可持续消除碘缺乏病的监测

Surveillance of sustainable elimination of IDD in Jiangsu Province

目的 对江苏省可持续消除碘缺乏病 (1DD)状况进行监测 ,为全国监测策略调整提供依据。方法 全省 PPS法 (除去高碘地区 )抽样调查甲状腺大小、尿碘、盐碘、健康教育、水碘水平 ,同时增加了智商 (1Q)及精神运动功能测定 (JPB)。对 1995— 2 0 0 1年的监测结果进行比较。结果 碘盐覆盖率、合格碘盐食用率从 1995年起逐年递增 ,8～ 10岁儿童尿碘水平从 1995年的 85μg/ L上升至 2 0 0 1年的 3 3 7.7μg/ L ;甲状腺肿大率触诊法由1995年的 17.3 %下降至 2 0 0 1年的 2 .8% ,B超法由 1997年的 8.8%下降至 2 0 0 1年的 l,4% ;甲状腺容积中位数1.9ml,范围有所缩小 ;学生及家庭妇女健康教育评分达到国家要求 ;平均智商 99.0 ,智力低下比例占 4.5 % ;JPB总 T分 3 69.6,异常比例 (总 T分≤ 2 80 )占 0 .7%。结论 碘缺乏病在江苏省已进入可持续消除碘缺乏病的发展阶段 ,今后监测应根据病情和防制措施落实情况选择指标和

Objective To provide recommendations for further national IDD surveillance by evaluating results of IDD Surveillance from l995-2001.Methods PPS random sampling was conducted in Jiangsu Province (except iodine excess areas),which IQ and JPB were included in the evaluate system.Results There were 1 160 children aged 8~10 years old.Median of Urine Iodine (UI) increased from 85 μg/L in l995 to 337.7 μg/L in 2001.The total goiter rate measured by palpation reduced from l7.3% in l995 to 2.8% in 2001.Goiter prevalence measure by ultrasound was 1.4% in 2001.Median of thyroid volume was 1.9 ml,which is significantly lower than those in 1997,1999 and 2001.Mean IQ was 99.0 and the proportion of children with low IQ (IQ<70) was 4.5%.Mean total score of JPB was 369.6,and abnormal rate (JPB≤280) was 0.7%.The coverage of iodized salt was 94.4%,the adequacy of iodine in salt was increased year by year from l995 to 2001.Acquisition of knowledge about IDD among both children and household women was sufficient to meet the requirements set by WHO.Conclusions IDD in Jiangsu Province has been sustainably eliminated.Surveillance system should be evaluated periodically and adjusted according to the severity of IDD.Indicators and frequency of IDD surveillance have been proposed.