山东省碘缺乏地区学龄儿童碘营养状况评估

Evaluation on the status of iodine nutrition in school-aged children from iodine deficiency areas in Shandong Province

目的掌握山东省碘缺乏地区儿童碘营养动态状况以评估全民食盐加碘措施效果和消除碘缺乏病进程。方法按照卫生部1995、1997、1999和2002年的监测方案分别进行碘缺乏病相关指标抽样调查。结果4次监测的居民户碘盐覆盖率分别为49.2%、84.0%、87.1%和93.0%,盐碘含量中位数分别为0 mg/kg、23.3 mg/kg、28.6 mg/kg和29.0 mg/kg。儿童尿碘中位数及>100μg/L的比例分别为234.1μg/L和75.8%、453μg/L和96.7%、267.3μg/L和86.5%、200.1μg/L和82.5%。儿童甲状腺肿大率触诊结果分别为26.3%、7.6%、13.2%和5.7%,B超结果后3次分别为7.6%、7.8%和1.6%。新生儿脐带血TSH>5 m IU/L的比例前3次分别为26.3%、27.7%和28.9%。结论山东省碘盐覆盖率逐年提高,儿童尿碘水平在正常范围内,甲状腺肿大率逐年降低。全民食盐加碘措施成效显著,儿童碘营养水平良好,应由碘缺乏病病情监测转变为碘营养监测。

Objective To master the status of iodine nutrition in school - aged children（SAC） from iodine deficiency areas so as to assess the effects of universal salt iodization（USI） and the progress of IDD elimination in Shandong Province. Methods Four monitoring indicators for IDD were carried out in 1995, 1997, 1999 and 2002 according to the planes of MOH. Results The results showed that the rates of iodized salt at household levels were 49.2% in 1995, 84.0% in 1997, 87.1% in 1999 and 93.0% in 2002, with the median of iodized salt content was 0, 23.3,28.6 and 29.0（ mg/kg）, correspondingly. The percentage with urinary iodine level more than 100 μL for four survey was respectively 75.8%, 96.7%, 86.5%, 82.5% with the median was 234. 1,453.0, 267.3, 200.1 （ μg/L）. The goiter rate of the children was respectively 26.3%, 7.6%, 13.2%, 5.7% with palpation and 7.6% in 1997, 7.8% in 1999, 1.6% in 2002 with ultrasonography. The percentage of neonatal TSH level higher than 5 mIU/L was 26.3%, 27.7%, 28.9%. Conclusions The rates of iodized salt at household levels in Shandong had obviously increased year by year, urinary iodine levels of SAC have been in normal and the goiter rate had decreased year by year. US1 against IDD has obvious effects, the condition of iodine nutrition in SAC had been better. It＇s necessary to change the survey of IDD into the evaluation of iodine nutrition.