2013、2014年山东省德州市水源性高碘地区停供碘盐后居民碘营养状况和甲状腺肿大率追踪调查  

A follow up study on iodine nutrition and goiter rate of residents in excessive iodine intaking areas after ceasing supplementation of iodized salt in Dezhou City Shandong Province in 2013 - 2014

作　　者：黄居梅[1] 刘源[1] 王晓明[1] 蒋雯[1] 王欣[1] 杨芳[1] 郭瑞娟[1] 张磊[1] 

机构地区：[1]山东省地方病防治研究所中心实验室,济南250014

出　　处：《中华地方病学杂志》2015年第11期820-823,共4页Chinese Journal of Endemiology

基　　金：中央补助地方公共卫生专项资金地方病防治项目（2013、2014）

摘　　要：目的掌握山东省德州市水源性高碘地区停供碘盐后居民内外环境碘含量变化及甲状腺肿大病情的消长趋势。方法2013、2014年，在德州市的10个水源性高碘县（市、区），每个县（市、区）抽取300户居民进行居民户食用盐监测；每年选取其中5个县（市、区）为监测点，根据水碘含量分为2组（150—300、〉300μg／L），在每组的县（市、区）选择1个水碘含量符合分组条件的乡镇作为监测点，在每个监测点的乡镇小学抽取100名8-10岁儿童（男、女各半），现场半定量检测儿童家中食用盐盐碘含量，确定为无碘盐后，采集其家中饮用水和即时尿样1份检测水碘和尿碘，并检测儿童甲状腺容积。水碘、尿碘含量检测采用砷铈催化分光光度测定法（ws／T107．2006）；甲状腺容积检测采用B超法。结果2013、2014年，德州市水源性高碘县（市、区）居民无碘盐食用率分别为96．1％（2882／2999）、92．7％（2781／3000）；儿童甲状腺肿大率分别为3．2％（16／506）、24．7％（129／523）；共检测饮用水1052份，水碘中位数为221．8μg／L，范围为0．5～1073．6μg／L；共检测儿童尿样1035份，尿碘中位数为405．9μg／L，范围为19．3～2464．1μg／L.水碘含量为〉300、150～300μg／L的监测点，甲状腺肿大率分别为16．5％（86／521）、11．6％（59／508），两者比较差异有统计学意义（χ2=4．86，P〈0．05）。儿童尿碘含量和家庭水碘含量成正相关（r=0．475，P〈0．01）；儿童家庭饮用水水碘中位数、儿童尿碘中位数与甲状腺肿大率均呈现U形曲线关系。结论德州市水源性高碘地区停供碘盐措施得到有效的实施，部分监测点改水效果明显，但仍有部分高碘地区高碘危害持续存在。饮用水水碘含量和甲状腺肿大率呈现U形曲线关系．在以后防治高碘的同时还要防范改水造成的碘缺乏。Objective To investigate the status of iodine content and goiter rate of the residents in excessive iodine intaking areas in Dezhou of Shandong Province after ceasing supplementation of iodized salt. Methods In ten excessive iodine intaking counties （cities, districts） from 2013 to 2014, 300 residents were selected from each county （city, district） to examine their household salt iodine level. Five counties （cities, districts） were chosen as monitoring sites every year, which were divided in two groups according to water iodine levels （150 - 300 and 〉 300 μg/L）. One town that met the requirement in each group was chosen as a test site, one hundred children aged 8 - 10 （50 male and 50 female） from each test site were selected to measure their household salt iodine level. If the household salt was confirmed a non-iodized salt, water samples and urine samples were collected. Water iodine and urinary iodine contents were measured by arsenic cerium catalytic spectrophotometry （WS/T 107- 2006）; thyroid volume was measured by B ultrasound. Results In 2013 and 2014, the rate of non-iodized salt was 96.1% （2 882/2 999） and 92.7% （2 781/3 000）; goiter rate was 3.2% （16/506） and 24.7% （129/523） in Dezhou City. Totally 1 052 household drinking water samples were measured, the median of water iodine level was 221.8 μg/L （0.5 - 1 073.6 μg/L）. Totally 1 035 urine samples were measured, the median of urinary iodine level was 405.9 μg/L （19.3 - 2 464.1 I.Lg/L）. In the two groups （water iodine was 150 - 300 and 〉 300 μg/L, respectively）, the goiter rate was 11.6% （59/508） and 16.5% （86/521）, the difference between them was statistically significant （X2 = 4.86, P 〈 0.05）. Urinary iodine level was proportional to household water iodine level （r = 0.475,P 〈 0.01）. The median of children＇ s household water iodine level and median of children＇s urinary iodine level had a U curve relationship with goiter rate. Conclusions The measure of stopping to supp

关 键 词：碘 水 尿 甲状腺 

分 类 号：R599[医药卫生—内科学]