目的 了解囊谦县8~ 10岁寄宿学生和走读学生碘缺乏病流行情况,为制定预防控制策略提供依据.方法 2012年抽取青海省囊谦县10个乡镇中心学校的8~ 10岁儿童,采集即时尿样,采用砷铈催化分光光度法检测尿碘;采用B超进行甲状腺容积检测;联合型瑞文(CRT-C2)智力测量表进行智商(IQ)测验.结果 共对553名儿童进行尿碘测定,其中寄宿学生203人,尿碘中位数为133.2 μg/L,尿碘<100 μg/L的占32.0%(65/203);走读学生350人,尿碘中位数为70.4 μg/L,尿碘<100 μg/L的占71.1%(249/350),寄宿学生和走读学生尿碘比较差异有统计学意义(Z=-6.947,P<0.05);对449名儿童进行了甲状腺容积的检查,其中走读学生272人,甲状腺肿大6人,肿大率为2.2%,寄宿学生177人,甲状腺肿大4人,肿大率为2.3%;对220名儿童进行了智商测验,其中寄宿学生110人,IQ均值为82.29,分数<69的占15.5%(17/110);走读学生110人,IQ均值为82.07,分数<69的占12.7%(14/110).结论 囊谦县寄宿学生和走读学生之间碘营养水平有明显差异;虽然学生尿碘水平低,甲状腺肿大率亦低,凸显了碘缺乏病在该地区流行的特殊性.碘缺乏虽然没有造成明显的甲状腺肿大,但其导致的智力损伤不容忽视.
Objective To master epidemiological condition of iodine nutrition among 8-10 years old school children in Nangqian County,and to provide evidence for making prevention and control strategy.Methods In 2012,students aged 8-10 from the center school in 10 towns of Nangqian County were selected,and instant urinary samples were collected and the urinary iodine was detected with As-Ce catalytic spectrophotometry method,the thyroid volume was measured with B ultrasonic method and IQ test with Combined Raven Test-C2 (CRT-C2).Results Urinary iodine of 553 children were detected,the urinary iodine median of 203 boarding students was 133.2 μg/L,among these,under 100 μg/L was 32.0% (65/203); while the urinary iodine median of 350 commuting students was 70.4 μg/L,under 100 μg/L was 71.1% (249/350),and the difference of the urinary iodine median between boarding students and commuting students was statistically significant (Z =-6.947,P < 0.05); among 499 school children,thyroid rate of the commuting students and the boarding students was 2.2% and 2.3%,respectively;220 school children were taken IQ test with Combined Raven Test-C2 (CRT-C2),average points of IQ tests in boarding students was 82.29,and 15.5% (17/110) less than 69 points; average points of IQ tests in commuting students was 82.07,and 12.7% (14/110) less than 69 points.Conclusions The difference of the iodine nutrition level between boarding students and commuting students was statistically significant.Coverage rate of iodized salt,urinary iodine levels and thyroid rate are low in Nangqian County,which highlights the epidemiological features of iodine deficiency disorders in this region.Although,iodine deficiency does not cause obvious goiter,intelligence harm should not be ignored.