河北省实施全民食盐碘化 10 年后碘缺乏病的控制情况。

Control of iodine deficiency disorders following 10-year universal salt iodization in Hebei Province of China.

机构信息

Hebei Provincial Centre for Disease Control and Prevention, Shijiazhuang 050021, Hebei, China.

出版信息

Biomed Environ Sci. 2009 Dec;22(6):472-9. doi: 10.1016/s0895-3988(10)60004-9.

DOI:10.1016/s0895-3988(10)60004-9

PMID:20337220

Abstract

OBJECTIVE

To evaluate the effectiveness of universal salt iodization (USI) for the control of IDD in Hebei province since it was implemented in 1995, identify the problems currently encountered in the implementation of USI and provide practical proposals for addressing these problems.

METHODS

Probability proportionate to size sampling (PPS) was employed in the surveillance of IDD, for which a total of 1200 school children aged 8-10 years were randomly selected from 30 counties around the whole province during each IDD survey. The iodine content of salt was determined quantitatively with the titration method. The iodine content of urinary samples was measured by the method of ammonium persulfate oxidation.

RESULTS

The coverage of iodized salt increased from 65.0% in 1995 to 98.0% in 1999, then decreased to 88.1% in 2005 which was below the national standard of 90%. The median urinary iodine of children aged 8-10 years varied between 160.1 microg/L and 307.4 microg/L, which was above the national standard. The proportion of urinary samples with iodine content above 300 microg/L was over 30% in 2005, implying exorbitant iodine nutrition among the children. The goiter rate (TGR) among children aged 8-10 years dropped from 11.8% in 1995 to 2.7% in 2005, indicating that the spread of endemic goiter was under control.

CONCLUSION

Preliminary elimination of IDD was achieved by USI in Hebei province. Nevertheless, some problems still existed in USI such as non-iodized salt competition, over iodization and un-standardized iodization. In order to address these problems, the management and supervision of salt market needs to be strengthened to prevent non-iodized salt from reaching households; updating equipment and modifying techniques are also necessary to ensure the quality of iodized salt; to clarify the causes of excessive urinary iodine content, the various sources of iodine from the diet need to be investigated in the future.

摘要

目的

评价河北省自 1995 年实施全民食盐碘化（USI）以来防治碘缺乏病（IDD）的效果，分析 USI 实施中存在的问题，为解决问题提供依据。

方法

采用按比例概率抽样（PPS）方法，对全省 30 个县的 8～10 岁学生进行IDD 监测，共检测 1200 名学生。盐碘含量采用滴定法定量检测，尿碘含量采用过硫酸铵消化-砷铈催化分光光度法测定。

结果

1995 年～1999 年碘盐覆盖率由 65.0%上升到 98.0%，2005 年降为 88.1%，低于 90%的国家标准。8～10 岁儿童尿碘中位数为 160.1μg/L～307.4μg/L，均高于国家标准。2005 年尿碘中位数大于 300μg/L 的儿童比例超过 30%，儿童碘营养处于过量水平。8～10 岁儿童甲状腺肿大率（TGR）由 1995 年的 11.8%降至 2005 年的 2.7%，表明IDD 已得到有效控制。