2014、2015年河南省水源性高碘地区居民碘营养监测结果分析

Analysis of iodine status of monitoring results in high water iodine areas in Henan Province from 2014 to 2015

目的了解河南省水源性高碘地区居民无碘食盐的食用情况，动态评价水源性高碘地区人群碘营养和病情变化趋势。方法在河南省的20个高碘县（市、区），按照东、西、南、北、中各抽取1个高碘乡．每个监测乡抽取4个行政村，每个行政村抽检15户居民家中食用盐。选择10个高碘县（市、区），以行政村为监测点，采集居民家中饮用水水样；同时在监测点所在小学，抽取100名8～10岁儿童，检测甲状腺容积和尿碘含量。盐碘检测采用半定量法，尿碘及水碘检测采用砷铈催化分光光度法，甲状腺容积检测采用B超法。结果2014、2015年河南省水源性高碘地区各检测盐样4440份，无碘食盐率分别为98．2％（4363／4440）和98．3％（4366／4440）。2014、2015年10个高碘县的水碘中位数分别为202．0、235．0μg／L。2014、2015年各检测儿童尿样970、999份，尿碘中位数分别为251．9、290．6μg／L。2014、2015年各检测儿童甲状腺容积937、948名，肿大率分别为3．4％（32／937）和7．8％（74／948）。按照水碘分层，随着水碘水平的升高，儿童尿碘水平和甲状腺肿大率随之升高，当水碘≥300μg／L时，儿童甲状腺肿大为8．4％，高于其他组（P〈0．05）。结论停供碘盐后，河南省水源性高碘地区部分儿童碘营养水平和甲状腺肿大率仍然偏高，建议在水碘〉150μg／L的地区，在采取供应无碘食盐的同时进一步落实改水降碘措施。

Objective To investigate the consumption rate of non-iodized salt, and evaluate the iodine status and goiter prevalence among school children in high water iodine areas of Henan Province from 2014 to 2015. Methods In the 20 counties with high water iodine, one township was randomly selected from each location （east, west, south, north and middle） in each county; secondly, 4 villages were selected from each chosen township; thirdly, 15 households were selected to collect salt samples from each chosen village. In the 10 chosen counties, one village with high water iodine was selected and water samples were collected; one school was sequentially selected from the chosen village and 100 school children aged 8 - 10 were chosen to collect their urine samples and measure their thyroid volume. Salt iodine was tested by semi-quantitative method; iodine contents of urine and water were tested by arsenic cerium catalytic spectrophometry; thyroid volume was measured by ultrasound method. Results In the 20 counties with high water iodine, 4 440 salt samples were collected and tested both in 2014 and 2015; the rates of non-iodized salt were 98.2% （4 363/4 440） in 2014 and 98.3% （4 366/4 440） in 2015. In the 10 chosen counties, the median water iodine contents from the chosen villages were 202.0 μg/L in 2014 and 235.0 μg/L in 2015; 970 and 999 urine samples of the students from the chosen villages were collected and tested in 2014 and 2015, and the median urinary iodine contents were 251.9 μg/L in 2014 and 290.6 μg/L in 2015; 937 and 948 students were examined in 2014 and 2015, the goiter rates were 3.4% （32/937） in 2014 and 7.8% （74/948） in 2015. Stratified by water iodine, the urinary iodine contents and goiter rates of school children increased with the rise of water iodine content. When the water iodine content exceeded 300 μg/L, goiter rate of school children was 8.4%, which was higher than other groups （P 〈 0.05）. Conclusions After stopping the supple of iodized salt in high water iodine areas, the current iodine status and goiter rate of school children are still higher than normal levels. Both noniodized salt supply and water improvement to reduce water iodine content should be taken in the areas with water iodine higher than 150μg/L.