2018年河北省碘缺乏病监测结果分析

Analysis of iodine deficiency disorders surveillance results in Hebei Province in 2018

目的掌握河北省碘缺乏病病情和人群碘营养状况,评价食盐加碘干预效果。方法依据《全国碘缺乏病监测方案(2016版)》,2018年在河北省162个县(市、区,以下简称县)进行碘缺乏病监测。每个监测县按东、西、南、北、中划分5个抽样片区,每个片区各抽取1个乡镇/街道,每个乡镇/街道抽取1所小学校,每所小学抽取8~10岁非寄宿学生40人,同时每个乡镇/街道中各抽取20名孕妇,儿童和孕妇均采集1次随机尿样和家中食用盐盐样,检测尿碘和盐碘含量,采用B超法检测儿童甲状腺肿大情况。结果162个县共采集8~10岁儿童尿样31883份,尿碘中位数为193.13μg/L。尿碘中位数低于100μg/L的县有1个,100~299μg/L的县有150个;共对8941名8~10岁儿童进行甲状腺B超检测,共检出甲状腺肿大人数232例,甲状腺肿大率为2.59%(232/8941);共采集15569名孕妇尿样,尿碘中位数为164.86μg/L,尿碘中位数<150μg/L的县有67个;共检测47455份盐样,包括31883份儿童家中盐样和15572份孕妇家中盐样。人口加权后碘盐覆盖率为88.79%,合格碘盐食用率为81.69%。结论河北省碘盐覆盖率和合格碘盐食用率均在90%以下,8~10岁儿童的碘营养处于适宜水平,儿童甲状腺肿大率在国家规定的标准以下,孕妇碘营养总体处于适宜水平,但67个县孕妇有碘营养不足风险。

Objective To master the situation of iodine deficiency disorders and iodine nutrition status of the population in Hebei Province,and to evaluate the effect of salt iodization intervention.Methods According to"National Surveillance Program on iodine deficiency disorders",in 2018,iodine deficiency disorders surveillance was carried out in 162 counties(cities,districts).Each monitoring county(city,district)was divided into 5 sampling areas according to its locations of east,west,south,north and middle.One township/street was selected in each area,1 primary school was selected in each township/street,and 40 non-boarding students aged 8-10 were selected from each primary school.In each monitoring county,20 pregnant women were selected from each of the 5 townships/streets.Both children and pregnant women were collected urine and salt samples for detection of iodine levels.The thyroid volume of students was detected by B-ultrasound.Results A total of 31883 urine samples were collected from children aged 8-10 years in 162 counties(cities,districts),with the median urinary iodine of 193.13μg/L.There was one county(cities,districts)with a median urinary iodine below 100μg/L,and the median urinary iodine in 150 counties(cities,districts)was 100-299μg/L.A total of 8941 children aged 8-10 years were tested thyroid by B-ultrasound.A total of 232 cases of goiter were detected,and the rate of goiter was 2.59%(232/8941).A total of 15569 urine samples of pregnant women were tested,the median urinary iodine was 164.86μg/L,and the number of counties(cities,districts)with a median urinary iodine below 150μg/L was 67.A total of 47455 salt samples were tested across the province,including 31883 salt samples from children's homes and 15572 salt samples from pregnant women's homes.The iodized salt coverage rate was 88.79%,and the consumption rate of qualified iodized salt was 81.69%.Conclusions The iodized salt coverage rate and the consumption rate of qualified iodized salt in Hebei Province are all below 90%.The iodine nutrition of children aged 8-10 years is at an appropriate level.The thyroid enlargement rate of children is below the national standard,and the iodine nutrition of pregnant women is generally at an appropriate level.But pregnant women in 67 counties(cities,districts)have a risk of iodine deficiency.