2017年重庆市碘缺乏病监测结果分析

Analysis of surveillance results of iodine deficiency disorders in Chongqing, 2017

目的掌握重庆市碘缺乏病病情现状,为科学防治碘缺乏病提供依据。方法2017年,采用横断面调查方法,对重庆市的26个区(县)进行碘缺乏病调查。每个区(县)按东、西、南、北、中划分为5个抽样片区,每个片区抽取1个乡镇/街道(至少包括1个街道),每个乡镇/街道抽取1所小学校,每所小学抽取8 ~ 10岁非寄宿儿童40人(男女各半),采集儿童家中食用盐样和即时尿样,进行盐碘、尿碘检测。同时对其中14个区(县)的8 ~ 10岁儿童进行甲状腺容积检测。结果共采集食用盐5 546份,其中碘盐5 520份,合格碘盐5 094份,非碘盐26份,盐碘含量平均值为26.1 mg/kg,范围为23.2 ~ 30.7 mg/kg。碘盐覆盖率、碘盐合格率、合格碘盐食用率、非碘盐率分别为99.53%(5 520/5 546)、92.28%(5 094/5 520)、91.85%(5 094/5 546)、0.47%(26/5 546)。共检测尿样5 565份,尿碘中位数为221.9 μg/L,尿碘< 50 μg/L的占2.98%(166/5 565),50 ~ 99 μg/L的占8.09%(450/5 565),100 ~ 199 μg/L的占31.66%(1 762/5 565),200 ~ 299 μg/L的占30.03%(1 671/5 565),≥300 μg/L的占27.24%(1 516/5 565)。共对3 111名儿童进行甲状腺容积检测,8、9、10岁组甲状腺容积中位数分别为2.6、2.9、3.1 ml,甲状腺肿大率为1.93%(60/3 111),各监测区(县)甲状腺肿大率范围为0.45%~ 2.74%。结论重庆市合格碘盐食用率、尿碘中位数等各项指标均达到国家消除碘缺乏病标准,儿童甲状腺肿大率维持在较低水平;部分地区合格碘盐食用率呈下降趋势,应重点加强对存在非碘盐区(县)的监测。

Objective To master the current status of iodine deficiency disorders in Chongqing, and provide evidence for scientific prevention and treatment of iodine deficiency disorders. Methods In 2017, a cross-sectional survey method was adopted. In 26 districts (counties) in Chongqing, each district (county) was divided into five sampling areas by east, west, south, north and middle. One township/street (including at least one street) was selected in each area and one primary school was selected in each township/street. Forty non-boarding students aged 8 to 10 years old(half males and half females) were selected from each primary school. Their salt and instant urine samples were collected for salt iodine and urine iodine detection. At the same time, thyroid volume was measured in 8 to 10 years old students in 14 districts (counties). Results A total of 5 546 edible salt samples were collected, including 5 520 iodized salts, 5 094 qualified iodized salts and 26 non-iodized salts. The average salt iodine content was 26.1 mg/kg and the range was 23.2 to 30.7 mg/kg. Iodized salt coverage rate, iodized salt pass rate, qualified iodized salt consumption rate, and non-iodized salt rate were 99.53%(5 520/5 546), 92.28%(5 094/5 520), 91.85%(5 094/5 546), and 0.47%(26/5 546), respectively. A total of 5 565 urine samples were tested, the median urinary iodine was 221.9 μg/L, urinary iodine < 50 μg/L accounted for 2.98%(166/5 565), 50 - 99 μg/L accounted for 8.09%(450/5 565), 100 - 199 μg/L accounted for 31.66%(1 762/5 565), 200 - 299 μg/L accounted for 30.03%(1 671/5 565), and ≥300 μg/L accounted for 27.24%(1 516/5 565). A total of 3 111 children were tested for thyroid volume. The median thyroid volume was 2.6, 2.9, 3.1 ml in the 8th, 9th, and 10th years, and the thyroid enlargement rate was 1.93%(60/3 111). The districts (counties) had a goiter rate ranging from 0.45% to 2.74%. Conclusions The consumption rates of qualified iodized salt and the median urinary iodine in Chongqing have reached the national standard for eliminating iodine deficiency disorders. The rate of goiter in children has remained at a low level, but the consumption rate of qualified iodized salt in some areas has shown a downward trend. The monitoring of the presence of non-iodized salt districts (counties) should be emphasized.