目的 评价广东省碘缺乏病防治效果及碘营养状况.方法 于2011年,在广东省按人口比例概率抽样法抽取30个县(市、区),从每个县(市、区)中各抽取1个乡镇(街道),每个乡镇(街道)中抽取1所小学,每个小学抽取8～ 10岁儿童40名检查甲状腺及采集家中盐样,用于盐碘测定.从40名儿童中,抽取12名儿童,采集尿样,用于尿碘测定.在抽中的小学校,抽取5年级学生40人进行智商(IQ)测验.在小学校附近,选择3个乡(镇、街道),每个乡(镇、街道)抽取孕妇和哺乳妇女各5人,采集尿样用于尿碘测定.甲状腺检查采用B超法;盐碘测定采用直接滴定法;尿碘采用砷铈催化分光光度方法测定;IQ测验采用中国联合型瑞文试验进行.根据地理位置和碘盐落实情况,分析平原及珠三角沿海轻度缺碘地区(碘盐落实地区,简称平原及珠三角)、历史病区(碘盐落实地区)和粤东粤西沿海地区(非碘盐问题地区,简称粤东粤西)的碘缺乏病防治效果.结果 检查8～ 10岁儿童1200名,甲状腺肿大率为3.5％(42/1200),不同地理位置儿童甲状腺肿大率比较差异有统计学意义(x2=6.6,P＜0.05),其中粤东粤西儿童甲状腺肿大率(6.1％)明显高于平原及珠三角和历史病区(3.3％、2.0％,x2值分别为5.6、7.1,P均＜0.05).共采集盐样1200份,盐碘均数为31.0 mg/kg,变异系数为23.2％,碘盐覆盖率为97.5％(1170/1200),合格碘盐食用率为96.1％(1153/1200).1200名8～ 10岁儿童尿碘中位数为186.5μg/L,不同地理位置儿童尿碘中位数比较差异有统计学意义(x2=5.9,P＜0.05),其中粤东粤西(162.4 μg/L)儿童尿碘中位数明显低于平原及珠三角(207.5 μg/L,x2=8.7,P＜0.01).孕妇和哺乳期妇女尿碘中位数比较差异有统计学意义(x2=58.9,P＜0.01),其中粤东粤西孕妇和哺乳期妇女尿碘(109.6 μg/L)明显低于历史病区和平原及珠三角(152.9、155.2μg/L,x2值分别为18.3、20.6,P均＜0.05).1208名5年级学生IQ平均值为102.8±14.3,其中平原及珠三角(104.3±13.9)和历史病区(102.7±14.3)学生IQ高于粤东粤西(100.3±14.7,t值分别为3.8、2.1,P＜0.01或＜0.05).结论 广东省碘缺乏病防治效果显著,实现了消除碘缺 乏病目标.普通人群碘营养处于适宜范围,但孕妇碘营养偏低,特别是受非碘盐冲销的粤东粤西应引起重点关注.
目的 評價廣東省碘缺乏病防治效果及碘營養狀況.方法 于2011年,在廣東省按人口比例概率抽樣法抽取30箇縣(市、區),從每箇縣(市、區)中各抽取1箇鄉鎮(街道),每箇鄉鎮(街道)中抽取1所小學,每箇小學抽取8～ 10歲兒童40名檢查甲狀腺及採集傢中鹽樣,用于鹽碘測定.從40名兒童中,抽取12名兒童,採集尿樣,用于尿碘測定.在抽中的小學校,抽取5年級學生40人進行智商(IQ)測驗.在小學校附近,選擇3箇鄉(鎮、街道),每箇鄉(鎮、街道)抽取孕婦和哺乳婦女各5人,採集尿樣用于尿碘測定.甲狀腺檢查採用B超法;鹽碘測定採用直接滴定法;尿碘採用砷鈰催化分光光度方法測定;IQ測驗採用中國聯閤型瑞文試驗進行.根據地理位置和碘鹽落實情況,分析平原及珠三角沿海輕度缺碘地區(碘鹽落實地區,簡稱平原及珠三角)、歷史病區(碘鹽落實地區)和粵東粵西沿海地區(非碘鹽問題地區,簡稱粵東粵西)的碘缺乏病防治效果.結果 檢查8～ 10歲兒童1200名,甲狀腺腫大率為3.5％(42/1200),不同地理位置兒童甲狀腺腫大率比較差異有統計學意義(x2=6.6,P＜0.05),其中粵東粵西兒童甲狀腺腫大率(6.1％)明顯高于平原及珠三角和歷史病區(3.3％、2.0％,x2值分彆為5.6、7.1,P均＜0.05).共採集鹽樣1200份,鹽碘均數為31.0 mg/kg,變異繫數為23.2％,碘鹽覆蓋率為97.5％(1170/1200),閤格碘鹽食用率為96.1％(1153/1200).1200名8～ 10歲兒童尿碘中位數為186.5μg/L,不同地理位置兒童尿碘中位數比較差異有統計學意義(x2=5.9,P＜0.05),其中粵東粵西(162.4 μg/L)兒童尿碘中位數明顯低于平原及珠三角(207.5 μg/L,x2=8.7,P＜0.01).孕婦和哺乳期婦女尿碘中位數比較差異有統計學意義(x2=58.9,P＜0.01),其中粵東粵西孕婦和哺乳期婦女尿碘(109.6 μg/L)明顯低于歷史病區和平原及珠三角(152.9、155.2μg/L,x2值分彆為18.3、20.6,P均＜0.05).1208名5年級學生IQ平均值為102.8±14.3,其中平原及珠三角(104.3±13.9)和歷史病區(102.7±14.3)學生IQ高于粵東粵西(100.3±14.7,t值分彆為3.8、2.1,P＜0.01或＜0.05).結論 廣東省碘缺乏病防治效果顯著,實現瞭消除碘缺 乏病目標.普通人群碘營養處于適宜範圍,但孕婦碘營養偏低,特彆是受非碘鹽遲銷的粵東粵西應引起重點關註.
목적 평개광동성전결핍병방치효과급전영양상황.방법 우2011년,재광동성안인구비례개솔추양법추취30개현(시、구),종매개현(시、구)중각추취1개향진(가도),매개향진(가도)중추취1소소학,매개소학추취8～ 10세인동40명검사갑상선급채집가중염양,용우염전측정.종40명인동중,추취12명인동,채집뇨양,용우뇨전측정.재추중적소학교,추취5년급학생40인진행지상(IQ)측험.재소학교부근,선택3개향(진、가도),매개향(진、가도)추취잉부화포유부녀각5인,채집뇨양용우뇨전측정.갑상선검사채용B초법;염전측정채용직접적정법;뇨전채용신시최화분광광도방법측정;IQ측험채용중국연합형서문시험진행.근거지리위치화전염락실정황,분석평원급주삼각연해경도결전지구(전염락실지구,간칭평원급주삼각)、역사병구(전염락실지구)화월동월서연해지구(비전염문제지구,간칭월동월서)적전결핍병방치효과.결과 검사8～ 10세인동1200명,갑상선종대솔위3.5％(42/1200),불동지리위치인동갑상선종대솔비교차이유통계학의의(x2=6.6,P＜0.05),기중월동월서인동갑상선종대솔(6.1％)명현고우평원급주삼각화역사병구(3.3％、2.0％,x2치분별위5.6、7.1,P균＜0.05).공채집염양1200빈,염전균수위31.0 mg/kg,변이계수위23.2％,전염복개솔위97.5％(1170/1200),합격전염식용솔위96.1％(1153/1200).1200명8～ 10세인동뇨전중위수위186.5μg/L,불동지리위치인동뇨전중위수비교차이유통계학의의(x2=5.9,P＜0.05),기중월동월서(162.4 μg/L)인동뇨전중위수명현저우평원급주삼각(207.5 μg/L,x2=8.7,P＜0.01).잉부화포유기부녀뇨전중위수비교차이유통계학의의(x2=58.9,P＜0.01),기중월동월서잉부화포유기부녀뇨전(109.6 μg/L)명현저우역사병구화평원급주삼각(152.9、155.2μg/L,x2치분별위18.3、20.6,P균＜0.05).1208명5년급학생IQ평균치위102.8±14.3,기중평원급주삼각(104.3±13.9)화역사병구(102.7±14.3)학생IQ고우월동월서(100.3±14.7,t치분별위3.8、2.1,P＜0.01혹＜0.05).결론 광동성전결핍병방치효과현저,실현료소제전결 핍병목표.보통인군전영양처우괄의범위,단잉부전영양편저,특별시수비전염충소적월동월서응인기중점관주.
Objective To assess the effectiveness of prevention program on iodine deficiency disorders and iodine nutritional status of residents in Guangdong Province.Methods Probability proportionate to size sampling(PPS) was employed in surveillance of iodine deficiency disorders.Thirty counties(cities,districts) were selected in Guangdong Province.In each county(city,district) one township(street) was selected; in each township (street) one primary school was selected and in each primary school 40 children aged 8-10 were chosen to examine their thyroid and to collect salt samples at their home for determination of salt iodine.Out of the 40 children,12 children were chosen to collect urine samples for determination of urinary iodine.From the primary schools chosen,40 grade 5 students were selected for intelligence quotient(IQ) test.In the nearby of the primary schools,3 townships(towns,street) were selected and in each township(town,street) 5 pregnant and 5 lactating women were selected to collect their urine samples for determination of urinary iodine.Type-B ultrasonic was used in measuring the thyroid volume.The iodine content of urine samples was measured by the method of arsenic and cerium catalysis spectrophotometry.The iodine content of salt was determined quantitatively with the titration method.IQ was tested by Chinese combined Raven's test.According to geographical location and the implementation of iodized salt,the effects of iodized salt on iodine deficiency disorders were analyzed in the plains and the Pearl River Delta Coastal region with mild iodine deficiency(iodized salt implementation region,referred to as the plains and the PRD),historical iodine deficiency areas (iodized implementation region) and the eastern and the western coastal areas of Guangdong(areas with non-iodized salt problem,referred to as the eastern and the western Guangdong).Results A total of 1200 children aged 8 to 10 were examined by type-B ultrasonic test,and goiter rate was 3.5％ (42/1200).The differences of goiter rate between the plains and the PRD,the historical iodine deficiency areas and the eastern and the western Guangdong were statistically significant (x2 =6.6,P ＜ 0.05).The goiter rate (6.1％) in the eastern and the western Guangdong was significantly higher than that of the plains and the PRD and the historical iodine deficiency areas (3.3％,2.0％,x2 =5.6,7.1,all P ＜ 0.05).A total of 1200 salt samples were examined.The median and coefficient of variation of iodine in the salt were 31.0 mg/kg and 23.2％,respectively.Coverage of iodized salt was 97.5％(1170/1200) while 96.1％(1153/1200) of consumed iodized salt was qualified.The median urinary iodine of 1200 children aged 8-10 was 186.5 μg/L,and the differences of median urinary iodine between the plains and the PRD,the historical iodine deficiency areas and the eastern and the western Guangdong were statistically significant(x2 =5.9,P ＜ 0.05).The median urinary iodine of the eastern and the western Guangdong(162.4 μg/L) was significantly lower than that of the plains and the PRD(207.5 μg/L,x2 =8.7,P ＜ 0.01).The difference of median urinary iodine between the plains and the PRD,the historical iodine deficiency areas and the eastern and the western Guangdong was statistically significant(x2 =58.9,P＜ 0.01).The median urinary iodine of the eastern and the western Guangdong(109.6 μg/L) was significantly lower than that of the historical iodine deficiency areas and the plains and the PRD(152.9,155.2 μg/L,x2 =18.3,20.6,all P ＜ 0.05).The mean IQ of the 1208 grade 5 students was 102.8 ± 14.3.The IQ of the plains and the PRD(104.3 ± 13.9) and the historical iodine deficiency areas(102.7 ± 14.3) was significantly higher than that of the eastern and the western Guangdong(100.3 ± 14.7,t =3.8,2.1,P＜ 0.01 orP＜ 0.05).Conclusions The goal of iodine deficiency disorders elimination is achieved as scheduled in Guangdong Province.The health level of general population has been improved significantly.Iodine nutrition is in the appropriate range (100-199 μg/L) in general population but low in pregnant women.The selling of non-iodized salt in the eastern and the western Guangdong Province should be followed closely.
