CAJ | 학술논문

目的了解新疆南疆地区碘缺乏病防治现状,掌握病情变化,评估防治效果.方法选择新疆南疆缺碘较为严重的和田地区洛浦县和克州地区阿克陶县的农村,选择8～ 10岁学龄儿童和育龄期妇女作为调查对象.采取现况调查与追溯历史资料调查相结合的方法,将专家分成克汀病临床诊断组、学校碘缺乏病调查组和入户碘缺乏病调查组,分别开展工作.对当地县疾控中心和乡医院经病例搜索出的疑似克汀病儿童(≤10岁)进行诊断.每个乡选择1所小学,调查100名8～ 10岁儿童,用B超法测定其甲状腺体积,测查智商,采集尿样检测尿碘含量.每个乡调查30名20 ～ 50岁育龄妇女,用触诊法检查甲状腺大小,采集尿样测定尿碘含量,用半定量法检测其家中盐样,并送实验室定量测定盐碘含量.每个乡采集水样测定水碘含量.结果 ①在洛浦县、阿克陶县未发现新发克汀病儿童;②洛浦县和阿克陶县8～ 10岁儿童尿碘中位数分别是201.6、174.2μg/L;B超法检查儿童甲状腺肿大率分别为0.5％(1/200)和3.5％(7/200);③洛浦县和阿克陶县8～ 10岁儿童平均智商分别是91.9和87.7;④洛浦县和阿克陶县20～50岁育龄期妇女尿碘中位数分别为163.9、192.3μg/L;⑤洛浦县和阿克陶县居民户碘盐覆盖率分别为96.7％和95.1％,居民合格碘盐食用率分别为91.7％(55/60)和85.2％(52/61),盐碘均数分别为25.9、24.8 mg/kg;⑥洛浦县和阿克陶县居民户饮用水含碘量最大值分别为3.27、3.60 μg/L.结论新疆南疆地区8～ 10岁儿童和育龄妇女碘缺乏病病情已得到有效控制,碘缺乏病防治效果显著.
목적 료해신강남강지구전결핍병방치현상,장악병정변화,평고방치효과.방법 선택신강남강결전교위엄중적화전지구락포현화극주지구아극도현적농촌,선택8～ 10세학령인동화육령기부녀작위조사대상.채취현황조사여추소역사자료조사상결합적방법,장전가분성극정병림상진단조、학교전결핍병조사조화입호전결핍병조사조,분별개전공작.대당지현질공중심화향의원경병례수색출적의사극정병인동(≤10세)진행진단.매개향선택1소소학,조사100명8～ 10세인동,용B초법측정기갑상선체적,측사지상,채집뇨양검측뇨전함량.매개향조사30명20 ～ 50세육령부녀,용촉진법검사갑상선대소,채집뇨양측정뇨전함량,용반정량법검측기가중염양,병송실험실정량측정염전함량.매개향채집수양측정수전함량.결과 ①재락포현、아극도현미발현신발극정병인동;②락포현화아극도현8～ 10세인동뇨전중위수분별시201.6、174.2μg/L;B초법검사인동갑상선종대솔분별위0.5％(1/200)화3.5％(7/200);③락포현화아극도현8～ 10세인동평균지상분별시91.9화87.7;④락포현화아극도현20～50세육령기부녀뇨전중위수분별위163.9、192.3μg/L;⑤락포현화아극도현거민호전염복개솔분별위96.7％화95.1％,거민합격전염식용솔분별위91.7％(55/60)화85.2％(52/61),염전균수분별위25.9、24.8 mg/kg;⑥락포현화아극도현거민호음용수함전량최대치분별위3.27、3.60 μg/L.결론 신강남강지구8～ 10세인동화육령부녀전결핍병병정이득도유효공제,전결핍병방치효과현저.
Objective In South Xinjiang,to understand the current preventive and control situation of iodine deficiency disorders (IDD),master the prevalence trend and assess the preventive and control effect.Methods In South Xinjiang,the investigation sites were selected in rural areas of Luopu and Aketao counties which located in Hotan and Kezhou Prefecture,respectively,and these places were severe iodine deficient areas.The investigation subjects were children aged 8-10 and women of child bearing age.The survey method was cross-section study combined with history data review.The project teams included the clinical diagnosis group of cretinism,the school IDD investigation group and the household IDD survey group,and these groups worked independently.The first group rechecked the doubtful cretinism(younger than 10) whom had been screened by local CDC and township hospital.The second group detected the thyroid volume by ultrasound,the Intelligence Quotient (IQ) and the urinary iodine of 100 children aged 8-10 from one primary school of each township.The last group randomly visited 30 women of child bearing age,palpated thyroid,sampled their urinary to test iodine,and collected their edible salt samples to detect iodine by semiquantitative method on the spot and quantitative method in the laboratory afterward.They also collected water samples in each township to test the water iodine.Results In Luopu and Aketao counties,① as for cretinism,no new patient was found; ② for 8-10 years old children,the medians of urinary iodine were 201.6,174.2 μg/L,respectively,and goiter rates were 0.5％(1/200) and 3.5％ (7/200),respectively; ③for 8-10 years old children,the Intelligence Quotients were 91.9 and 87.8,respectively; ④ for women of child bearing age of 20-50 years old,the medians of urinary iodine were 163.9,192.3 μg/L,respectively; ⑤ for iodized salt,the coverage rates were 96.7％(58/60) and 95.1％(58/61),the uptake rates of qualified iodized salt were 91.7％ (55/60) and 86.2％ (52/61),the means of salt iodine were 25.9,24.8 mg/kg,respectively; ⑥for drinking water,the maximum values of water iodine were 3.27,3.60 μg/L,respectively.Conclusion The IDD at present of 8-10 years old children and women of child bearing age in South Xinjiang has effectively controlled,prevention and control effect is obviously.