2014年浙江省温州市碘缺乏病高危监测分析

Monitoring and analysis on iodine deficiency disorders in the high risk areas of Wenzhou City in 2014

目的了解温州市实现消除碘缺乏病阶段目标后病情动态，为防治工作提供科学依据。方法选择2014年度居民户合格碘盐食用率〈80％且历史上曾有地方性克汀病（地克病）流行的苍南、泰顺、永嘉3个县作为高危监测点，每个调查点抽取3个乡，每个乡抽取2所小学，每所小学抽取40名8．10岁儿童采集尿样（男女各半）。同时在每所小学所在村，抽取10名孕妇采集尿样与家中食用盐盐样．儿童甲状腺B超检查由省级专业人员进行。尿碘测定采用过硫酸铵-砷铈催化分光光度法（GB／T13025．7-2012），盐碘测定采用直接滴定法。结果病例搜索未发现地克病病例，8～10岁儿童总体甲状腺肿大率为2．04％（16／783）；8～10岁儿童和孕妇尿碘中位数分别为116．1、108．2μg／L；碘盐覆盖率为90．48％（171／189），合格碘盐食用率为84．66％（160／189）。孕妇尿碘含量与家庭盐碘含量呈正相关（r=0．54，P〈0．05）。结论温州市儿童碘营养处于适宜水平，孕妇碘营养处于碘缺乏状态。

Objective To understand the dynamic conditions after reaching the stage goal of elimination of iodine deficiency disorders （IDD） in Wenzhou, and to provide a scientific basis for prevention and treatment of IDD. Methods Three counties that the annual consumption rate of qualified iodized salt 〈 80% in 2014 and had the prevalence of endemic cretinism in history, Cangnan, Taishun and Yongjia, were selected as high risk monitoring areas. Three townships were selected in each area, and two primary schools were selected from each township, and 40 children urine samples were collected in each school （half male and half female） and the age of children were 8 - 10 years old. And near the location of these primary schools; we randomly selected 10 pregnant women in each village, and estimated the urinary iodine level and salt iodine concentration, respectively. The examination of thyroid by B ultrasound was performed in children by provincial professionals. Urinary iodine was determined using the arsenic cerium catalytic spectrophotometric method （GB/T 13025.7-2012）. Salt iodine was determined by direct titration. Results Endemic cretinism case was not found in this survey, total goiter rate of 8 - 10 years old children was 2.04% （16/783）. The median of urinary iodine was 116.1 and 108.2 μg/L, respectively, in 8 - 10 years old children and pregnant women. Iodized salt coverage rate was 90.48% （171/189）, the intaking rate of qualified iodized salt was 84.66% （160/189）. The concentration of pregnant women urinary iodine and salt iodine was positively correlated （r = 0.54, P 〈 0.05）. Conclusions Children＇s iodine nutrition is in the appropriate level, but pregnant women are in iodine definciency in Wenzhou City.