摘要目的 全面了解青海省实施综合干预措施后碘缺乏病动态变化趋势,评估干预措施的防治效果,发现并解决存在的问题.方法 依据《全国碘缺乏病监测方案》,1995、1997、1999、2002、2005和2011年,按人口比例概率抽样方法(PPS),在青海省选择30个县(市、区),每个县(市、区)选择1所小学,每所小学抽取40名8～ 10岁学生(数量不足时,从最邻近的学校补足),进行甲状腺容积测定及其家中盐碘含量测定.在所抽的40名学生中,抽取12名学生采集尿样,检测尿碘.结果 青海省居民碘盐覆盖率从1995年的75.24％(793/1 054)提高到2011的93.31％(1 143/1 225),合格碘盐食用率由1995年的55.12％(581/1 054)提高到2011年的90.04％(1 103/1 225),均呈逐年上升趋势;儿童尿碘中位数由1995年的143.26 μg/L提高到2011年175.45 μg/L,而＜50 μg/L和＜100μg/L的比例显著下降;儿童甲状腺肿大率由1995年的11.6％(116/1000)下降到2011年的0.3％(2/671).结论 青海省碘缺乏病防治效果显著,当前人群碘营养处于良好的适宜状态,食盐碘含量符合青海实际.但高盐价与经济发展滞后之间的矛盾,现行防治措施与传统生活习惯之间的矛盾,非碘盐易得与购买碘盐不便之间的矛盾阻碍了青海省实现消除碘缺乏病目标的进程,也是今后碘缺乏病防治工作的主要障碍.

abstractsObjective To find out the changing trends of iodine deficiency disorders after carrying out intervention measures,to evaluate the intervention effect,and to identify and solve problems.Methods According to the "National Iodine Deficiency Disorders Surveillance Scheme" in Qinghai Province,within the region in accordence with the standard group sampling method(PPS),30 counties(cities),thyroid volume of 40 8-10-yearold students was examined.Twelve students were selected from those 40 students for testing of their urinary iodine levels.Results The coverage rate of iodized salt increased from 75.24％ (793/1 054) to 93.31％ (1 143/1 225)and the rate of qualifie0 iodized salt increased from 55.12％(581/1 054) to 90.04％(1 103/1 225) from 1995 to 2011,and both of which showed an increasing trend.The median urinary iodine increased from 143.26 μg/L to 175.45 μg/L from 1995 to 2011,and the proportions of less than 50 μg/L and less than 100 μg/L decreased significantly.The rate of child thyroid goiter decreased from 11.6％(116/1 000)to 0.3％ (2/671) from 1995 to 2011.Conclusions The prevention effect on iodine deficiency disorders is obvious; the iodine nutrition of current population is in a suitable condition,and salt iodine content is appropriate in accordance with Qinghai Province actual situation.But the contradiction between high salt prices and lagging economic development,between existing control measures and traditional habits,among non-iodized salt readily available and the purchasing inconvenience of iodized salt,have hindered the realization of eliminating iodine deficiency disorders in Qinghai Province,which is a major problem.