2009年甘肃省碘缺乏病调查结果分析

Analysis of an investigation results on iodine deficiency disorders in Gansu in 2009

目的 掌握甘肃省碘缺乏病防治现状,为制订碘缺乏病的防治措施提供依据.方法 2009年,在甘肃省14个市（州）,每个市（州）抽取1个达标县（市、区、旗）,并按东、西、南、北、中5个方位各抽取1个乡（镇、街道）,不足5个乡时全部抽取;在所抽取的每个乡（镇、街道）,各抽取1个村,进行居民户碘盐情况及碘盐销售网络调查.同时在每个村抽取1所小学,进行儿童尿碘、甲状腺、智商检查及碘缺乏病知晓状况调查.结果 共检测1420份食用盐,加权碘盐覆盖率为99.53%,加权合格碘盐食用率为98.15%.共对1761名8～10岁儿童检测尿碘,中位数为225.87μg/L,在14个县中,有5个县儿童尿碘处于适宜水平,7个县超过了碘适宜水平.2个县处于碘过量水平.共对3051名8～10岁儿童进行甲状腺检查,加权甲状腺肿大率为1.9%,只有红古区儿童加权甲状腺肿大率大于5%,为5.3%.共对2815名8～10岁儿童进行智商检测,平均智商为105.3,除卓尼县和康乐县之外,其余各县儿童智商均在100以上.碘缺乏病知晓调查平均分为3.2分.知道缺碘不聪明的占57.08%（1229/2153）,知道缺碘致甲状腺肿大的占71.76%（1544/2153）,知道碘盐是最好的防治方法的占68.04%（1465/2153）,向家人讲述碘盐好处的占61.82%（1331/2153）.共凋查了87个乡（镇）102个村的食盐销售情况,每个乡（镇）都有一个碘盐代销点,每个村至少有1个碘盐零售店,但73.5%（75/102）的零售店无销售许可证.结论 甘肃省碘缺乏病防治取得了显著进展,合格碘盐食用率达到国家消除标准,甲状腺肿大率明显下降,大多数县儿童尿碘处于＂大于适宜水平＂,碘盐销售网络基本健全,但各县碘缺乏病健康教育工作进展不平衡.

Objective To master the status in control of iodine deficiency disorders （IDD） in Gansu province and to provide the basis for development of control strategies. Methods One county which reached the national standardization of IDD elimination was selected randomly from each of 14 cities of Gansu province in 2009, then one town was selected respectively from five directions （east, south, west, north, and central） of the above selected counties. One village was chosen from every town which was selected for investigating household iodized salt and iodized salt sales network. At the same time the thyroid of children was examined, their urinary iodine （UI） was determined, the intelligence quotient（IQ） values of children were measured and health education was surveyed in one primary school which was chosen in each of the selected town. Results A total of 1420 edible salt samples were tested;the weighted iodized salt coverage rate and the weighted qualified iodized salt rate were 99.53% and 98.15 respectively. Urine samples were collected from 1761 children included in the study. The urinary iodine median was 225.87 μg/L. The urinary iodine medians were at optimal levels in five counties, over the optimal levels in seven counties and at excessive levels in two counties. A total of 3051 children aged 8 - 10 were randomly selected for thyroid examination. The weighted thyroid goiter rate（TGR） of children was 1.9%, and TGR was higher than 5% only in Hoaggu county. IQ of 2815 children was tested and the mean IQ was 105.3, except for the country of Zhuoni and Kangle, the mean IQ of other counties were over 100. The average score of health education was 3.2.Children of 57.08% （1229/2153） knew that iodine deficiency could lead to mental retardation, 71.76% （1544/2153） knew that iodine deficiency could cause thyroid goiter, 68.04%（ 1465/2153 ） knew that eating iodized salt was the best method for IDD prevention and control and 61.82%（1331/2153） informed their families of the benefits of eating iodized salt. Each town had one agency selling iodized salt and each village had one more retail store with iodized salt, but 73.5%（75/102） of the stores without license for the sales. Conclusions Great progress has been made on the prevention and control of IDD in Gansu province. The qualified iodized salt consumption rate has reached the national standard for IDD elimination, TGR has decreased markedly, the urinary iodine levels in more counties are over the optimal levels and iodized salt distribution network is basically sound. But progress in health education is uneven.