2017年苏州市部分地区8~10岁儿童碘营养水平及甲状腺结节患病率调查

Investigation on iodine nutrition level and prevalence of thyroid nodules among children aged 8-10 years old in some areas of Suzhou City in 2017

目的了解苏州市部分地区学龄儿童碘营养状况及甲状腺结节患病情况,为制定科学补碘策略提供依据。方法按照《江苏省碘缺乏病监测方案(2017版)》要求,对苏州市吴中区、常熟市和太仓市按东、西、南、北、中各随机抽取1个乡镇,采集末梢水水样1份;各随机抽取1所小学,抽取8~10岁非寄宿学生40名,采集尿样和学生家中食用盐样进行检测,并进行甲状腺B超检查。结果苏州市吴中区、常熟市和太仓市共检测15份水样,水碘中位数均<10μg/L。共检测食用盐600份,碘盐覆盖率、碘盐合格率、合格碘盐食用率分别为97.33%(584/600)、99.32%(580/584)、96.67%(580/600),盐碘均数为(22.44±4.62)mg/kg,地区间比较差异有统计学意义(F=41.407,P<0.05),其中常熟市最高,太仓市最低。共检测8~10岁儿童尿样600份,尿碘中位数为182.90μg/L,地区间比较差异有统计学意义(χ^2=14.277,P<0.05),其中苏州市吴中区最高,太仓市最低。甲状腺B超检查600人,肿大率为1.33%(8/600),地区间比较差异无统计学意义(χ^2=1.014,P>0.05)。甲状腺结节检出率为23.33%(140/600),标化率为20.19%。不同性别学生甲状腺结节检出率比较,差异无统计学意义(χ^2=0.633,P>0.05);不同年龄、不同地区学生甲状腺结节检出率比较,差异有统计学意义(χ^2=14.731、49.585,均P<0.05)。结论苏州市吴中区、常熟市和太仓市8~10岁学龄儿童碘营养总体处于适宜水平。今后应持续巩固碘缺乏病防治监测,深入开展碘营养科学研究。

Objective To realize the iodine nutritional status and thyroid nodules among school-age children in some areas of Suzhou City, provide basis for making scientific iodine supplement strategy. Methods Based on the requirements of Monitoring program for iodine deficiency disorders in Jiangsu Province(2017 Edition), one township was randomly selected from Wuzhong District of Suzhou City, Changshu City and Taicang City according to the east, west, south, north and middle, to collect one sample of peripheral water. One primary school was randomly chosen to collect 40 non-boarding students aged 8-10 years old.Urine and salt samples from children’s home were collected for examination. B-ultrasonic examination of thyroid was conducted.Results Totally 15 samples from Wuzhong District of Suzhou City, Changshu City and Taicang City were tested, and the water iodine medians were less than 10 μg/L. Totally 600 samples of edible salt were tested. The coverage rate of iodized salt, qualified rate of iodized salt and consumption rate of qualified iodized salt was respectively 97.33%(584/600), 99.32%(580/584) and96.67%(580/600), and the mean of salt iodine was(22.44±4.62)mg/kg. There was statistically significant difference among different areas(F=41.407, P<0.05), and the highest and lowest was in Changshu City and Taicang City respectiv ely. A total of 600 urine samples of 8-10 year-old children were detected. The median urinary iodine was 182.90 μg/L. There was statistically significant difference among different areas (χ^2=14.277, P<0.05), and the highest and lowest was in Wuzhong District of Suzhou City and Taicang City respectively. Among 600 people with B-ultrasonic examination of thyroid, the goiter rate was1.33%(8/600), and the difference was not statistically significant among different areas (χ^2=1.014, P>0.05). The detection rate of thyroid nodule was 23.33%(140/600) and the standardized rate was 20.19%. The difference in the detection rate was not statistically significant among sex groups(χ^2=0.633, P>0.05), while the differences in the detection rate were statistically significant among different groups in age and area (χ^2=14.731, 49.585, both P<0.05). Conclusion The iodine nutrition of children aged 8-10 years old in Wuzhong District of Suzhou City, Changshu City and Taicang City is at an appropriate level. In the future, it is necessary to continue to consolidate the prevention and monitoring of iodine deficiency disorders, and carry out scientific research on iodine nutrition.