中华地方病学杂志
中華地方病學雜誌
중화지방병학잡지
Chinese Journal of Endemiology
2013年
5期
529-532
,共4页
叶枫%张海涛%吴鹤松%王安伟%李加国%马琳%张浩伟%郭玉熹%赵溯
葉楓%張海濤%吳鶴鬆%王安偉%李加國%馬琳%張浩偉%郭玉熹%趙溯
협풍%장해도%오학송%왕안위%리가국%마림%장호위%곽옥희%조소
碘缺乏病%监测%甲状腺容积%碘
碘缺乏病%鑑測%甲狀腺容積%碘
전결핍병%감측%갑상선용적%전
Iodine Deficiency Disorders%Surveillance%Thyroid volume%Iodine
目的 了解云南省碘缺乏病病情、居民碘营养水平及防治措施落实情况,为全省碘盐浓度调整提供科学依据.方法 按照《2011年度地方病防治项目实施方案》(中疾控地病发[2011]13号),采用按人口比例概率抽样(PPS)方法在云南省抽取30个项目县(市、区),收集各县(市、区)历史水碘资料,排除水碘大于150μg/L的乡镇.采用单纯随机抽样法,每个项目县(市、区)抽取1所行政村小学,每个小学抽取约40名8~ 10岁学生(非寄宿),进行甲状腺容积检查,并测定家中食用盐的碘含量;在所选学生中抽取12名采集尿样进行尿碘含量测定;在抽中学校的所在村(居委会),按东、西、南、北、中5个方位各抽取1份饮用水水样,如为集中式供水地区,则采集2份末梢水样进行水碘测定;每个项目县(市、区)选取3个乡镇,每个乡镇抽取孕妇和哺乳期妇女各约5人,进行尿碘检测.在全省未开展碘缺乏病病情监测的其他96个县(市、区),按东、西、南、北、中5个方位各抽取1个乡镇(不足5个乡时全部抽取),每个乡镇各抽取1所行政村小学,每所小学各抽取约20名8~ 10岁学生(非寄宿学生,男、女各半),采集尿样,检测尿碘.甲状腺容积的检测采用B超法;食用盐碘含量的测定采用直接滴定法;尿碘及水碘水平的检测采用砷铈催化分光光度法.结果 2011年云南省30个项目县(市、区),8~ 10岁学生甲状腺肿大率为1.8%(22/1207);盐碘中位数为29.9 mg/kg,碘含量的变异系数为22.8%,碘盐覆盖率为99.1%(1196/1207),碘盐合格率为96.1%(1149/1196),合格碘盐食用率为95.2%(1149/1207),其中1个县碘盐覆盖率<95.0%,3个县碘盐合格率<90.0%,4个县合格碘盐食用率<90.0%;儿童尿碘中位数为274.1 μg/L;水碘中位数为1.6 μg/L;孕妇和哺乳期妇女尿碘中位数分别为217.3、171.5μg/L.96个县8~ 10岁儿童尿碘中位数为259.0 μg/L.结论 云南省外环境普遍缺碘;碘盐含碘量相对比较均匀,碘盐供应较好;儿童碘营养水平整体上处于超适宜范围,食用盐碘含量有下调的空间.
目的 瞭解雲南省碘缺乏病病情、居民碘營養水平及防治措施落實情況,為全省碘鹽濃度調整提供科學依據.方法 按照《2011年度地方病防治項目實施方案》(中疾控地病髮[2011]13號),採用按人口比例概率抽樣(PPS)方法在雲南省抽取30箇項目縣(市、區),收集各縣(市、區)歷史水碘資料,排除水碘大于150μg/L的鄉鎮.採用單純隨機抽樣法,每箇項目縣(市、區)抽取1所行政村小學,每箇小學抽取約40名8~ 10歲學生(非寄宿),進行甲狀腺容積檢查,併測定傢中食用鹽的碘含量;在所選學生中抽取12名採集尿樣進行尿碘含量測定;在抽中學校的所在村(居委會),按東、西、南、北、中5箇方位各抽取1份飲用水水樣,如為集中式供水地區,則採集2份末梢水樣進行水碘測定;每箇項目縣(市、區)選取3箇鄉鎮,每箇鄉鎮抽取孕婦和哺乳期婦女各約5人,進行尿碘檢測.在全省未開展碘缺乏病病情鑑測的其他96箇縣(市、區),按東、西、南、北、中5箇方位各抽取1箇鄉鎮(不足5箇鄉時全部抽取),每箇鄉鎮各抽取1所行政村小學,每所小學各抽取約20名8~ 10歲學生(非寄宿學生,男、女各半),採集尿樣,檢測尿碘.甲狀腺容積的檢測採用B超法;食用鹽碘含量的測定採用直接滴定法;尿碘及水碘水平的檢測採用砷鈰催化分光光度法.結果 2011年雲南省30箇項目縣(市、區),8~ 10歲學生甲狀腺腫大率為1.8%(22/1207);鹽碘中位數為29.9 mg/kg,碘含量的變異繫數為22.8%,碘鹽覆蓋率為99.1%(1196/1207),碘鹽閤格率為96.1%(1149/1196),閤格碘鹽食用率為95.2%(1149/1207),其中1箇縣碘鹽覆蓋率<95.0%,3箇縣碘鹽閤格率<90.0%,4箇縣閤格碘鹽食用率<90.0%;兒童尿碘中位數為274.1 μg/L;水碘中位數為1.6 μg/L;孕婦和哺乳期婦女尿碘中位數分彆為217.3、171.5μg/L.96箇縣8~ 10歲兒童尿碘中位數為259.0 μg/L.結論 雲南省外環境普遍缺碘;碘鹽含碘量相對比較均勻,碘鹽供應較好;兒童碘營養水平整體上處于超適宜範圍,食用鹽碘含量有下調的空間.
목적 료해운남성전결핍병병정、거민전영양수평급방치조시락실정황,위전성전염농도조정제공과학의거.방법 안조《2011년도지방병방치항목실시방안》(중질공지병발[2011]13호),채용안인구비례개솔추양(PPS)방법재운남성추취30개항목현(시、구),수집각현(시、구)역사수전자료,배제수전대우150μg/L적향진.채용단순수궤추양법,매개항목현(시、구)추취1소행정촌소학,매개소학추취약40명8~ 10세학생(비기숙),진행갑상선용적검사,병측정가중식용염적전함량;재소선학생중추취12명채집뇨양진행뇨전함량측정;재추중학교적소재촌(거위회),안동、서、남、북、중5개방위각추취1빈음용수수양,여위집중식공수지구,칙채집2빈말소수양진행수전측정;매개항목현(시、구)선취3개향진,매개향진추취잉부화포유기부녀각약5인,진행뇨전검측.재전성미개전전결핍병병정감측적기타96개현(시、구),안동、서、남、북、중5개방위각추취1개향진(불족5개향시전부추취),매개향진각추취1소행정촌소학,매소소학각추취약20명8~ 10세학생(비기숙학생,남、녀각반),채집뇨양,검측뇨전.갑상선용적적검측채용B초법;식용염전함량적측정채용직접적정법;뇨전급수전수평적검측채용신시최화분광광도법.결과 2011년운남성30개항목현(시、구),8~ 10세학생갑상선종대솔위1.8%(22/1207);염전중위수위29.9 mg/kg,전함량적변이계수위22.8%,전염복개솔위99.1%(1196/1207),전염합격솔위96.1%(1149/1196),합격전염식용솔위95.2%(1149/1207),기중1개현전염복개솔<95.0%,3개현전염합격솔<90.0%,4개현합격전염식용솔<90.0%;인동뇨전중위수위274.1 μg/L;수전중위수위1.6 μg/L;잉부화포유기부녀뇨전중위수분별위217.3、171.5μg/L.96개현8~ 10세인동뇨전중위수위259.0 μg/L.결론 운남성외배경보편결전;전염함전량상대비교균균,전염공응교호;인동전영양수평정체상처우초괄의범위,식용염전함량유하조적공간.
Objective To study the situation of iodine deficiency disorders (IDD),iodine nutrition status and implementation of preventive measures in Yunnan Province,and to provide a scientific basis for adjusting the iodine content in salt.Methods The surveillance had been carried out based on the implementation plan of "2011 Endemic Diseases Control & Prevention Project".Thirty counties (cities,districts) were selected by the method of population probability sampling (PPS).Historical water iodine data were collected in each county (city,district),which excluded the township where the water iodine was higher than 150 μg/L.Using simple random sampling method,1 administrative village primary school was selected in each county(city,district).About 40(8-10 years old) students(non boarding) from the primary school were randomly selected to test the thyroid volume and the edible salt iodine.The urinary iodine(UI) of 12 students who were randomly selected from the 40 students was tested.In the village(neighborhood),5 drinking water samples were selected according to their sub-area positions in the north,the south,the east,the west and the center of the village,and in centralized water supply area,2 tap water samples were collected to test the water iodine.Three townships were selected from each county(city,district),5 pregnant women and 5 lactating women were selected from each township to test UI.In other 96 counties(cities,districts),5 townships were randomly selected according to their sub-area positions in the north,the south,the east,the west and the center of the county (selected all if less than 5 townships).One administrative village primary school.was randomly selected from each township,about 20(about 8-10 year olds,non boarding,half male and half female) students were randomly selected from each primary school to test UI.The thyroid volume was determined by type-B ultrasound method.The salt iodine content was measured by sodium subsulfite method.Both UI and water iodine contents were determined by As3--Ce4+ catalytic spectrophotometry.Results The goiter rate of children aged 8-10 years was 1.8%(22/1207) in the 30 counties in 2011.The median of salt iodine was 29.9 mg/kg.The coefficient variation(CV) of salt iodine was 22.8%.The iodized salt coverage rate was 99.1% (1196/1207).The qualified rate of iodized salt and qualified iodized salt coverage rate was 96.1% (1149/1196) and 95.2% (1149/1207),respectively.The iodized salt coverage rate that lower than 95.0% was found only in 1 county.The qualified rate of iodized salt that lower than 90.0% was found in 3 counties.The qualified iodized salt coverage rate that less than 90.0% was found in 4 counties.The median of urinary iodine(MUI) of children was 274.1 μg/L.The median of water iodine content was 1.6 μg/L.The MUI of pregnant women was 217.3 μg/L.The MUI of lactation women was 171.5 μg/L.In 96 counties,the MUI of the students aged 8-10 years was 259.0 μg/L.Conclusions Iodine deficiency of external environment is universal in Yunnan Province.The iodine content in iodized salt is relatively uniform.The children's iodine nutrition status exceeds an appropriate level in Yunnan Province on the whole and the iodine content of salt should be reduced properly.