2011年四川省碘缺乏病监测结果分析

Surveillance Results of Iodine Deficiency Disorders in Sichuan in 2011

目的掌握四川省碘缺乏病病情、居民碘营养水平及防治措施落实情况,为制订防治措施提供科学依据。方法按＂人口比例概率抽样方法＂（PPS）在全省抽取30个县,每个县抽取1所小学;每个小学抽查40名8～10岁儿童甲状腺容积,并定量检测其家中食用盐碘含量;抽取其中12名儿童检测尿碘,并调查其家中居民人均日盐摄入量;在抽中学校附近选择3个乡（镇、街道办）,每个乡（镇、街道办）抽取孕妇和哺乳妇女各5人检测尿碘;在抽中学校的所在村（居委会）,按东、西、南、北、中各抽取1份饮用水水样,如为集中式供水地区,则采集2份末梢水样检测水碘。全省在上述PPS法未抽到的152个县中,每县按东、西、南、北、中5个方位各抽取1个乡（镇、街道）,每个乡（镇、街道）抽取1所小学,每所小学抽检20名8～10岁儿童（男、女各半）尿碘。结果 B超法检查儿童1 221人,甲状腺肿大率4.1%;检测盐样1 206份,合格碘盐食用率98.1%,碘盐覆盖率99.9%,碘盐合格率98.2%,盐碘中位数32.8 mg/kg;检测儿童尿碘15393份,尿碘中位数208.9μg/L,其中男性儿童尿碘中位数（214.9μg/L）高于女性（203.2μg/L,Z=6.97,P〈0.05）;孕妇尿碘457份,尿碘中位数170.8μg/L;哺乳妇女尿碘452份,尿碘中位数159.5μg/L;水碘81份,水碘中位数2.7μg/L,范围0.2～49.6μg/L,水碘低于10μg/L比例为82.7%（67/81）;调查363户家庭食盐摄入量,人均日摄盐量8.46 g。结论四川自然环境普遍缺碘;人群碘营养水平总体适宜,继续保持消除碘缺乏病状态。

Objective To master the epidemic status of iodine deficiency disease（ IDD） and the iodine nutritional level among residents in Sichuan,and thus to provide scientific reference for formulating prevention strategies. Methods A total of 30 primary schools in 30 counties were selected in Sichuan with population probability sampling method in 2011.In each selected school,40 children aged 8-10 were randomly selected for thyroid examination and the iodine content of salt at their home were determined as well. Twelve children were selected for urine test and the average daily salt intake was also investigated. Three towns near each selected school were selected randomly and urine samples were randomly collected from 5 pregnant and 5 lactating women. One drinking water sample was collected in five directions（ east,south,west,north and central） of each administrative village or neighborhood committee where the sampled schools located. In areas with centralized water supply,2 tap water samples were collected. In other not selected 152 counties, one town was selected in five directions（ east, south, west, north and central） in each county, and one primary school was selected in each town. Twenty children aged 8- 10 in each school were randomly selected for analysis of urinary iodine. Results The thyroid goiter rate（ TGR） of children was 4.1% in total of the 1221 children checked by B-ultrasound. The consumption rate of qualified iodized salt, the iodized salt coverage rate, the qualified rate of iodized salt, and the median of iodized salt were respectively 98.1%, 99.9%, 98.2% and 32.8mg /kg. The urinary iodine median was 208.9 μg /L in total of 15393 children urine samples. The male urinary iodine median（214.9μg /L） was higher than female（203.2μg /L）（ Z = 6.97,P〈0.0 5）. The urinary iodine median was 170.8 μg /L in total of 457 urine samples of pregnant women. The urinary iodine median was 159.5μg /L in total of 452 urine samples of lactating women. The water iodine median of the 81 water samples was 2.7 μg /L. Total of 363 salt intake of the households were surveyed and the per capita daily salt intake was 8.46 g. Conclusion The natural environment is in general iodine deficiency in Sichuan. IDD has been controlled effectively and the urinary iodine stays at an optimal level.