目的调查2009年江苏省碘缺乏病病情现状,对江苏省食盐加碘近15年来可持续消除碘缺乏病防治效果进行评价,为相关政策调整提供科学依据。方法2009年,在江苏省除去高碘地区外,采用人口比例概率抽样方法(PPS)选取30个县(市、区),在每个县(市、区)抽取40名8—10岁儿童作为调查对象,采用触诊和B超法检测儿童甲状腺肿大情况并测定其尿碘,采集其家中食用盐样测定含碘量,同时进行智商检测。采用问卷对儿童和妇女进行健康教育调查。结果本次调查共检测1200名8—10岁儿童甲状腺,触诊法和B超法甲状腺肿大率分别为1.70%(20/1200)、1.00%(12/1200),甲状腺容积中位数为1.3ml;共检测1200份盐样,居民户碘盐覆盖率、合格碘盐食用率分别为97.5%(1170/1200)、94.5%(1134/1200);共检测598名8~10岁儿童尿样,尿碘中位数为325.3μg/L;598名8~10岁儿童智商为112A±13.2,智力低下比例占0.5%(3/598);636名学生及149名家庭妇女健康教育知晓率分别为95.9%(1830/1908)、9614%(431/447)。结论江苏省防治碘缺乏病效果显著,成绩稳固,建议应根据人群碘营养水平适时调整盐碘,监测时应考虑特需人群,可与以县为单位的碘盐监测有机结合开展。
Objective To evaluate the control effect of the policy sustainable elimination of iodine deficiency disorders on the disease status after 15 years salt iodization, and to provide a scientific basis for the relevant policy adjustments. Methods Probability sampling method(PPS) was used to select 30 counties in Jiangsu province(except those iodine excess areas), of each county 40 children aged 8 - 10 were selected as the investigation objects, their thyroids were examined by palpation and B ultrasound, urinary iodine(UI), household salt iodine, and intelligence quotient(IQ) were also investigated. A questionnaire-based health education survey of children and women was also conducted. Results A total of 1200 salt samples were detected and the coverage and qualified rates of iodized salt were 97.5% (1170/1200) and 94.5% (1134/1200), respectively. Five hundred and ninety eight urinary samples of children aged 8 to 10 were detected. The median urinary iodine was 325.3 p,g/L. Of 1200 children aged 8 to 10 examined, goiter was 1.70% (20/1200) by palpation and 1.00% (12/1200) by B ultrasound. Average IQ of those 598 children was 112.4 ± 13.2, and the proportion of mental retardation was 0.5% (3/598). The health education awareness were 95.9% (1830/1908) and 96.4% (431/447) for 636 students and 149 family women, respectively. Conclusions The control effect of iodine deficiency disorders is significant in Jiangsu province. Salt iodine concentration should be adapted to people's iodine nutritional status. Iodine nutrition needs of special population such as pregnant, lactation women and infants should be taking into account, and should also be combined with salt iodization status surveillance at county level.