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[俄罗斯联邦的碘缺乏情况]

[Iodine deficiency in the Russian Federation].

作者信息

Dedov I I, Sviridenko N Iu

出版信息

Vestn Ross Akad Med Nauk. 2001(6):3-12.

Abstract

Epidemiological surveys for iodine deficiency (ID) were made in 30 regions of Russia in 1992 to 1999. A total of 40,999 individuals aged 7 to 17 years were examined. The advent of new assessments of the thyroid and new indicators of iodine deficiency has changed approaches to epidemiological surveys. The WHO standards for estimating the prevalence and severity of ID have been introduced into Russian practice. In Central Russia, the lowest (median 30-58 micrograms/l) iodine concentrations were found in rural dwellers; in more urbanized areas (cities, towns) the median was 50-78 micrograms/l. ID was more pronounced in the regions of East Russia where it was predominantly moderate (median 30-52 micrograms/l). In some areas, ID was severe (median 16-20 micrograms/l). As the severity of ID increases, the incidence of such conditions, as goiter, hypothyroidism, endemic cretinism is on the rise. Mild to moderate goiter endemia prevailed in Central Russia. The manifestations of goiter endemia were more pronounced in rural children (18-30%) than in urban ones (8-14%). East Russia was marked by moderate to severe goiter endemia (8-14%): the incidence of goiter ranged from 17 to 40%. There were only sporadic cases of goiter in some areas of the Sakhalin Region. In the Moscow and Voronezh Regions and the Republic of Kalmykia there were areas showing a high goiter incidence which did not correspond to the level of ID. An epidemiological analysis has indicated that dietary and water iodine intake is decreased in most regions of Russia. The actual dietary iodine intake was 40-80 micrograms/day, i.e. 2-3 times of the recommended allowance (150 micrograms). The Endocrinology Research Center has tested different models of preventive and therapeutical measures for eliminating iodine deficiency-caused diseases by using iodinated foodstuffs (salt, bread, butter) ad iodine medicaments.

摘要

1992年至1999年期间,在俄罗斯的30个地区开展了碘缺乏病的流行病学调查。共检查了40999名7至17岁的个体。甲状腺新评估方法和碘缺乏新指标的出现改变了流行病学调查方法。世卫组织估计碘缺乏病患病率和严重程度的标准已引入俄罗斯实践。在俄罗斯中部,农村居民碘浓度最低(中位数为30 - 58微克/升);在城市化程度较高的地区(城市、城镇),中位数为50 - 78微克/升。碘缺乏在俄罗斯东部地区更为明显,主要为中度(中位数为30 - 52微克/升)。在一些地区,碘缺乏严重(中位数为16 - 20微克/升)。随着碘缺乏严重程度的增加,甲状腺肿、甲状腺功能减退、地方性克汀病等疾病的发病率也在上升。俄罗斯中部地区以轻度至中度甲状腺肿流行为主。甲状腺肿流行在农村儿童(18 - 30%)中的表现比城市儿童(8 - 14%)更为明显。俄罗斯东部以中度至重度甲状腺肿流行(8 - 14%)为特征:甲状腺肿发病率在17%至40%之间。萨哈林地区的一些地区仅有散发性甲状腺肿病例。在莫斯科和沃罗涅日地区以及卡尔梅克共和国,存在一些甲状腺肿发病率高但与碘缺乏水平不相符的地区。一项流行病学分析表明,俄罗斯大多数地区的饮食和水中碘摄入量有所下降。实际饮食碘摄入量为40 - 80微克/天,即推荐摄入量(150微克)的2至3倍。内分泌学研究中心通过使用加碘食品(盐、面包、黄油)和碘药物,测试了消除碘缺乏病的不同预防和治疗措施模型。

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