摘要目的 了解山东省历史水源性高碘地区居民碘营养状况,为完善水源性高碘地区高碘危害干预策略提供依据.方法 2017年,在山东省7个市的38个历史高碘县(市、区),每个县(市、区)将所辖乡镇(街道)按东、西、南、北、中划分为5个片区,在每个片区抽取1个乡镇(街道),每个乡镇(街道)抽取4个行政村,每个行政村抽取15份居民家庭食用盐进行不加碘食盐检测;选择19个历史高碘县(市、区)进行居民饮用水碘含量、8～ 12岁儿童尿碘含量和甲状腺容积的检测.采用半定量法检测居民食用盐;砷铈催化分光光度测定法(WS/T 107-2006)检测水碘和尿碘含量;B超法检测儿童甲状腺容积.结果 共检测居民家庭食用盐9 703份,其中不加碘食盐9 575份,不加碘食盐食用率为98.68％;38个历史高碘县(市、区)中,20个县(市、区)全部停供碘盐、18个县(市、区)部分停供碘盐,不加碘食盐食用率分别为99.37％(6 013/6 051)和98.54％(3 562/3 652).共调查了19个历史高碘县(市、区)的居民饮用水,水碘中位数为75.50μg/L,范围为8.50～420.70 μg/L;其中,有9个监测点的水碘中位数＞ 100μg/L,仍属水源性高碘地区.共检测儿童尿样2 009份,尿碘中位数为256.35μg/L;8～12岁儿童的甲状腺肿大率为7.86％(158/2 009),不同年龄间儿童甲状腺肿大率比较差异有统计学意义(x2=43.649,P＜0.05).结论 虽然山东省历史水源性高碘地区不加碘食盐食用率处于较高水平,但居民饮用水水碘含量跨度较大,儿童碘营养处于超适宜水平,应进一步扩大高碘地区改水降碘工程覆盖面,加强对重点人群的碘营养状况监测.

abstractsObjective To observe the iodine nutritional status in historical water-borne high iodine areas in Shandong Province,so as to provide a basis for improving the intervention strategy of high-iodinated goiter in water-borne high iodine areas.Methods In 2017,in 38 historical high-iodine counties (cities,districts) in 7 cities of Shandong Province,each county (city,district) was divided 5 regions according to the east,west,south,north,and middle.One township (street) was taken in each regions,and four administrative villages were selected in each township (street).In each administrative village 15 household salt samples were extracted for non-iodine salt detection;detection of iodine content of drinking water,urine iodine content and thyroid volume of children aged 8-12 years were carried out in 19 high iodine counties (cities,districts).The semi-quantitative method was used to detect the iodine level of edible salt of residents;the arsenic cerium catalytic spectrophotometry method(WS/T 107-2006) was used to detect the water iodine and urinary iodine content;the B-ultrasound method was used to examine the thyroid volume of children.Results A total of 9 703 edible salt samples were collected from residents,including 9 575 non-iodine salt and the consumption rate of non-iodine salt was 98.68％.Among the 38 high iodine counties (cities,districts),20 counties (cities,districts) all stopped supplying iodized salt and 18 counties(cities,districts) partial stopped,the consumption rates of non-iodine salt were 99.37％ (6 013/6 051) and 98.54％ (3 562/ 3 652),respectively.The iodine content of drinking water in 19 monitoring sites was detected.The median water iodine was 75.50 μg/L,ranging from 8.50 to 420.70 μg/L.Among them,the median water iodine of 9 monitoring sites was ＞ 100 μg/L,still belonged to the water-borne high iodine area.Totally 2 009 children were detected urinary iodine,the median urinary iodine concentration was 256.35 μg/L;the goiter rate of children aged 8-12 years was 7.86％ (158/2 009),there was a statistically significant difference in the rate of goiter between children of different ages (x2 =43.649,P ＜ 0.05).Conclusions Although the consumption rates of non-iodine salt in historical water-borne high iodine areas of Shandong Province are at a higher level,the water iodine content of drinking water has a larger span,iodine nutrition in children is over the appropriate level.The coverage of projects to improve water quality and reduce iodine in high iodine areas should be further expanded,and monitoring of iodine nutritional status of key populations should be strengthened.