天津市碘缺乏病高危地区碘营养状况调查

Iodine nutritional status in high-risk areas of iodine deficiency disorders in Tianjin

目的调查2008—2010年天津市碘缺乏病高危地区儿童和育龄妇女的碘营养状况，为科学补碘提供依据。方法2008—2010年选取汉沽区，2010年增加大港区和静海县作为调查点。将汉沽区划分为5个片区。每个片区抽取1个非高碘乡（镇），每个乡（镇）抽取4个非高碘行政村，每个行政村抽检15户居民盐样，进行碘盐半定量检测。大港区和静海县分别选取3个乡（镇），每个乡（镇）抽取2个行政村，每个行政村对20户家中盐样进行盐碘测定。2009年在汉沽区进行碘盐监测的5个乡（镇），每个乡（镇）选取1所小学，每所小学抽取40名8～10岁儿童．进行甲状腺容积检查，同时选取其中20名学生进行尿碘监测。2010年每个调查区（县）选取3个乡（镇），每个乡（镇）抽取2所小学，每所小学抽取40名8一lO岁儿童，进行甲状腺容积检测和尿碘检测。2008—2010年在汉沽区进行碘盐监测的居民户中分别选取150、50和60名育龄妇女，2010年在大港区和静海县进行碘盐监测的居民户中分别选取60名育龄妇女，采集尿样，进行尿碘检测。盐碘采用半定量试剂盒检测，甲状腺容积采用B超法检查，诊断采用《地方性甲状腺肿诊断标准》（WS276．2007），按《砷铈催化分光光度测定》（WS／T 107．2006）进行尿碘检测。结果2008—2010年汉沽区碘盐覆盖率分别为65．0％（195／300）、70．3％（211／300）和91．3％（274／300），2010年大港区碘盐覆盖率为40．0％（48／120），静海县为38-3％（46／120）。2009年汉沽区共采集106名8—10岁儿童尿样，尿碘中位数为205．4μg／L，2010年3个调查点共采集249、250和239份儿童尿样，尿碘中位数分别为193．0、293．1和216．8μg／L。2年汉沽区8～10岁儿童甲状腺肿大率分别为4．24％（9／212）和3．59％（9／251），大港区为3．60％（9／250），静海县为5．44％（13／239）。2008—2010年汉沽区育龄妇女尿碘中位数分别为134．9、196．1、229．5μg／L，大港区为316．9μg／L，静海县为190．9μg／L。结论天津市碘缺乏病高危地区人群的碘营养水平，好于国家强化补碘要求的限值，个别地区由于存在水碘较高问题。致使部分人群疑存碘过量问题，应引起重视。

Objective To investigate the nutritional status of children and women of childbearing age in high-risk areas of iodine deficiency disorders in Tianjin in 2008 - 2010 and to provide a scientific basis for iodine supplementation. Methods Hangu District was selected as survey point from 2008 to 2010, Dagang District and Jingan County were increased in 2010. Hangu District was divided into five areas, one township（town） that was not high iodine was selected from each area, four administrative villages were selected from each township （town）, and 15 households were selected from each administrative village. Three township（town） were selected from Dagang and Jingan County, respectively. Two administrative villages were selected from each township（town）, and 20 households were selected from each administrative village. Iodine level of salt samples from each household was determined. In 2009, one primary school was selected from each survey township （town）, thyroid volume of 40 8 - 10-year-old students was examined, and urine iodine of 20 students was tested. In 2010, three township（town） were selected from each survey point, two primary school were selected from each survey township （town）, 40 8 - 10-year-old students were selected from each primary school, urine iodine and thyroid volume of the students were determined.150, 50 and 60 women of childbearing age from Hangu District were selected from 2008 to 2010, and 60 were selected from Dagang District and Jingan County, respectively. Urine iodine of the women was tested. Iodine content of salt was tested by a semi-quantitative test kit; diagnosis of endemic goiter was based on the ＂Diagnostic Criteria of Endemic Goiter＂ （WS 276-2007）; urinary iodine test was based on the ＂Arsenic Cerium Catalytic Spectrophotometry＂ （WS/T 107-2006）. Results Coverage rates of iodized salt in Hangu District in the 3 years were 65.0% （195/300）,70.3% （211/300） and 90.8% （274/300）, respectively. Coverage rates of iodized salt in Dagang District and Jinghai County were 40.0%（48/120） and 38.3%（46/120）. In 2009, the median urinary iodine of children aged 8 - 10 in Hangu District was 205.4 μg/L and in 2010, the medians urinary iodine of children aged 8 - 10 of the three survey point were 193.0, 293.1 and 216.8 μg/L. Goiter rates of children aged 8 - 10 in Hangu District were 4.24% （9/212） and 3.59% （9/251）, and in Dagang District and Jinghai County were 3.60% （9/250） and 5.44% （13/239）. The medians urinary iodine in women of childbearing age in Hangu District in the 3 years were 134.9,196.1 and 229.5 μg/L, respectively. The medians urinary iodine in women of childbearing age in Dagang District and Jinghai County were 316.9 and 190.9 μg/L. Conclusions The nutritional status of high-risk areas of iodine deficiency disorders in Tianjin are better than the national limit of enhanced iodine requirements. Due to higher water iodine in the same areas, some people are iodine excess, to which we should pay more attention.