1995—2005年天津市碘盐干预防治碘缺乏病效果评价

Efficiency Evaluation of Iodized Salt Supply in Prevention of Iodine Deficiency Disease in Tianjin in 1995-2005

目的评价碘盐干预防治碘缺乏病(IDD)效果,为科学补碘提供依据。方法于1995—2005年按人口比例概率抽样方法(PPS)抽取天津市30个监测学校(城市∶乡镇∶乡村=1∶1∶1),以8～10岁学生1200人(男∶女=1∶1)为监测对象,以5年级学生600人、家庭主妇150人以及饮用水中碘含量中位数>150(300)μg/L的8～10岁学生994人为调查对象进行调查,内容包括儿童甲状腺肿大率、尿碘水平、合格碘盐食用率、5年级学生碘缺乏病知识普及现状问卷、家庭主妇相关预防知识问卷和同等碘盐干预条件下的高水碘对人群健康影响调查。结果8～10岁人群甲状腺肿大率由1995年(干预前)的32.6%降至2005年(干预后)的1.8%;人群尿碘中位数由1995年(干预前)的96.1μg/L提高至2005年的228.1μg/L。2005年,滨海地区监测人群合格碘盐食用率低于全市总体水平,甲状腺肿大率高于全市总体水平,经χ2检验,差异均有统计学意义(合格碘盐食用率:χ2=16.47,P<0.01;甲状腺肿大率:χ2=4.36,P<0.05)。在同等碘盐干预条件下,水源性高碘地区8～10岁人群甲状腺肿大率和尿碘水平均高于低水碘地区,差异均有统计学意义(P<0.01)。结论低水碘地区碘盐干预防治IDD效果显著,部分水源性高碘地区碘营养过剩问题应引起重视,科学补碘是提高整体防治效果的关键。

Objective To evaluate the efficiency of ten years of iodized salt supply in prevention and control of iodine deficiency disease （IDD） in Tianjin. Methods 1 200 pupils aged 8-10 years with 1：1 of sex ratio were chosen in the regions where iodized salt supply had been conducted for 10 years （1995-2005）, the prevalence rate of goiter, the level of urine iodine and the iodized salt consumption were investigated. Results The prevalence rate of goiter of children aged 8-10 years in Tianjin decreased from 32.6% to 1.8% after 10 years of iodized salt supply, the median of urinary iodine increased from 96μg/L to 228μg/L. In the high water iodine regions, the prevalence rate of goiter was 8.1%, the median of urinary iodine was 576μg/L. Conclusion 10 years of iodized salt supply can significantly prevent and control IDD in the regions where there is iodine deficiency in drinking water, but the problem should not be neglected that iodine excess in the regions where the concentration of iodine in drinking water is higher. Reasonable iodine supplement is the key to prevent and control IDD as a whole.