新疆喀什地区儿童碘营养状况及与甲状腺大小的关系

The nutritional status of iodine in children and its correlation with thyroid size in Kashi, Xinjiang

目的 了解新疆喀什地区碘营养状况,并探讨尿碘水平与甲状腺大小的关系.方法 在喀什地区12县市采取抽样调查,砷铈催化分光光度测定尿碘,砷铈氧化还原法测定水碘,直接滴定法检测盐碘,并抽取3个县儿童用B超检查甲状腺各径及容积.结果 喀什地区水碘中位数＜10μg/L,属于碘缺乏病病区,随着碘盐覆盖率（98.7％）和碘盐合格率（96.8％）的提高,喀什地区尿碘中位数为177.05 μg/L,总体属碘适量;但不同县之间尿碘频数分布差异较大,有6个县碘缺乏比例＞20％,有5个县碘过量比例＞20％;维吾尔族和汉族、高原和平原、城市与农村儿童碘营养状况均无明显差异;英吉沙、伽师和莎车无甲状腺肿儿童的甲状腺右宽和右厚与尿碘呈正相关（r=0.113,P=0.012;r=0.092,P=0.04）.结论 新疆喀什地区碘缺乏状态已基本纠正,但不同县市之间需更为细化的补碘方案以防止碘缺乏或碘过量所致的甲状腺疾病.

Objective To investigate the nutritional status of iodine in children in Kashi and to evaluate the relationship between urinary iodine and thyroid size.Methods Twelve counties in Kashi were investigated.Urinary iodine was determined by arsenic-cerium catalytic spectrophotometry,and iodine in water by arsenic-cerium oxidationreduction method,and iodized salt was tested by direct titration.Type B ultrasonography to determine length and thickness of thyroid gland was performed in selective counties.Result The median water iodine was ＜ 10 μg/L,but with the rise of coverage rate and qualified rate of iodized salt,the median urinary iodine became 177.05 μg/L.The frequency distribution was different among different counties,there were 6 counties （＞20％） being iodine deficient,and 5 counties （＞20％） with iodine excess.Moreover,urinau iodine showed no difference between Uygur and Han,upland and plain,city and countryside.Furthermore,urinary iodine was correlated with right lobe width and thickness （r=0.113,P=0.012; r=0.092,P=0.04）.Conclusion The iodine deficient situation is basically corrected in Kashi,however a more refined iodine supplement project is needed to prevent thyroid diseases.