用体表面积标化甲状腺容积标准评价停供碘盐对高碘地区儿童甲状腺肿大的干预效果  

Assessing the effectiveness of removing iodized salt on iodine excessive goiter using thyroid volume reference for body surface area

作　　者：吕胜敏[1] 徐栋[1] 王玉春[2] 杜永贵[1] 贾丽辉[1] 马景[1] 

机构地区：[1]河北省疾病预防控制中心地方病防治所,石家庄050021 [2]衡水市疾病预防控制中心

出　　处：《中华预防医学杂志》2015年第4期356-361,共6页Chinese Journal of Preventive Medicine

基　　金：河北省科技支撑项目（11276103D-3）

摘　　要：目的：用体表面积标化甲状腺容积标准评估停供碘盐对水源性高碘地区儿童甲状腺肿大的干预效果。方法2010年5月在河北省衡水市，以单纯随机法选取了3个水碘中位数在150～300μg/L的高碘乡的452名8～10岁儿童，用B超测量其甲状腺容积。2010年7月，根据国家政策在该地区停供碘盐。在2013年10月，又在这3个乡采用单纯随机法选取了459名8～10岁儿童，用B超测量其甲状腺容积，用WHO推荐的体表面积（BSA）标化的甲状腺容积标准判定其甲状腺肿大情况。结果BSA标化的儿童甲状腺肿大率从停供碘盐前的33%（149/452）下降到6%（30/459）（χ2=100.64，P〈0.001）。8、9、10岁儿童的BSA标化甲状腺肿大率分别从停供碘盐前的38%（35/92）、31%（59/193）、33%（55/167）下降到6%（10/164）、7%（11/163）、7%（9/132），差异有统计学意义（χ2值分别为41.35、31.66、29.79, P值均〈0.001）。男孩和女孩的BSA标化甲状腺肿大率分别从停供碘盐前的34%（83/244）和32%（66/208）下降到6%（14/225）和7%（16/234）（χ2值分别为55.01、45.06, P〈0.001）。结论河北省高碘地区停供碘盐后BSA标化的儿童甲状腺肿大率下降。Objective Using the thyroid volume criteria for body surface area（BSA） to assess more precisely the effectiveness of removing iodized salt on the goiter status of children living in areas with excessive iodine in drinking water. Methods Three towns with median water iodine（MWI） of 150-300 μg/L were selected by simple random method in Hengshui city of Hebei province of China in May of 2010. A total of 452 and 459 children in the 3 towns were randomly selected to measure thyroid volume by ultrasound. Iodized salt was removed in July of 2010. In October of 2013,459 children in these 3 towns were selected by simple random method to measure their thyroid volume by ultrasound again. Their goiter status was judged using the criteria of thyroid volume for BSA recommended by the WHO. Results After removing iodized salt, the overall BSA specific goiter prevalence in the three towns significantly decreased from 33%（149/452） to 6%（30/459） （χ2=100.64,P〈0.001）. The BSA specific goiter prevalence in 8, 9 and 10 year-old children decreased respectively from 38%（35/92）, 31%（59/193） and 33%（55/167） to 6%（10/164）, 7%（11/163） and 7%（9/132） （χ2 values were 41.35, 31.66, 29.79,P〈0.001）. The BSA specific goiter prevalence in boys and girls decreased from 34%（83/244） and 32%（66/208） to 6%（14/225） and 7%（16/234） （χ2 values were 55.01, 45.06, P〈0.001） respectively. Conclusion The BSA specific children′s goiter prevalence decreased significantly after removing iodized salt from their diet in the HIA in Hebei province.

关 键 词：体表面积 氯化钠 膳食 甲状腺肿 饮水 

分 类 号：R725.8[医药卫生—儿科]