2015年全国水源性高碘地区监测结果分析

National monitoring results in high water iodine areas in 2015

目的了解水源性高碘地区居民的高碘甲状腺肿大（甲肿）病情、碘营养状况和食用不加碘食盐情况。方法在天津、河北、山西、江苏、安徽、山东、河南、陕西8个省（市）所有高碘地区和高碘病区县（市、区，以下简称县）进行居民户不加碘食用盐监测。另外，选取高碘县水碘含量在150—300μg／L和〉300μg／L地区50％的监测点进行饮用水水碘调查、儿童尿碘和甲状腺容积检测。结果在8个高水碘省份的110个县开展了居民户食用盐监测，共检测25597份食用盐样品，不加碘食盐为24640份，不加碘食盐率为96.3％，按县级人口加权后的不加碘食盐率为96．9％。在高碘县共调查了73个监测点，所在地区覆盖人口为183663人，有64个监测点水碘≥150μg／L，占87．7％；水碘中位数为250．8μg／L；共监测5991名6～12岁儿童甲状腺容积，儿童总甲肿率为6．2％，其中河北、山西、河南、天津和山东儿童甲肿率均〉5％；共监测了4618名儿童的尿碘，尿碘中位数为373．0μg／L，其中天津、河北、山西、江苏和山东儿童尿碘均〉300μg／L。结论尽管我国水源性高碘地区不加碘食盐率处于较高水平，但大部分监测点已改水水碘中位数仍在150μg／L以上，儿童尿碘中位数〉300μg/L，处于碘过量水平，儿童总甲肿率超过了5％，建议进一步采取相应措施，寻找低碘水源、改水降碘、加强健康宣教，在高碘地区增加重点人群甲状腺功能等监测。

Objective To observe the high iodine induced thyroid goiter condition, iodine nutritional status and coverage rate of non-iodized salt in high water iodine areas. Methods The household non-iodized salt was monitored in counties （cities, regions） of high water iodine areas and high iodine diseased areas in Tianjin, Hebei, Shanxi, Jiangsu, Anhui, Shandong, Henan and Shaanxi provinces. Among the monitoring sites, where the water iodine were 150 - 300 μg/L or higher than 300 μg/L, 50% of the them were selected to investigate the water iodine, children urinary iodine and thyroid volume of children in high iodine counties. Results Household edible salt was monitored in 110 counties of 8 provinces, with a total of 25 597 salt samples. The number of non-iodized salt was 24 640, and the coverage rate of non-iodized salt was 96.3%. After being weighted based on the population of counties, the coverage rate of non-iodized salt was 96.9%. In all, 73 survey areas include 183 663 people, 64 monitoring sites （87.7%） where the water iodine level were higher or equal to 150 μg/L and the median of water iodine was 250.8μg/L. Totally 5 991 children aged 6 - 12 were measured thyroid volume, the total goiter rate was 6.2%, the children thyroid goiter rate was higher than 5% in Hebei, Shanxi, Henan, Tianjin and Shandong provinces. Totally 4 618 children were detected urinary iodine, the median urinary iodine concentration was 373.0 μg/L, and the children median urinary iodine concentration was exceeded 300μg/L in Tianjin, Hebei, Shanxi, Jiangsu and Shandong provinces. The children urinary iodine concentration and goiter rate increased gradually with increasing of water iodine content. Conclusions The non-iodized salt coverage rate is high in high water iodine areas, most monitored areas have changed drinking water sources, but the median water iodine concentration is still higher than 150μg/L. Children median urinary iodine concentration is higher than 300μg/L, iodine is in a excessive status. The children total goiter rate is higher than 5%. Some countermeasures are proposed to search low iodine water, change water sources, do health education, and add other surveillance measures, such as thyroid function detection on target groups, and so on.