CAJ | 학술논문

目的了解山西省水源性高碘地区居民碘营养及儿童甲状腺肿大病情现状,为建立和完善水源性高碘地区的长效防治工作机制提供科学依据.方法 2012年,根据碘缺乏病监测历史资料,在山西省选择10个高碘县(市、区),每个县(市、区)按东、西、南、北、中各抽取1个高碘乡镇(不足5个则全部抽取),每个乡镇抽取4个村,每个村抽取15个居民户,采集家中食用盐盐样,检测盐碘.在10个高碘县(市、区)中选择5个高碘县(市、区),每个县(市、区)各选择1或2个村,采集居民户饮用水水样,测定水碘;在每个村小学,抽取100名8～10岁儿童检查甲状腺,并抽取其中30名,检测尿碘含量.结果在10个高碘县(市、区),共检测居民食用盐1 680份,无碘食盐率为85.2％(1 432/1 680).在5个高碘县(市、区)的6个村中,共检测儿童尿样256份,尿碘中位数为487.2μg/L.其中,3个已改水村和3个未改水村的儿童尿碘中位数分别为271.0、692.6 μg/L,未改水村儿童尿碘碘过量(≥300 μg/L)比例[85.8％(139/162)]高于已改水村[41.5％(39/94),x2=53.06,P＜0.05];共对591名8～ 10岁儿童进行了甲状腺检查,甲状腺肿大率为6.6％(39/591),已改水村甲状腺肿大率[3.8％(11/291)]低于未改水村[9.3％(28/300),x2=6.52,P＜0.05].结论山西省高碘地区居民停供碘盐后碘营养水平总体上仍然过量,儿童甲状腺肿大病情尚未得到有效控制;改水降碘是控制高碘病情的根本途径.
목적 료해산서성수원성고전지구거민전영양급인동갑상선종대병정현상,위건립화완선수원성고전지구적장효방치공작궤제제공과학의거.방법 2012년,근거전결핍병감측역사자료,재산서성선택10개고전현(시、구),매개현(시、구)안동、서、남、북、중각추취1개고전향진(불족5개칙전부추취),매개향진추취4개촌,매개촌추취15개거민호,채집가중식용염염양,검측염전.재10개고전현(시、구)중선택5개고전현(시、구),매개현(시、구)각선택1혹2개촌,채집거민호음용수수양,측정수전;재매개촌소학,추취100명8～10세인동검사갑상선,병추취기중30명,검측뇨전함량.결과 재10개고전현(시、구),공검측거민식용염1 680빈,무전식염솔위85.2％(1 432/1 680).재5개고전현(시、구)적6개촌중,공검측인동뇨양256빈,뇨전중위수위487.2μg/L.기중,3개이개수촌화3개미개수촌적인동뇨전중위수분별위271.0、692.6 μg/L,미개수촌인동뇨전전과량(≥300 μg/L)비례[85.8％(139/162)]고우이개수촌[41.5％(39/94),x2=53.06,P＜0.05];공대591명8～ 10세인동진행료갑상선검사,갑상선종대솔위6.6％(39/591),이개수촌갑상선종대솔[3.8％(11/291)]저우미개수촌[9.3％(28/300),x2=6.52,P＜0.05].결론 산서성고전지구거민정공전염후전영양수평총체상잉연과량,인동갑상선종대병정상미득도유효공제;개수강전시공제고전병정적근본도경.
Objective To investigate the nutritional status of iodine among residents and the goiter disease of children in high water iodine areas in Shanxi Province,and to provide a scientific basis for establishment of longlasting control strategies and measures.Methods In 2012,according to the historical monitoring data,in the 10 high water iodine counties (citys,districts),one town was selected based on its location (east,west,south,north and middle) in each county (citie,district).In county (city,district) with 5 townships or less,all townships were selected.Four villages were selected in each township and fifteen residents in each village were selected to test salt iodine level.In five high water iodine counties (city,district),one or two high water iodine villages were selected,water samples were collected and the iodine content was measured; one hundred students aged 8-10 years old were chosen to examine their thyroid size.Thirty children were chosen from above students to collect their urine samples and to determine the iodine content.Results In 10 high water iodine counties (citys,districts),1 680 salt samples were tested.The rate of non-iodized salt was 85.2％ (1 432/1 680); in six villages of five high water iodine counties (citys,districts),the median of urinary iodine of 256 children aged 8 to 10 was 487.2 μg/L; in three villages which had improved the quality of water,the median of urinary iodine was 271.0 μg/L; other three villages which had not improved the quality of water,the median of urinary iodine was 692.6 μg/L.In those villages which had not improved the quality of water,urinary iodine of children ≥300 μg/L accounted for 85.8％ (139/162); in those villages which had improved the quality of water,high urinary iodine of children accounted for 41.5％ (39/94),and the difference was statistically significant (x2 =53.06,P ＜ 0.05).The thyroid was investigated among 591 children aged 8-10 years old,and the goiter rate was 6.6％(39/591).In those villages which had improved the quality of water,the goiter rate of children was 3.8％ (11/291),but in villages which had not improved the quality of water,the goiter rate of children was 9.3％ (28/300),and the difference was statistically significant (x2 =6.52,P ＜ 0.05).Conclusion The iodine nutrition level of residents in high water iodine areas in Shanxi is excessive,children's goiter disease has not been effectively controlled; water improvement to reduce iodine is the basic way to control the disease of high iodine.