摘要目的 分析防治策略的调整对山西省碘缺乏病(IDD)流行趋势的影响,为国家适时采取针对性防治措施和科学调整干预策略提供依据.方法 采用资料回顾性分析方法,收集整理1995年以来山西省国家级、省级碘缺乏病监测资料,2004年以来山西省碘盐监测资料.分析儿童甲状腺肿大率、尿碘中位数、盐碘中位数、盐碘均数、碘盐覆盖率、碘盐合格率、合格碘盐食用率等指标及其相互关系.结果 1995年以来,8～ 10岁儿童触诊和B超甲肿率均呈现稳定下降态势.盐碘中位数、均数和尿碘中位数总体上呈现“上升→下降→稳定→下降”的曲线,即:三项指标从1995年(29.1 mg/kg、31.7±15.0 mg/kg、199.3μg/L)开始逐年上升,至1999年(48.7mg/kg、53.4±29.4mg/kg、407.5 μg/L)达到顶点;1999年后开始下降,到2001年(34.7mg/kg、36.2±11.9 mg/kg、282.1 μg/L)下降势态终止;并在2001-2011年基本稳定;2013年(26.0mg/kg、26.5±6.3 mg/kg、192.0 μg/L)起,再次较大幅度下降.碘盐合格率和合格碘盐食用率总体上呈现“下降→上升→稳定”的曲线,即:两率从1995年(72.61％、68.25％)起曲折下降,至1999年(44.80％、43.67％)达到低谷;1999年后开始上升,到2002年(94.73％、91.80％)基本稳定;从2002-2013年保持稳定态势.结论 山西省自2000年以来一直处于持续消除碘缺乏病状态,防治策略调整后人群碘营养水平日趋合理.

abstractsObjective To analyze the effect of adjustments of control strategy on epidemic trend of iodine deficiency disorders (IDD) in Shanxi Province after universal salt iodization (USI),and to provide basis for timely adopting targeted control countermeasure and scientifically adjusting intervention strategy.Methods A method of retrospective analysis was performed to collect data from IDD surveillance at national or province levels after 1995,and from iodized salt surveillance of the province after 2004.According to the statistics and analysis of children's goiter rate,median urinary,median and mean of salt iodine,coverage rate of iodized salt,qualified rate of iodized salt,consumption rate of qualified iodized salt and their relationship.Results Since 1995,the children's goiter rate by palpation and B-ultrasound showed a steady descending trend.The median salt iodine,mean salt iodine and children's median urinary iodine showed a trend of rise→decline→stable→decline.Namely:The three indicators began to rise year by year from 1995 (29.1 mg/kg,31.7 ± 15.0 mg/kg,199.3 μg/L),in 1999 (48.7 mg/kg,53.4 ± 29.4 mg/kg,407.5 μg/L) reached its climax; and then decreased,in 2001 (34.7 mg/kg,36.2 ± 11.9 mg/kg,282.1 μg/L)stoped; which were basically stable from 2001 to 2011; since 2013 (26.0 mg/kg,26.5 ± 6.3 mg/kg,192.0 μg/L),a significant decline began.The rate and edible rate of qualified iodized salt showed a trend of decline→rise→stable.Two indexes began to decline circuitously from 1995 (72.61％,68.25％),and dipped to a low point in 1999 (44.80％,43.67％); then began to rise,until 2002 (94.73％,91.80％) reached basic stability; and remained steady from 2002 to 2013.Conclusions Following the process of prevention and treatment of IDD for more than 30 years in Shanxi Province,with the depth understanding of the range of adequate iodine nutrition,according to the monitoringfeedback mechanism,the strategy of salt iodization has been adjusted several times,the target of continuous elimination of IDD has achieved since 2000 and the levels of iodine nutrition in population are more reasonable.Salt iodization strategy should continue to adhere to.