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陕西省富平县刘集镇疑似高碘性甲状腺肿病区调查结果分析

Analysis of a survey results of patients with suspected high iodine goiter in Liuji Town Fuping County of Shaanxi Province

摘要:

目的 调查疑似高碘性甲状腺肿病例,确定陕西省富平县刘集镇是否为饮水型高碘性甲状腺肿病区.方法 触诊法普查陕西省富平县刘集镇6333名7~15岁儿童甲状腺.采集刘集镇所辖23个村和3所小学校居民生活饮用水各1份,用硫酸砷铈催化分光光度法测定含碘量,离子电极法测定含氟量,乙二胺四乙酸二钠滴定法测定含钙量,百里酚分光光度法测定含硝酸盐量.采集刘集镇所辖3所小学校60名7~15岁儿童尿样,用硫酸砷铈催化分光光度法测定含碘量,采集3所小学校儿童家中食用盐样188份,用直接滴定法检测含碘量.另按水碘< 100、100~、200~、300~、≥400μg/L分为5组,按水氟<1.0、1.0~、1.5~、≥2.0 mg/L分为4组,按水中硝酸盐含量分为超标组(> 20 mg/L)和未超标组(≤20 mg/L),分别进行甲状腺肿大率组间比较.结果 刘集镇7~15岁儿童甲状腺肿大率为30.06%(1904/6333);尿碘中位数为1013.13 μg/L,>500μg/L的比例占76.67% (46/60);水碘中位数为450.34 μg/L;儿童甲状腺肿大率随着水碘升高而呈先降后升趋势[36.84%(91/247)、28.38%(573/2019)、24.73%(294/1189)、31.64% (205/648)、33.23%(741/2230),x2=9.52,P< 0.05],随着水氟升高而降低[35.36%(93/263)、32.94%(533/1618)、29.79%(914/3068)、26.30% (364/1384),x2=19.21,P< 0.01],而与水中硝酸盐含量无关[29.04% (966/3326)、31.19% (938/3007),x2=3.47,P>0.05].结论 根据调查结果,陕西省富平县刘集镇是陕西省第一个确定的地方性饮水型高碘甲状腺肿病区.

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abstracts:

Objective To survey the suspected patients with high iodine goiter in Liuji Town Fuping County of Shaanxi Province.Methods Totally 6333 students aged 7 to 15 were examined their thyroid by the palpation method at Liuji Town.One copy of drinking water sample was collected in the 23 villages and three schools under jurisdiction of Liuji Town.Iodine,fluorine,calcium and nitrate content in the water were determined by cerium sulfate catalytic spectrophotometry,fluoride ion electrode,EDTA titration and thymol spectrophotometry,respectively.Iodine levels of 60 student's urine samples and 188 copies of household salt samples were determined.The research was divided into 5 groups according to the water iodine level of < 100,100-,200-,300-and ≥400 μg,/L; into 4 groups according to the water fluoride level of < 1.0,1.0-,1.5-and ≥2.0 mg/L; into 2 groups(> 20 mg/L and ≤20 mg/L groups,respectively) according to the levels of water nitrate,and goiter rate was compared between groups.Results Goiter rate of the students was 30.06% (1904/6333),the median of urinary iodine level was 1013.13 μg/L,of which proportions of more than 500 μg/L accounted for 76.67% (46/60).The median water iodine level was 450.34 μg/L.Student's goiter rate first decreased and then increased [36.84%(91/247),28.38%(573/2019),24.73%(294/1189),31.64%(205/648),33.23%(741/2230),x2=9.52,P < 0.05] with water iodine increasing,and decreased with water fluorine increasing [35.36%(93/263),32.94%(533/1618),29.79%(914/3068),26.30%(364/1384),x2 =19.21,P < 0.01].The goiter rate had nothing to do with the content of nitrate[29.04%(966/3326),31.19%(938/3007),x2 =3.47,P > 0.05].Conclusion Liuji Town Fuping County of Shaanxi Province is the first identified endemic area of drinking-water-borne high iodine thyroid.

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作者: 戴宏星 [1] 曾鹏 [2] 王柯怡 [2] 张新桂 [3] 马振江 [1] 周引阁 [1] 范中学 [1] 郭世宏 [3]
作者单位: 陕西省地方病防治研究所碘缺乏病防治研究室, 西安,710003 [1] 陕西省渭南市富平县疾病预防控制中心 [2] 陕西省渭南市疾病预防控制中心 [3]
期刊: 《中华地方病学杂志》2013年32卷4期 408-411页 ISTICPKUCA
栏目名称: 现场调查
DOI: 10.3760/cma.j.issn.2095-4255.2013.04.014
发布时间: 2013-09-09
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