2016-2018年广西北海市8~10岁儿童碘缺乏病监测结果分析

Analysis of monitoring results of iodine deficiency disorders in children aged 8-10 years in Beihai City Guangxi from 2016 to 2018

目的 了解广西壮族自治区北海市8~ 10岁儿童碘缺乏病现状,为采取针对性的防治措施提供依据.方法 按照《全国碘缺乏病监测方案(2016年版)》和《2016-2018年北海市碘缺乏病监测方案》要求,2016-2018年,采用分层多阶段抽样方法,将北海市按照行政区域划分,每个区县分别按照东、西、南、北、中5个方位,各抽取1所小学,每所小学抽取40名8~ 10岁非寄宿学生,采集儿童食用盐盐样和尿样,对盐碘、尿碘含量进行检测,B超法检测儿童甲状腺容积并计算甲状腺肿大率.结果 共调查8~ 10岁儿童800名,其中2016、2017年各调查200名,2018年调查400名;男女比例为1.08∶1.00(415/385);8~ 10岁儿童食用盐碘含量中位数为19.7 mg/kg;合格碘盐食用率为54.4%(435/800).北海市8~ 10岁儿童尿碘中位数为154.3μg/L,8、9、10岁儿童尿碘中位数分别为182.0、141.9、163.3 μg/L;男童尿碘中位数(164.3 μg/L)高于女童(140.0μg/L,Z=-3.765,P< 0.05);不同地区8~10岁儿童尿碘中位数比较差异有统计学意义(H=33.621,P<0.05),铁山港区最低(117.6 μg/L);尿碘中位数在适宜范围(100~<200 μg/L)的占39.3%(314/800).8~ 10岁儿童总的甲状腺肿大率为1.1%(9/800);不同地区儿童甲状腺肿大率比较差异有统计学意义(P<0.05),海城区甲状腺肿大率(3.5%,7/200)高于其他地区.结论 北海市8~10岁儿童碘营养状况为碘适宜,应继续坚持食盐加碘防治碘缺乏病,对不同区县8~ 10岁儿童应采取因地制宜、精准补碘的措施.

Objective To understand the current status of iodine deficiency disorders in children aged 8-10 years in Beihai,Guangxi,and to provide evidence for prevention and treatment of the disease.Methods According to the"National Iodine Deficiency Disorders Surveillance Program"(2016 edition)and the"2016-2018 Beihai Iodine Deficiency Disorders Surveillance Program",Beihai was divided into administrative regions by stratified multi-stage sampling method in 2016-2018.Each district and county was divided into five parts according to directions:east,west,south,north and middle.One primary school was selected in each direction and 40 non-boarding students aged 8-10 years were selected from each primary school.Urine samples and edible salt samples were collected from children to detect urinary iodine and salt iodine contents.Thyroid volume of children was determined by B-ultrasound method,and the rate of goiter was calculated.Results A total of 800 children aged 8-10 years were investigated,including 200 in 2016,200 in 2017,and 400 in 2018.The ratio of male to female was 1.08:1.00(415/385);the median salt iodine of children aged 8-10 years was 19.7 mg/kg;the edible rate of qualified iodized salt was 54.4%(435/800).The median urinary iodine of children aged 8-10 years in Beihai was 154.3μg/L.The median urinary iodine of children aged 8,9 and 10 years were 182.0,141.9,163.3μg/L,respectively.The median urinary iodine of boys(164.3μg/L)was higher than that of girls(140.0μg/L,Z=-3.765,P<0.05);there was a difference in the median urinary iodine between children aged 8-10 years in different regions(H=33.621,P<0.05),and Tieshangang District had the lowest(117.6μg/L);the median urinary iodine of 314 people was in the appropriate range(100-<200μg/L),accounting for 39.3%(314/800).The total thyroid goiter rate was 1.1%(9/800)in children aged 8-10 years;the thyroid goiter rate was different in children from different regions(P<0.05),and the thyroid goiter rate(3.5%,7/200)in children aged 8-10 years in Haicheng District was higher than that in other areas.Conclusions The iodine nutrition status of children aged 8-10 years in Beihai is appropriate.Beihai should continue to adhere to salt iodization to prevent and treat iodine deficiency disorders,and take measures to adapt to local conditions and accurately supplement iodine for children aged 8-10 years in different districts and counties.