2004年滨州市高碘地区8～10岁儿童的甲状腺肿大情况和尿碘水平

Investigation on Goiter in Children Aged 8-10 Years in High Iodide Areas in Binzhou, Shandong

目的为进一步摸清水源性高碘的分布,以探讨水源性高碘危害的现状,为高碘甲状腺肿的防治提供参考依据。方法于2004年,选择滨州市惠民县(麻店、姜楼、辛店、皂户李)、阳信县(温店、水落坡)、无棣县(柳堡)、滨城区(里则、旧镇)和开发区(杜店)5个县(区)的10个乡镇的中心小学,在每所学校随机抽取8～10岁小学生200名,男女各半,其家庭人均收入、交通、教育、医疗条件、自然生态环境、生活习惯等基本一致。对全部调查对象(2000人)进行甲状腺触诊,采用GB16004—1995《地方性甲状腺肿的诊断及分度标准》进行判定。随机抽取1000人,采集其尿样,采用WS/T107—1999尿碘的砷铈催化分光光度测定方法检测其尿碘含量。从采集尿样学生中随机抽取500人,采用SA-600P型便携式凸阵B超仪进行甲状腺B超检查。结果共调查2000人,尿碘含量为247.41～1153.25μg/L,中位数为533.51μg/L。经B超检查的500人中,甲状腺肿大(简称为"甲肿")者94人,肿大率为18.8%。男性甲肿率为16.8%(42/250),女性甲肿率为20.8%(52/250),两者间差异无统计学意义(χ2=1.310,P>0.05)。柳堡、旧镇的甲肿率最高,分别达到了38%,34%,水落坡最低,为8%;不同乡镇甲肿率比较,差异有统计学意义(χ2=30.186,P<0.01)。10个乡镇均被界定为高碘甲状腺肿病区。旧镇的尿碘中位数最高,达到了1080.60μg/L,柳堡最低,为272.30μg/L;不同乡镇尿碘水平比较,差异有统计学意义(Z=8.70,P<0.01)。不同年龄组甲肿率、尿碘水平比较,差异均无统计学意义(甲肿率:χ2=2.767,P>0.05;尿碘:Z=0.547,P>0.05)。且甲肿率随年龄的增长而升高。结论建议以饮用水源所覆盖的行政村为单位进行高碘地区的划定。

Objective To investigate the relationship between the content of iodide in water and children goiter in the high iodide areas. Methods Pupils aged 8-10 years from 17 primary schools in 10 towns of Huimin county, Yangxin county, Wudi county, Bincheng county were chosen. Based on the contents of water iodide,the pupils were divided into groups, the prevalence of goiter and the content of urinary iodide were determined. Results The prevalence of goiter in the children aged 8-10 was 18.8%,the prevalence showed an increasing tendency. In a certain range, increase of content of iodide in water did not caused an increased prevalence of goiter. There was no association was found between the content of iodide in water and the prevalence of goiter. Conclusion According to the results of the present paper, despite the contents of iodide in drinking water meets the standard of high iodide area, there is still no dose-effect relationship between the prevalence of goiter in the children aged 8-10 years and the content of iodide in water, whereas as the high iodide exposure time prolong, the prevalence of goiter demonstrates an increase tendency.