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目的为进一步了解西藏碘缺乏病病情、居民碘营养水平及防治措施落实情况,巩固和完善西藏碘缺乏病长效防控机制。方法采用随机抽样法,按照按照人口比例概率抽样(PPS),在全区抽取30个县开展碘缺乏病病情监测,从抽取到的县(市、区)中抽取1个乡(镇)的1所小学,每所小学随机抽查50名8-10岁学生的甲状腺容积和尿样,在每个被抽取的小学所在地的乡(镇)采集20名孕妇尿样;采用砷铈催化分光光度方法(WS/T 107-2006)测定尿碘;采用B超法检查甲状腺容积,并按地方性甲状腺肿的诊断标准(WS 276-2007)判定;采集儿童家中食用盐,用硫代硫酸钠直接滴定法(GB/T 13025.7-2012)测定。结果 B超检查8-10岁儿童甲状腺1 272人次,肿大率为2.7%(34/1 272);检测盐样1 200份,盐碘中位数为26.6 mg/kg,合格碘盐食用率为73.1%(877/1 200);检测8-10岁儿童和孕妇尿样1 534份和565份,尿碘中位数分别为140.0μg/L、129.2μg/L。结论食盐加碘含量调整后,西藏自治区8-10岁儿童碘营养总体处于适宜水平,但部分地区(阿里、那曲)碘盐覆盖率偏低,部分地区(日喀则市)孕妇碘营养缺乏,全区合格碘盐食用率较低,应监管好碘盐配送工作,并加强生产层次碘盐碘含量的检测工作,同时应积极推进目标人群的健康教育促进工作。
Objective To further understand the condition of iodine deficiency disorders in Tibet, the iodine nutrition level of residents and the implementation of prevention and treatment measures, and to consolidate and improve the long-term prevention and control mechanism of iodine deficiency disorders in Tibet. Methods A random sampling method was used to monitor iodine deficiency disorders in 30 counties according to the proportion of population (PPS). One (township) 1 Primary schools, each primary school randomly selected 50 thyroid volume and urine samples of 8-10-year-old students in each primary school where the township (town) collected 20 samples of pregnant women; using arsenic cerium catalytic spectrophotometry ( WS / T 107-2006) for the determination of urinary iodine; thyroid volume was checked by B-ultrasonography and the diagnosis was made according to the diagnostic criteria of endemic goiter (WS 276-2007); the edible salt in children’s home was collected and directly titrated with sodium thiosulfate (GB / T 13025.7-2012) determination. Results A total of 1,272 thyroid gland samples were obtained from children aged 8-10 years. The rate of swelling was 2.7% (34/1 272). A total of 1 200 salt samples were detected, with a median salt iodine concentration of 26.6 mg / kg. 73.1% (877/1 200). The urinary iodine samples of 8-10 years old and pregnant women were 1 534 copies and 565 copies respectively. The urinary iodine median was 140.0 μg / L and 129.2 μg / L, respectively. Conclusion After adjustment of salt and iodine content, the iodine nutrition of children aged 8-10 years in Tibet Autonomous Region is generally at an appropriate level, but the coverage of iodized salt in some areas (Ali, Nagqu) is low, iodine deficiency in pregnant women in some areas (Shigatse) Qualified iodized salt consumption rate should be good to regulate the distribution of iodized salt and iodine salt production levels to strengthen the detection of iodine content, and should actively promote the health promotion of the target population.