2018-2020年青岛市8~10岁儿童碘缺乏病监测情况分析

Surveillance results of iodine deficiency disorders in children aged 8-10 years in Qingdao City from 2018 to 2020

目的了解青岛市儿童的碘营养状况及碘缺乏病防治效果,为指导居民科学补碘以及适时采取针对性防治措施和科学调整干预策略提供依据。方法根据《全国碘缺乏病监测方案(2016版)》和《山东省碘缺乏病监测方案》要求,2018-2020年,采用整群抽样法,抽取青岛市8~10岁儿童,采集家中食用盐盐样及随机尿样进行碘含量检测,B超法测定儿童甲状腺容积,并进行甲状腺容积与身体发育指标间的相关性分析。结果2018-2020年,共监测儿童6057人,其中男童3068人、女童2989人。儿童家中食用盐和碘盐的碘含量中位数分别为23.50、24.10 mg/kg,碘盐合格率、碘盐覆盖率、合格碘盐食用率分别为89.95%(4832/5372)、88.69%(5372/6057)、79.78%(4832/6057)。不同年份间碘盐合格率、碘盐覆盖率、合格碘盐食用率比较,差异均有统计学意义(χ^(2)=135.26、314.71、342.87,P均<0.001)。共采集儿童尿样6057份,尿碘中位数为193.92μg/L,其中<100μg/L的占16.2%(979/6057),≥300μg/L的占22.5%(1361/6057)。不同年份、性别、是否食用碘盐间尿碘中位数比较,差异均有统计学意义(H/Z=37.25、-3.89、-5.69,P均<0.001),其中男童尿碘中位数高于女童,食用碘盐组尿碘中位数明显高于食用非碘盐组;不同年龄间尿碘中位数比较,差异无统计学意义(H=4.33,P=0.119)。儿童总甲状腺肿大率(甲肿率)为3.45%(71/2057),不同年份间儿童甲肿率比较,差异有统计学意义(χ^(2)=42.68,P<0.001),2020年甲肿率[7.31%(45/616)]明显高于2018、2019年[2.81%(18/641)、1.00%(8/800),P均<0.001]。儿童甲状腺容积与身高、体重均呈正相关(r=0.20、0.22,P均<0.001)。结论青岛市8~10岁儿童碘营养总体处于适宜水平,但个别年份儿童甲肿率处于相对较高水平,碘盐合格率、碘盐覆盖率、合格碘盐食用率均低于国家消除碘缺乏病标准,需引起重视。

Objective To investigate the iodine nutritional status of children in Qingdao City and the effects of prevention and treatment measures on iodine deficiency disorders(IDD),and to provide a scientific basis for guiding residents to scientifically supplement iodine,taking timely targeted prevention and control measures,and scientifically adjusting intervention strategies.Methods According to"National Iodine Deficiency Disorders Surveillance Program(2016 edition)"and"Iodine Deficiency Disorders Surveillance Program of Shandong Province",from 2018 to 2020,using the cluster sampling method,children aged 8-10 years in Qingdao City were chosen to test their household salt iodine content and random urinary iodine content,and to examine their thyroid volume by B-ultrasonography,and the correlation between thyroid volume and physical development indexes was analyzed.Results From 2018 to 2020,a total of 6057 children were monitored,including 3068 boys and 2989 girls.The median of salt iodine and iodized salt iodine of children was 23.50 and 24.10 mg/kg.The qualified rate of iodized salt was 89.95%(4832/5372),the coverage rate of iodized salt was 88.69%(5372/6057),and the consumption rate of qualified iodized salt was 79.78%(4832/6057).There were significant differences in the qualified rate of iodized salt,the coverage rate of iodized salt and the consumption rate of qualified iodized salt between different years(χ^(2)=135.26,314.71,342.87,P<0.001).A total of 6057 urine samples were collected from children,and the median of urinary iodine was 193.92μg/L,of which 16.2%(979/6057)were<100μg/L,and 22.5%(1361/6057)were≥300μg/L.There were statistically significant differences in the medians of urinary iodine between different years,gender and whether eating iodized salt(H/Z=37.25,-3.89,-5.69,P<0.001),the median of urinary iodine in boys was higher than that of girls,and the median of urinary iodine in eating iodized salt group was higher than that of eating non-iodized salt group.There was no significant difference in the median of urinary iodine between different age(H=4.33,P=0.119).The rate of goiter in children was 3.45%(71/2057),and the difference between different years was statistically significant(χ^(2)=42.68,P<0.001).The incidence of goiter in 2020[7.31%(45/616)]was significantly higher than that in 2018 and 2019[2.81%(18/641),1.00%(8/800),P<0.001].Thyroid volume of children was positively correlated with height and weight(r=0.20,0.22,P<0.001).Conclusions The iodine nutritional level of children aged 8-10 years in Qingdao City is appropriate.However,the incidence of goiter in children in some years is relatively high.The qualified rate of iodized salt,the coverage rate of iodized salt and the consumption rate of qualified iodized salt are all lower than the national standard for elimination of IDD,which should be paid attention to.