2014年全国碘缺乏病高危地区重点调查结果分析

Analysis of key findings at high risk areas of iodine deficiency disorders in China, 2014

目的了解我国碘缺乏病高危地区人群碘营养状况，为碘缺乏病防治研究工作提供科学依据和针对性的防治策略。方法按照2012年修订的《碘缺乏病监测方案》，以乡（镇、街道办事处，统称为乡）为单位，在浙江、福建、广东、广西、河南、青海和新疆7个省份的32个监测县（市、区、旗，统称为县）的高危地区采取单纯随机抽样的方法抽取调查乡开展监测．搜索疑似地方性克汀病（简称地克病）病例，检测儿童甲状腺容积、儿童和孕妇尿碘、孕妇家庭盐碘含量。结果本次调查未发现疑似地克病病例及确诊地克病病例。7个项目省份儿童B超甲状腺肿大率为1．8％（141／7968）；尿碘中位数为163．0μg／L，除河南省儿童尿碘中位数为305．1μg/L外，其他省份儿童尿碘中位数均处于100-199μg/L；孕妇尿碘中位数为120．8μg／L，除河南省孕妇尿碘中位数为234．9μg/L外，其他省份的孕妇尿碘中位数均〈150μg／L。7个项目省份碘盐覆盖率为80.3％（1577／1963）．广西、青海、福建和浙江的碘盐覆盖率均〈80％。除青海外，6个项目省份176个村进行了村级碘盐销售网络情况调查．食盐零售点销售加碘盐的占96．3％（737／765）。调查7个项目省份2024名孕妇家中的食盐来源．购买食盐的占8713％（1766／2024），自采和以物易物的分别占食盐来源3．6％（72／2024）和9．2％（186／2024）。本次调查未发现投服碘油的儿童，仅新疆47．5％（487／1026）的孕妇投服了碘油。结论碘缺乏病高危地区儿童尿碘水平总体适宜，但孕妇尿碘总体水平偏低，应提高部分地区碘盐覆盖率和碘盐浓度，适时采取健康教育、应急补碘和推广孕妇碘盐等措施，防止出现新发地克病病例。

Objective To investigate the population nutritional status of iodine in areas at high risk of iodine deficiency disorders （IDD） in our country and provide scientific basis for development control strategy to IDD. Methods According to the national IDD surveillance protocol which was revised in 2012, township （town, street office） as a unit, seven provinces including Zhejiang, Fujian, Guangdong, Guangxi, Henan, Qinghai and Xinjiang, 32 monitoring counties in high-risk areas were chosen into the survey by simple random sampling. New cretinism cases were searched, the thyroid volume was examined in children, the urinary iodine in children and pregnant woman, and the family salt iodine level was tested. Results The survey found no suspected cases and no confirmed endemic cretinism cases. The goiter rate was 1.8% （141/7 968）and the median of urinary iodine was 163.0 μg/L in children in the 7 project provinces. In addition to the median urinary iodine of 305.1 μg/L in Henan children, the median urinary iodine in other provinces was in the 100 - 199 μg/L. The median of urinary iodine in pregnant women was 120.8 μg/L, in addition to the median urinary iodine of 234.9 μg/L in pregnant women in Henan, the median urinary iodine of pregnant women in other provinces was less than 150 μg/L. The coverage rate of iodized salt in the 7 project provinces was 80.3% （1 577/1 963）, the coverage rate of iodized salt was less than 80% in Guangxi, Qinghai, Fujian and Zhejiang. The 176 villages in the 6 project provinces were surveyed iodized salt bought through network, except Qinghai. Sale of iodized salt from salt retail accounted for 96.3% （737/765）. Survey of the 7 provinces of 2 024 women, pregnant women found that purchased salt accounted for 87.3%（1 766/ 2 024）. Purchased and replaced salts was accounted for 3.6% （72/2 024） and 9.2% （186/2 024）, respectively. The survey did not found a children who had taken iodine oil, only 47.5% （487/1 026） of pregnant women in Xinjiang had taken iodine oil. Conclusions The iodine nutrition level is appropriate in children in the areas at high risk of IDD, but the iodine nutrition level in pregnant women is low. Some areas should improve the coverage rate of iodized salt and iodized salt concentration, take health education at the right moment, promote iodized salt for pregnant women, and prevent new cretinism cases.