盐碘新标准实施前后山东省日照市儿童碘营养状况分析

Children＇s iodine nutrition status before and after implementation of a new standard of iodized salt in Rizhao City of Shandong Province

目的分析盐碘新标准实施对山东省日照市学龄儿童碘营养水平的影响。方法盐碘含量调整前后（2011年、2012—2014年），在全市范围内开展碘营养状况调查工作。每个区县按东、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4个行政村，每个村抽检15户居民食用盐盐样；在上述部分乡镇的中心小学每所小学抽取至少20名8—10岁学生，采集尿样，检测尿碘；同时每所小学抽取至少40名8～10岁学生，进行甲状腺容积检查。结果盐碘含量调整前（2011年），共检测食盐样品1164份，盐碘含量在18～33mg／kg的比例为93．7％（1091／1164）；共采集8-10岁儿童尿样400份，尿碘中位数为250．7μg／L；触诊法检诊儿童甲状腺200人，甲状腺肿大率为3．0％（6／200）。调整后（2012—2014年），共检测食盐样品3600份，盐碘含量在18-33mg／kg的比例为88．5％（3186／3600）；采集儿童尿样1122份，尿碘中位数为140．4μg／L；触诊法检诊儿童甲状腺1336人，甲状腺肿大率为1．0％（13／1336）。结论盐碘新标准实施后日照地区儿童碘营养状况降低到适宜水平，调整后的盐碘含量更安全。日照市应长期坚持食盐加碘防治策略。

Objective To analyze the impact of a new salt iodine standard on children＇s iodine nutrition status. Methods A survey on iodine nutritional status was carried out in Rizhao before and after salt iodine content adjustment （2011, 2012 - 2014）. A town was selected from 5 areas （east, west, south, north, middle） in every county of Rizhao, 4 villages were selected from each town, and then edible salt samples were collected in 15 households from each village. A central primary school was selected in some sampled town, at least 20 of these children＇s instant urine samples were collected for detection of urinary iodine, and at least 40 children aged 8 - 10 years old were selected for examination of thyroid volume. Results Totally 1 164 salt samples were collected before the adjustment, 93.7% （1 091/1 164） of salt iodine concentration was in 18 - 33 mg/kg; totally 400 urine samples of 8 - 10 children were collected and the median urinary iodine （MUI） was 250.7 μg/L; the thyroid glands of 200 children were inspected and the goiter rate with palpation was 3.0% （6/200）. Totally 3 600 salt samples were collected after the adjustment, 88.5% （3 186/3 600） of salt iodine concentration was in 18 - 33 mg/kg; totally 1 122 urine samples of 8 - 10 children were collected and the MUI was 140.4 μg/L; the thyroid glands of 1 336 children were inspected, the goiter rate with palpation was 1.0% （13/1 336）. Conclusions After implementation of the new standard, children＇s iodine nutrition has down to appropriate levels. So the salt iodine concentration after adjustment may be safer and the salt iodization prevention strategies should be carried out for a long time in Rizhao City.