2014年西藏碘缺乏病病情监测报告

Analysis of surveillance results of iodine deficiency disorders in Tibet in 2014

目的为进一步了解西藏碘缺乏病病情、居民碘营养水平及防治措施落实情况,巩固和完善西藏碘缺乏病长效防控机制。方法采用随机抽样法,按照按照人口比例概率抽样(PPS),在全区抽取30个县开展碘缺乏病病情监测,从抽取到的县(市、区)中抽取1个乡(镇)的1所小学,每所小学随机抽查50名8-10岁学生的甲状腺容积和尿样,在每个被抽取的小学所在地的乡(镇)采集20名孕妇尿样;采用砷铈催化分光光度方法(WS/T 107-2006)测定尿碘;采用B超法检查甲状腺容积,并按地方性甲状腺肿的诊断标准(WS 276-2007)判定;采集儿童家中食用盐,用硫代硫酸钠直接滴定法(GB/T 13025.7-2012)测定。结果 B超检查8-10岁儿童甲状腺1 272人次,肿大率为2.7%(34/1 272);检测盐样1 200份,盐碘中位数为26.6 mg/kg,合格碘盐食用率为73.1%(877/1 200);检测8-10岁儿童和孕妇尿样1 534份和565份,尿碘中位数分别为140.0μg/L、129.2μg/L。结论食盐加碘含量调整后,西藏自治区8-10岁儿童碘营养总体处于适宜水平,但部分地区(阿里、那曲)碘盐覆盖率偏低,部分地区(日喀则市)孕妇碘营养缺乏,全区合格碘盐食用率较低,应监管好碘盐配送工作,并加强生产层次碘盐碘含量的检测工作,同时应积极推进目标人群的健康教育促进工作。

Objective To further understand the situation of iodine deficiency disorders（ IDD）,iodine nutritional level of residents and the implementation of prevention and control measures,to consolidate and improve the prevention and treatment of IDD in the district.Methods According to population probability sampling（ PPS） method, in the region selected 30 counties carried out IDD surveillance, using simple random sampling method, in the the counties（ cityies, districts） to extract a township（ town） of a primary school, each school for a random sample of 50 8 to 10 years old students to collect urine samples of children, and in each sample of primary school collected 20 samples of pregnant women, by arsenic cerium catalytic spectrophotometry method（ WS/T107-2006） determination of urine iodine; using ultrasound examination of thyroid volume.And according to the diagnostic criteria for endemic goiter（ WS 276-2007） judgement,collected edible salt, sodium thiosulfate direct titration method（ GB/T13025.7-2012） determination.Results Examination for 8 to 10 years old children with thyroid 1 272 passengers by ultrasound the goiter rate was 2.7%（ 34/1 272）; 1 200 salt samples were examined, the median salt iodine was 26.6 mg/kg, qualified iodized salt consumption rate was 73.1%（ 877/1 200）; 8 to 10 years old children＇s urine samples were detected,1534, 565 copies of urine samples of pregnant women and children, the median urinary iodine were 140.0 μg/L, 129.2 μg/L,respectively.Conclusion After the adjustment of salt iodine content, iodine nutritional status of 8 to10 years children are at appropriate level in general, but in some areas（ ALI, Naqu）,the coverage rate of iodized salt is very low. The region＇s qualified iodized salt consumption rate is low, the regulatory iodized salt distribution and the work of the iodine content detection should be strengthened. At the same time we should actively promote the health education for the target population.