2007年云南省重点地区碘缺乏病调查分析

Analysis of Investigation on IDD in High Risk Area of Yunnan in 2007

目的调查云南省高危地区(昭通市的永善县、普洱市的江城县)碘缺乏病流行现况及防治措施落实情况,适时采取应急强化补碘措施。方法入户家庭主妇问卷调查、采集居民食用盐测定碘含量;入校调查8～10岁学生智商水平、尿碘含量、甲状腺大小(B超和触诊);搜索诊断新发地方性克汀病病人。结果永善县、江城县碘盐覆盖率分别为85.6%,86.7%,其中永善县莲峰镇为65.2%;合格碘盐食用率分别为77.2%,86.1%;儿童甲肿率B超法分别为7.6%,11.3%,触诊法分别为0.5%,0.9%;儿童IQ均值与标准差分别为84.89±18.53,92.73±15.29。2个县的儿童、孕妇和哺乳期妇女尿碘中位数均>200μg/L,家庭主妇碘缺乏病健康教育知晓率不到50%。永善县发现散在地方性克汀病病例3例。结论食盐加碘后,儿童和妇女的碘营养缺乏状况除局部地区非碘盐冲击严重外,总体上已得到纠正。应开展碘缺乏病健康教育宣传,加大非碘盐督查力度;对有地方性克汀病病例而碘盐覆盖率<80%的乡镇开展重点人群的应急补碘,及时阻断碘缺乏危害。

Objective To investigate and analyze the prevalence and implementation of control measures of iodine deficiency disorders （ IDD ）, to provide basis for emergency and intensifying iodine supplement measures in high risk area of Yongshan and Jiangcheng counties. Methods Questionnaire was carried out by going to housewives＇households, edible salt was also collected to detect iodine content. Intelligence quotient level, urinary iodine concentration and thyroid gland size （by B ultrasonic and palpation ） were investigated in students aged from 8 to 10 years old in school. New cases with endemic cretinism were searched for diagnosis. Results The coverage rate of iodized salt was 85.6%, 86.7% in Yongshan County and Jiangcheng County, respectively. Out of that, it was 65.2% at Lianfeng countryside in Yongshan County. The edible rate of qualified iodized salt was 77.2%, 86.1%. Goiter rate was 7.6%, 11.3% by B ultra method, and 0.5%, 0.9% by palpation, respectivly in children group. IQ average value and the standard deviation were 84.89 ± 18.53, 92.73 ± 15.29. Urine iodine median was all less than 200μg/L in children, pregnant women and women in lactation. Awareness rate of IDD was less than 50% in housewife group in those two counties. Three new sporadic cases with cretinism were found in Yongshan County. Conclusions Iodine nutrition condition in children and women have been improved since edible salt supplied with iodine in the province, and iodine deficiency have been remedied, except for some local districts where the iodized salt rate is very low. In order to prevent and control IDD, we should develop heath education on IDD, reinforce the surveillance of non - iodized salt. In those areas with cretinism case and iodized salt coverage less than 80%, we should carry out emergency supplement of iodine in the high risk groups so as to timely prevent iodine deficiency.