CAJ | 학술논문

目的调查重庆市与西藏林芝地区碘缺乏病高危地区病情现状,为制订预防控制方案提供依据.方法 2007年由国家统一制订方案并抽样,重庆市调查城口和巫溪县,西藏林芝地区调查林芝、波密、米林和朗县4个县;林芝县抽查5个乡,其余县抽查3个乡;每个乡抽1所乡小学和2所村小学,以触诊和B超法同时检查8～10岁儿童甲状腺,同时检测尿碘;每个乡抽取2个村,每个村检测30户居民家庭食用盐含碘量,同时检测30名育龄妇女尿碘;搜索克汀病病例.结果调查居民碘盐,重庆市调查340户,碘盐覆盖率98.82%(336/340);林芝地区调查915户,碘盐覆盖率为66.34%(607/905),重庆市高于林芝地区(x2=139.56,P＜0.01).儿童甲状腺容积触诊和B超检查,重庆市儿童甲状腺肿大率分别为9.27%(89/960)和8.34%(61/731);林芝地区儿童甲状腺肿大率分别为7.80%(102/1308)和5.53%(69/1248),两地触诊法检查肿大率比较差异无统计学意义(x2=1.37,P＞0.05),B超法重庆市高于林芝地区(x2=5.51,P＜0.05);儿童尿碘中位数,重庆市为319.15μg/L,其中城口县为345.75μg/L,巫溪县为281.39 μg/L;林芝地区为189.81 μg/L,其中林芝县为207.81μg/L、波密县为161.12μg/L、米林县为131.83 μg/L、朗县为334.60μg/L;育龄妇女尿碘中位数重庆市为248.42μg/L,林芝地区为121.25μg/L,儿童和育龄妇女尿碘均以重庆市为高;重庆市和林芝地区均未发现新发克汀病病例.结论重庆市和林芝地区碘缺乏病高危地区儿童甲状腺肿大率降至10%以下,未发现新发克汀病,防治成效显著.重庆市存在碘过量;西藏林芝县和朗县儿童存在碘过量,妇女存在碘不足,其原因有待进一步调查,波密和米林均存在碘不足.重庆市应降低食盐加碘量,林芝地区在进一步调查基础上调整补碘措施.
목적 조사중경시여서장림지지구전결핍병고위지구병정현상,위제정예방공제방안제공의거.방법 2007년유국가통일제정방안병추양,중경시조사성구화무계현,서장림지지구조사림지、파밀、미림화랑현4개현;림지현추사5개향,기여현추사3개향;매개향추1소향소학화2소촌소학,이촉진화B초법동시검사8～10세인동갑상선,동시검측뇨전;매개향추취2개촌,매개촌검측30호거민가정식용염함전량,동시검측30명육령부녀뇨전;수색극정병병례.결과 조사거민전염,중경시조사340호,전염복개솔98.82%(336/340);림지지구조사915호,전염복개솔위66.34%(607/905),중경시고우림지지구(x2=139.56,P＜0.01).인동갑상선용적촉진화B초검사,중경시인동갑상선종대솔분별위9.27%(89/960)화8.34%(61/731);림지지구인동갑상선종대솔분별위7.80%(102/1308)화5.53%(69/1248),량지촉진법검사종대솔비교차이무통계학의의(x2=1.37,P＞0.05),B초법중경시고우림지지구(x2=5.51,P＜0.05);인동뇨전중위수,중경시위319.15μg/L,기중성구현위345.75μg/L,무계현위281.39 μg/L;림지지구위189.81 μg/L,기중림지현위207.81μg/L、파밀현위161.12μg/L、미림현위131.83 μg/L、랑현위334.60μg/L;육령부녀뇨전중위수중경시위248.42μg/L,림지지구위121.25μg/L,인동화육령부녀뇨전균이중경시위고;중경시화림지지구균미발현신발극정병병례.결론 중경시화림지지구전결핍병고위지구인동갑상선종대솔강지10%이하,미발현신발극정병,방치성효현저.중경시존재전과량;서장림지현화랑현인동존재전과량,부녀존재전불족,기원인유대진일보조사,파밀화미림균존재전불족.중경시응강저식염가전량,림지지구재진일보조사기출상조정보전조시.
Objective To investigate iodine deficiency disorders(IDD) in Chongqing and Linzhi, and to provide scientific basis for IDD control and prevention. Methods According to the national program developed in 2007, investigation was conducted in Chengkou and Wuxi county in Chongqing municipality, and Linzhi, Bomi,Milin and Langxian county in Linzhi prefecture. Five towns were sampled in Linzhi county, and 3 in other counties.In each town, one township primary school and two village primary schools were selected to inspect thyroid by B ultrasound and palpation, and urinary iodine of children aged 8 to 10 years was tested in these schools. Meanwhile,2 villages were selected in each town for test of salt iodine level and urinary iodine of childbearing age women and search cretin cases. Results Three hundred and forty families in Chongqing and 915 families in Linzhi were investigated. The coverage of iodized salt in Chongqing was 98.82%(336/340), which was significantly higher than that in Linzhi[66.34%(607/905), x2 = 139.56, P ＜ 0.01]. Goiter rate of children in Chongqing was 9.27%(89/960) by palpation and 8.34% (61/731) by B ultrasound, while goiter rate of children in Linzhi was 7.80%(102/1308) by palpation and 5.53% (69/1248) by B ultrasound. The difference of goiter rate by palpation between Chongqing and Linzhi was not statistically significant (x2 = 1.37, P ＞ 0.05 ). But goiter rate of children by B ultrasound in Chongqing was higher than that in Linzhi (x2= 5.51, P ＜ 0.05). In Chongqing, the median urinary iodine was 319.15 μg/L, and 345.75 μg/L in Chengkou county and 281.39 μg/L in Wuxi county. In Linzhi prefecture, the median urinary iodine was 189.81 μg/L, and 207.81 μg/L in Linzhi county, 161.12 μg/L in Bomi county, 131.83 μg/L in Milin county and 334.60 μg/L in Langxian county. The median urinary iodine in childbearing women were 248.42 μg/L in Chongqing and 121.25 μg/L in Linzhi. The median urinary iodine in Chongqing both in children and women were higher than those in Linzhi. No new cretin case was found in these two areas. Conclusions Goiter rate in high risk areas of IDD in Chongqing and Linzhi has decreased to less than 10%.No new cretin case is found in these areas. It can be concluded that the work of control and prevention is effective.There is excess iodine in Chongqing. In Linzhi county and Langxian county, iodine is excess in children and deficient in women. Further investigation should be conducted to find out the reason. Population iodine is excess in Bomi and Milin counties. The concentration of salt iodine should be decreased in Chongqing. In Linzhi prefecture,adding iodine measures should be adjusted based on further investigation.