河北省易县儿童不同时期甲状腺肿流行特征及干预效果评价

Epidemic characteristics of the goiter in children and its intervention effect evaluation in different periods in Yixian county of Hebei province

目的了解易县学龄儿童不同时期甲状腺肿流行特征及干预效果。方法全县按东、西、南、北、中划分5个抽样片区,在东、西、南、北片区各随机抽取2个乡镇,在中部片区随机抽取1个乡镇,共抽取9个乡镇做为监测点。在每个被监测乡镇随机抽取至少2所小学,在每所小学抽取40名以上8~10岁学生进行甲状腺触摸检查。结果干预前不同年龄之间、不同性别之间、不同民族之间甲状腺肿大率差异无统计学意义（P均〉0.05）,不同区域之间甲状腺肿大率山区高于平原（P〈0.01）;干预初期不同年龄、不同性别、不同民族甲状腺肿大率差异无统计学意义（P均〉0.05）,不同区域之间甲状腺肿大率山区高于平原（P〈0.01）;综合干预阶段不同年龄、不同性别、不同民族、不同区域甲状腺肿大率差异无统计学意义（P均〉0.05）。通过综合干预的实施,儿童甲状腺肿大率由1993年的23.40%降至1998年的4.06%,自1998年至2011年一直控制在5%以内。结论综合干预是降低儿童甲状腺肿大率的有效措施,应不断完善和推广。

Objective To learn goiter prevalence characteristics of children and the intervention effect evaluation in different periods in Yixian County. Methods Divide the county into 5 areas by east, west, south, north and central region. Select 9 towns as monitoring spots： randomly select 2 towns from each one region of east, west, south and north, and 1 town from the central region. At least two elementary schools were randomly selected in each monitored township, taking 40 or more students from 8 to 10-years-old to get thyroid palpation. Results There was no significant difference of goiter rate before the intervention between different ages, different genders, and different ethnic groups （P〉0.05）, but goiter rate was higher in Mountain area than that in the plain between different regions （P〈0.01）. There was no significant difference of goiter rate in the early intervention between different ages, different genders, and different ethnic groups （P〉0.05）, but goiter rate was higher in Mountain area than that in the plain between different regions （P〈0.01）. In the comprehensive intervention stage there was no significant difference of goiter rate between different ages, different genders, and different ethnic groups and the same in different regions （P〉0.05）. Through the implementation of comprehensive intervention, children goiter rate decreased from 23.40% in 1993 to 4.06% in 1998, and were controlled within 5% from 1998 to 2011. Conclusion The comprehensive intervention is a effective measure to reduce the goiter rate of children, which should be improved continuously.