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目的了解甘肃省临泽县居民重点人群碘摄入量的现况和甲状腺功能状态,为食盐碘化量的标准提供科学依据。方法采用分层抽样方法按东、南、西、北、中随机选择1个乡,每个乡选择8~10岁儿童20名(男女各半)、18~49岁成年男性、未孕育龄妇女、孕妇和哺乳期妇女各10名,测定血清TSH、FT4、FT3、甲状腺过氧化物酶抗体(Tm Ab)、甲状腺球蛋白抗体(TGAb)及尿碘;同时测定所选乡镇所有水源水的水碘含量,调查3个乡60名8~10岁儿童家庭食盐摄入量。结果水碘中位数为6.18μg/L,盐碘中位数为28.8 mg/kg,合格碘盐食用率为99.0%,人均日摄盐量为(4.7±0.9)mg/kg;8~10岁儿童、18~49岁男性、未孕育龄妇女、孕妇和哺乳期妇女5种人群尿碘中位数分别为180.6μg/L、161.0μg/L、199.3μg/L、135.1μg/L和104.9μg/L,不同人群的TSH(χ~2=42.580)、FT4(F=23.375)、FT3(F=51.859)、TG Ab(χ~2=15.594)和TM Ab(χ~2=14.675)差异均有统计学意义(均P<0.05);8~10岁儿童的TSH、FT4和FT3均高于其他人群,差异有统计学意义(χ~2=12.680,P<0.05),育龄妇女的TGAb和TMAb阳性率最高为20.4%,差异有统计学意义(χ~2=31.560,P<0.05);各人群甲状腺功能异常主要为亚临床甲状腺功能减退症和亚临床甲状腺功能亢进症,8~10岁儿童亚临床甲状腺功能减退症最高为7.8%,差异有统计学意义(χ~2=2.758,P<0.05),未孕育龄妇女亚临床甲状腺功能亢进症最高为7.4%,差异有统计学意义(χ~2=6.445,P<0.05)。结论临泽县是碘缺乏地区,在目前碘摄入量下,尿碘显示孕妇和哺乳期妇女碘营养不足,8~10岁儿童和未孕育龄妇女甲状腺疾病潜在的危险性相对较高。
Objective To understand the status of iodine intake and thyroid function in key population in Linze County, Gansu Province, and provide a scientific basis for the standard of iodized salt. Methods A stratified sampling method was used to select one township randomly from east, south, west, north and south. Each township selected 20 children aged 8-10 years (half male and half female), 18-49-year-old male, 10 pregnant women and lactating women were collected. Serum levels of TSH, FT4, FT3, Tm Ab, TGAb and urinary iodine were measured. Iodine content, survey 3 townships 60 children 8 to 10 years old family salt intake. Results The median of iodized water was 6.18 μg / L, the median of salt iodine was 28.8 mg / kg, the qualified iodized salt was 99.0%, and the daily average daily salt intake was (4.7 ± 0.9) mg / kg. The urinary iodine median of the five groups of children aged 18-49 years, 18-49 years old, nonpregnant women, pregnant women and lactating women were 180.6μg / L, 161.0μg / L, 199.3μg / L, 135.1μg / L and 104.9 The difference of TSH (χ ~ 2 = 42.580), FT4 (F = 23.375), FT3 (F = 51.859), TG Ab (χ ~ 2 = 15.594) and TM Ab (χ ~ 2 = 14.675) (All P <0.05). The TSH, FT4 and FT3 in children aged 8-10 were higher than those in other groups (χ ~ 2 = 12.680, P <0.05) And TMAb positive rate was the highest (20.4%), the difference was statistically significant (χ ~ 2 = 31.560, P <0.05); thyroid dysfunction in each population were mainly subclinical hypothyroidism and subclinical hyperthyroidism, 8-10 The highest subclinical hypothyroidism in aged children was 7.8%, the difference was statistically significant (χ ~ 2 = 2.758, P <0.05). The highest subclinical hyperthyroidism was 7.4% in women of childbearing age, the difference was statistically significant (χ ~ 2 = 6.445, P <0.05). Conclusions Linze County is an iodine deficiency area. Under the current iodine intake, urinary iodine shows iodine deficiency in pregnant women and lactating women. The potential risk of thyroid disease in children aged 8-10 years and in women of childbearing age is relatively high.