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目的:了解食盐加碘对碘缺乏危害干预效果,为政府确定适宜的碘盐浓度提供科学依据。方法:按容量比例概率抽样法,选取东西南北中5个方位,每个方位随机抽取1所小学与4个村,监测对象为8～10岁儿童和居民户。触诊法、B超法检查甲状腺;砷铈催化分光光度法测定尿碘;直接滴定法测定盐碘。评价技术指标:居民户合格碘盐食用率;甲状腺肿大率;尿碘中位数;碘缺乏病防治知识知晓率。结果:干预前,1995年8～10岁儿童甲状腺肿大率为12.50%,尿碘均值为79.34μg/L,水碘几何均值14.35μg/L,人体内、外环境轻度缺碘。干预后,1996-2011年检测居民户食用盐3 690份,合格碘盐食用率为92.55%;2011年调查1 272人日,人日均碘盐消耗量6.88g,标准差1.72,总体均数95%可信限3.51～10.25g。1996-2011年触诊8 781人,甲状腺肿大523人,肿大率为5.28%,呈下降趋势(χ2=15.34,P<0.001);儿童尿碘中位数为196.10μg/L,平均尿碘高于1995年(χ2=17.91,P<0.001);2010年碘缺乏病防治知识问卷调查4～5年级学生141人,知晓率为97.87%;家庭主妇45人,知晓率为100%。结论:该地区碘缺乏病防治效果显著,达到国家消除碘缺乏病标准;儿童尿碘水平保持在相对适宜状态。按照国家“因地制宜、分类指导、科学补碘”的原则,各地的盐碘含量应根据人体内、外环境缺碘程度适当调整。
Objective: To understand the effect of iodized salt on the harm of iodine deficiency, and provide a scientific basis for the government to determine the suitable concentration of iodized salt. Methods: According to the method of probabilistic sampling of capacity, five orientations were selected. One primary school and four villages were randomly selected for each orientation. The monitoring objects were children aged 8 to 10 and residents. Palpation, thyroid by B-ultrasonography; arsenic cerium catalytic spectrophotometric determination of urinary iodine; direct titration salt iodine. Evaluation of technical indicators: Households qualified iodized salt consumption rate; Goiter rate; Urinary iodine median; Knowledge of prevention of iodine deficiency disorders awareness. Results: Before the intervention, the rate of goiter in children aged 8-10 years was 12.50% in 1995, the average urinary iodine was 79.34μg / L, the geometric mean of water iodine was 14.35μg / L, and the human body had a slight iodine deficiency in the external environment. After the intervention, 3 690 household salt samples were tested during 1996-2011, and the qualified iodized salt consumption rate was 92.55%. In 2011, 1,272 person-days were surveyed, with daily average iodized salt consumption of 6.88 g and standard deviation of 1.72. The overall average 95% confidence limits 3.51 ~ 10.25g. There were 8 781 palpated patients with 523 cases of goiter during 1996-2011. The swelling rate was 5.28%, showing a decreasing trend (χ2 = 15.34, P <0.001). The median urinary iodine in children was 196.10 μg / L with average urine Iodine was higher than that in 1995 (χ2 = 17.91, P <0.001). In 2010, knowledge of prevention and treatment of iodine deficiency disorders was used to investigate 141 students in grades 4 to 5 with a awareness rate of 97.87% and 45 housewives with a knowledge rate of 100%. Conclusion: The control effect of iodine deficiency disorders in this area is remarkable, reaching the national standard of eliminating iodine deficiency disorders. Urinary iodine levels in children remain relatively suitable. According to the principle of “adjusting to local conditions, guiding by categories, and scientific supplementing iodine”, salt iodine content in different places should be properly adjusted according to the degree of iodine deficiency in the body and external environment.