目的了解德州市水源性高碘5县(市、区)停供碘盐后居民内外环境碘含量变化及儿童碘营养状况。方法采用整群抽样法,分别于2013、2015年在德州市的德城区、庆云县、平原县、乐陵市、禹城市5个高碘县(市、区),每县(市、区)抽取300户居民进行居民户食用盐监测;再根据水碘含量把5个县区分为2组(150~300、>300μg/L),在每组的县(市、区)选择1个水碘含量符合分组条件的乡镇作为监测点,在每个监测点的乡镇小学抽取100名8~10岁儿童,采集其家中饮用水和即时尿样1份检测水碘和尿碘。结果 2013、2015年5个县(市、区)分别检测居民户碘盐1 500、1 316份,无碘盐食用率分别为96.07%(1 471/1 500)、94.91%(1 249/1 316);两年共检测儿童家庭饮用水1 017份,2013年检测514份,水碘检测值为0.90~1 073.60μg/L,中位数为166.90μg/L,平均数为208.80μg/L。其中,水碘<10μg/L的48份,占9.34%;10~149μg/L的171份,占33.27%;≥150μg/L的295份占57.39%。2015年检测503份水样,水碘检测值为1.20~943.10μg/L,中位数为28.80μg/L,平均数为96.00μg/L。其中,水碘<10μg/L的30份,占5.96%;10~149μg/L的374份,占74.35%;≥150μg/L的99份占19.69%。水碘中位数2015年低于2013年(P<0.01);2015年高水碘频数明显下降,两年水碘含量频数分布差异有统计学意义(P<0.01)。两年共检测儿童尿样1 011份,2013年检测尿碘500份,检测值为19.30~2 464.10μg/L,中位数为517.4μg/L。其中,尿碘值<100μg/L的33份,占6.60%;100~199μg/L的68份占13.60%,>400μg/L的298份占59.60%;2015年检测尿碘511份,检测值为1.50~1 583.50μg/L,中位数为220.6μg/L。其中尿碘<100μg/L的87份占17.03%;100~199μg/L的136份占26.61%;>400μg/L的124份占24.27%,2015年明显低于2013年(P<0.01);2015年碘适宜频数增加、高碘频数下降,两年尿碘含量频数分布差异有统计学意义(P<0.01);尿碘含量和家庭水碘含量除2015禹城县无相关外(P>0.05)均成正相关(P<0.01)。结论德州市高碘5个县(市、区)停供碘盐措施得到有效的实施,4个监测点改水效果明显,但德城区高碘危害持续存在。2015年总体结果优于2013年,饮用水水碘适宜数量、尿碘适宜频数均大幅上升。 Objective To understand the changes of iodine content inside and outside the city and the iodine nutrition status of children after iodized salt was stopped in 5 counties with high iodine content in water-source cities of Dezhou. Methods The method of cluster sampling was used to measure the incidence of iodine in five counties (cities, districts) in Decheng, Qingyun, Pingyuan, Leling and Yucheng in 2013 and 2015 respectively. ) 300 households were selected for household salt monitoring. According to water iodine content, five counties were divided into two groups (150-300 and> 300μg / L), and one water was selected in each county (city and district) Towns and villages with iodine content meeting the grouping conditions were taken as monitoring points. 100 children aged from 8 to 10 were selected from township primary schools at each monitoring point to collect drinking water and instant urine samples from their homes for detection of water iodine and urine iodine. Results In 2013 and 2015, 1 500 and 1 316 pieces of iodized salt were detected in 5 counties (cities and districts) respectively. The rates of using iodine-free salt were 96.07% (1 471/1 500) and 94.91% (1 249/1 316). A total of 1 017 samples of drinking water for children were tested in two years and 514 samples in 2013. The detected values ​​of water iodine were 0.90 ~ 1 073.60μg / L with a median of 166.90μg / L with an average of 208.80μg / L . Among them, 48 were water iodine <10μg / L, accounting for 9.34%; 171 were 10 ~ 149μg / L, accounting for 33.27%; 295 were more than 150μg / L accounting for 57.39%. In the 503 samples tested in 2015, the water iodine value was 1.20 ~ 943.10μg / L, the median was 28.80μg / L, the average was 96.00μg / L. Among them, the water iodine <10μg / L of 30, accounting for 5.96%; 10 ~ 149μg / L of 374, accounting for 74.35%; ≥ 150μg / L of 99 accounted for 19.69%. The median of water iodine in 2015 was lower than that of 2013 (P <0.01). In 2015, the frequency of high water iodine decreased obviously, and the frequency distribution of water iodine in two years showed statistically significant difference (P <0.01). A total of 1 011 urine samples were tested in two years and 500 urinary iodine in 2013. The measured values ​​ranged from 19.30 to 2 464.10 μg / L with a median of 517.4 μg / L. Among them, 33 with urinary iodine value <100μg / L accounted for 6.60%; 68 with 100 ~ 199μg / L accounted for 13.60%; 298 with> 400μg / L accounted for 59.60%; 511 with iodine in 2015, 1.50 ~ 1 583.50μg / L, the median was 220.6μg / L. Of which 87 were accounted for 17.03% of the total urinary iodine <100μg / L, 136.6% of the population were from 100 to 199μg / L and 24.27% were for the group of> 400μg / L, significantly lower than that of 2013 (P <0.01) In 2015, the frequency of suitable iodine increased and the frequency of high iodine decreased. There was significant difference in the frequency distribution of urinary iodine between the two years (P <0.01) ) Were positively correlated (P <0.01). Conclusion The effective measures for stopping iodized salt in Dezhou iodine in 5 counties (cities and districts) of Dezhou were effectively implemented. The water quality of 4 monitoring sites was obvious, but the dangers of high iodine in Decheng district persisted. The overall result in 2015 is better than that in 2013, and the appropriate number of drinking water iodine and the appropriate frequency of urinary iodine have all risen sharply.