贵州省新生儿足跟血促甲状腺激素水平及人群碘营养状况调查  

Investigation on the status of neonatal heel blood thyroid stimulating hormone and iodine nutrition of pregnant women and children in Guizhou Province

作　　者：周德梅[1] 安冬[1] 张念恒[1] 安露[1] 王娟[1] 杨宇[1] 姚丹成[1] 李杨[1] 杨莉[1] Zhou Demei;An Dong;Zhang Nianheng;An Lu;Wang Juan;Yang Yu;Yao Dancheng;Li Yang;Yang Li(Integrated Department of Institute of Endemic Disease,Guizhou Center for Disease Control and Prevention,Guiyang 550004,China)

机构地区：[1]贵州省疾病预防控制中心地方病防治研究所综合科,贵阳550004

出　　处：《中华地方病学杂志》2019年第8期646-652,共7页Chinese Journal of Endemiology

基　　金：联合国儿童基金会合作计划(2015).

摘　　要：目的了解贵州省新生儿足跟血促甲状腺激素(TSH)水平及人群碘营养状况.方法2016、2017年,在贵州省各市(州)选择政府所在地的市(区、县)为城市调查点,再抽取1个经济相对落后且距市(州)政府所在地较远的县(市、区)为农村调查点.每个调查点分别采集300份居民户食用盐测定盐碘;300份出生后72h的新生儿足跟血测定TSH,世界卫生组织、联合国儿童基金会、国际控制碘缺乏病理事会(WHO/UNICEF/ICCIDD)建议新生儿TSH水平>5mU/L的比例<3%为非缺碘地区,即第97百分位数(P97)值应≤5mU/L,试剂盒正常参考值为≤9mU/L;150名8~10岁儿童和150名孕妇1次即时尿样测定尿碘.结果全省调查居民户食用盐5400份,盐碘中位数为27.9mg/kg,合格碘盐食用率为94.89%(5124/5400);新生儿5400例,TSH中位数为2.62mU/L,P97为6.91mU/L,>5mU/L的比例为10.67%(576/5400),>9mU/L的比例为1.00%(54/5400);8~10岁儿童尿样3588份,尿碘中位数为212.3μg/L,<50μg/L的比例为2.81%(101/3588),<100μg/L的比例为12.76%(458/3588);孕妇尿样2695份,尿碘中位数为163.1μg/L,<150μg/L的比例为44.04%(1187/2695).结论贵州省碘盐质量稳定,儿童和孕妇总体上碘营养状况良好.今后应加强新生儿TSH水平和孕妇碘营养水平监测.Objective To understand the thyroid stimulating hormone (TSH) level of neonates and iodine nutritional status of pregnant women and children in Guizhou Province. Methods From 2016 to 2017, a city (district, county) in government location in Guizhou Province was selected as the urban survey site, and a county (city, district) whose economy was relatively backward and farther from the city (prefecture) in government location was selected as the rural survey site. In each survey site, 300 salt samples were collected for determination of salt iodine;300 blood samples in the heel of neonates after birth 72 hours were taken for measurement of TSH. The World Health Organization, United Nations International Children's Emergency Fund, and the International Committee for the Control of Iodine Deficiency (WHO/UNICEF/ICCIDD) recommend that when the proportion of neonates(TSH levels > 5 mU/L) is < 3%, the area is non-iodine-deficient. In other words, the 97th percentile (P97) value should be ≤5 mU/L. The normal reference value of the kit is ≤9 mU/L. And urinary iodine of 150 children aged 8 - 10 and 150 pregnant women was determined. Results A total of 5 400 edible salt samples were tested, the median of salt iodine was 27.9 mg/kg, and the consumption rate of qualified iodized salt was 94.89%(5 124/5 400);5 400 neonatal heel blood samples were collected, the median of TSH was 2.62 mU/L, TSH P97 was 6.91 mU/L, and samples proportion with TSH > 5 mU/L was 10.67%(576/5 400), and > 9 mU/L (the cut-off value of kit) was 1.00%(54/5 400). Among 3 588 cases of children aged 8 to 10 years, the median of urinary iodine was 212.3 μg/L, those with urinary iodine < 50 μg/L was 2.81%(101/3 588), and < 100 μg/L was 12.76%(458/3 588). Among the 2 695 pregnant women, the median of urinary iodine was 163.1 μg/L, and 44.04%(1 187/2 695) were < 150 μg/L. Conclusions The quality of iodized salt is stable in Guizhou, the iodine nutrition status of children and pregnant women are good. The neonatal TSH and nutritional status of pregnant w

关 键 词：促甲状腺激素 碘 新生儿 儿童 孕妇 

分 类 号：R722.1[医药卫生—儿科]