μg/L ;孕妇尿碘中位数分别为 16 1.0 μg/L、15 0 .9μg/L、15 8.0 μg/L ;成人尿碘中位数分别为 16 7.7μg/L、174.8μg/L、16 5 .2 μg/L ,均较 10年前显著提高 (P均 <0 .0 1) ;(3)触诊检查 8～ 10岁在校儿童甲状腺肿大率分别为 6 .5 %、7.5 %和 7.4%,儿童甲状腺肿大率与 10年前相比有所下降 ,但仅凯里地区差异较为显著 (P <0 .0 5 ) ,而贵阳和都匀地区差异无显著性 (P均 >0 .0 5 ) ;(4 )新生儿脐血TSH >5mIU/L的百分率分别为 18.0 %、2 1.8%和 2 0 .0 %,均较 10年前显著下降 (P均 <0 .0 5 ) ;(5 )新生儿脐血甲状腺球蛋白 (Tg)的中位数分别为 9.2 8μg/L、7.84μg/L及 8.2 5 μg/L。 结论 贵州省三个监测点的碘盐合格率、不同层次?

Objective In order to assess the present status of the prophylaxis and the eliminating process for iodine deficiency disorders (IDD) in Guizhou province. Methods Guiyang, Douyun and Kaili regions were selected as IDD monitoring spots of Guizhou province. In these districts, the monitoring indicators for IDD were determined and compared with those ten years ago. Results From 1999 to 2000 in Guiyang, Douyun and Kaili: (1) Themeansofiodineconcentrationiniodized salt of households were 43.6 mg/kg, 43.2 mg/kg and 45.3 mg/kg, respectively, and the qualified rates were 97.5%, 95.8% and 97.9%, respectively, all of them were obviously higher than those ten years ago (P<0.01); (2) The medians of urinary iodine for school children aged 8 to 10 years were 166.3 μg/L, 167.8 μg/L and 165.2 μg/L, respectively; for pregnant women 161.0 μg/L, 150.9 μg/L and 158.0 μg/L, respectively; for adults 167.7 μg/L, 174.8 μg/L, 165.2 μg/L, respectively, which were statistically higher than those ten years ago (P<0.01); (3) Thegoiterratesofschoolchildrenaged8 to 10 years (by palpation) were 6.5%, 7.5% and 7.4%, respectively, all lower than those ten years ago, the change of which in Guiyang and Douyun did not reach statistical significance while in Kaili it dropped markedly (P<0.05); (4) The percentages of neonatal levels of TSH>5 mIU/L were in 18.0%, 21.8% and 20.0% infants, respectively, obviously descended from those ten years ago (P<0.05); (5) The medians of neonatal thyroid globulin (Tg) were 9.28 μg/L, 7.84 μg/L and 8.25 μg/L, respectively. Conclusion The qualified rates of iodized salt, the levels of urinary iodine of different populations and neonatal Tg in the three monitoring spots already reach the IDD-elimination criteria, which indicates that an obvious control effect is obtained in Guizhou province, however, the prevalence of goiter rate for school children aged 8 to 10 years and the percentages of neonatal TSH over 5 mIU/L are still higher compared with the IDD-eliminating criteria, which do not keep pace with the levels of iodized salt and urinary iodine. These phenomena are well worth investigating.