2008年山东省碘缺乏病高危地区核实调查

Verification survey on iodine deficiency in high-risk regions of Shandong Province in 2008

目的调查核实山东省碘缺乏病高危地区，为进一步实施应急补碘措施提供参考依据。方法2008年在山东省碘缺乏病高危地区济南市历城区和寿光市，查阅既往卫生部门统计的克汀病的发病记录；各抽取3个乡镇，每个乡镇抽取2所学校，每所学校抽取40名8～10岁儿童作为观察对象，采用触诊、B超法检测甲状腺．并采集尿样检测尿碘（砷铈催化分光光度法）；每个乡镇抽取2个村，每个村抽取20名18～40岁育龄妇女作为观察对象，检测尿碘和家庭食用盐含碘量（直接滴定法）。结果自1995年来，未发现克汀病新发病例和疑似病例：济南市历城区和寿光市儿童触诊、B超法甲状腺肿大率分别为7．5％（18／241）、6．2％（15／241），5．0％（13／259）、1．2％（3／259）；采集尿样分别为240、249份，尿碘中位数分别为226．3、282．7μg／L。采集育龄妇女尿样各120份，尿碘中位数分别为187．2、321．7μg／L；采集盐样各120份，非碘盐分别为8份和2份，碘盐合格率均为100％。结论济南市历城区和寿光市目前尚不需要启动应急补碘措施，但需进一步加强盐业监督和稽查，彻底消除非碘盐和不合格碘盐的危害。

Objective To survey the highly risk iodine deficiency regions of Shandong Province and to provide reference basis for further executing urgent iodine supply. Methods The annual document of cretinism in Licheng District in Jinan City and Shouguang City, the two iodine deficiency regions, were referred. Forty children aged 8 - 10 years of 2 targeted schools from 3 towns out of every targeted region underwent palpation, ultrasonography and As3＋-Ce4＋ catalyzing spectrophotometry for ultra iodine examination. Twenty women aged 18 - 40 years from 2 villages sampled from every targeted town received ultra iodine examination and edible salt examination of iodine with direct titration. Results No new cretinism and suspected cretinism was found since 1995 in the regions. The goiter rates of children of the two regions detected with palpation and ultrasonography were 7.5% （18/241）,6.2% （15/241） and 5.0% （13/259）,1.2% （3/259）, respectively. Two hundred forty and 249 urine samples were respectively collected in school children, in which the median urinary iodine was 226.3,282.7 μg/L. One hundred twenty urine samples were respectively collected from the two group of women, resulting a median urinary iodine of 187.2,321.7 μg/L. Eight and 2 salt samples were free of iodine in 120 salt samples collected each region, respectively. The rate of qualified iodized salt was 100%. Conclusions It is not necessary to urgently implement iodine supply in Shouguang City and Lieheng District. However, reinforcement of supervise on salt industry and eliminating the hazard from non-iodized and disqualified iodized salt remains in need.