甘南藏族自治州碘缺乏病防治效果分析

Prevention and treatment effect of IDD in Gannan Tibetan Autonomous Prefecture,Gansu Province

目的掌握甘肃省甘南藏族自治州（简称甘南州）居民碘盐食用情况及人群碘营养状况,为制定有效的防控措施提供依据。方法采用整群抽样法,2014年在甘南州8个县（市）按东、西、南、北、中各抽5个乡,每个乡采60份居民户家中盐样测定盐碘,检测8-10岁儿童甲状腺,采集8-10岁儿童、育龄妇女、孕妇和哺乳期妇女及其0-2岁婴幼儿尿样检测尿碘;采集集中式与分散式生活饮用水水样381份检测水碘,用3日称重法检测居民户人均食盐日摄入量。结果 2014年甘南州碘盐覆盖率、碘盐合格率、合格碘盐食用率和非碘盐率分别为99.71%、99.37%、99.08%和0.29%,盐碘中位数为25.71 mg/kg;儿童、育龄妇女、孕妇、哺乳期妇女及其婴幼儿尿碘中位数分别为197.80μg/L、170.61μg/L、164.30μg/L、140.32μg/L和151.08μg/L;居民人均食盐摄入量为4.7 g/d;生活饮用水水碘中位数为2.00μg/L。结论甘南州食盐加碘预防碘缺乏病成效显著,已达到我国消除碘缺乏病标准,但部分县（市）人群碘营养差异较大,全民食盐加碘仍是全州今后防治碘缺乏病的主要措施。

Objective To master intake of iodized salt and iodine nutritional status in residents in Gannan prefecture, to provide basis for formulating effective measures of prevention and control. Methods Cluster sampling method was taken to sample 5 townships from 8 counties （cities） in Gannan prefecture, respectively in 5 directions. Salt samples of 60 house- holds were collected in each township for determination of salt iodine content. In the 8 counties （cities）, thyroid of children aged 8 to 10 years were examined. Urine iodine of infants of 0 to 2 year-old, the children, women at productive age of 20 to 40 years, pregnant and lactating women was detected. In the 8 counties （cities）, centralized and decentralized drinking water was collected to detect for water iodine. Daily intake of average salt intake of the residents was investigated with 3-day weighing method. Results The coverage rate, qualified rate of iodized salt, and intake rate of qualified iodized salt and rate of non iodized salt rate were 99.71%, 99.37%, 99.08% and 0.29%, with median of salt iodine of 25.71 mg/kg. While the median of urine iodine was 151.08 μg/L, 197.80 μg/L, 170.61μg/L, 164.30 μg/L, and 140.32μg/L of the infants of 0 to 2 year-old, the children, the women at productive age of 20 to 40 years, the pregnant and lactating women, respectively. The per capita intake of salt was 4.7 g/d in Gannan, and the median of water iodine was 2.00 μg/L of drinking water samples. Conclusions The effect of IDD prevention by supplement of iodized salt is remarkable in Gannan prefecture. The coverage rate and intake rate of qualified iodized salt, and iodine nutrition level of the special groups reach the national standard of IDD elimination. However, there are differences in iodine nutrition in some cities and counties. Universal supplement of io- dized salt is still main measures of IDD control in Gannan prefecture.