目的了解高碘地区外环境中饮用水碘含量和重点人群的碘营养状态以及病情的变化趋势。方法选择水碘在50~99μg/L、100~149μg/L、150~299μg/L、≥300μg/L的村,每个水碘水平选择9个村小学开展8~10岁儿童甲状腺肿及尿碘含量调查,学校所在村孕妇尿碘含量调查。同时采集8~10岁儿童及孕妇家庭食用盐进行半定量检测,剔除食用含碘食盐的样本。结果本次共应用B超检测8~10岁儿童837名,发现20人甲状腺肿大,平均肿大率为2.4%。按照水碘分层,水碘在50~99μg/L及水碘≥300μg/L组甲状腺肿大率为4%。检测8~10岁儿童尿碘1 184份,尿碘中位数为342.4μg/L。调查孕妇尿碘543份,尿碘中位数为318.2μg/L。在水碘大于99μg/L的各组,无论是儿童或是孕妇尿碘中位数均大于300μg/L,且大于300μg/L的比例超过60%。在水碘低于100μg/L组,儿童和孕妇的尿碘中位数均低于300.0μg/L,明显低于其他水碘在100μg/L以上地区孕妇的尿碘中位数。结论在高碘地区落实停供碘盐的防治措施后,高碘甲状腺肿已经低于5%,在水碘大于100μg/L地区,儿童和孕妇尿碘处于碘过量状态。提示在高碘地区除了落实供应不加碘食用盐以外还需要改水采取降碘措施。 Objective To understand the iodine content in drinking water and the iodine nutrition status of key populations in high iodine area and the changing trend of the disease. Methods Water iodine was selected in villages of 50 ~ 99μg / L, 100 ~ 149μg / L, 150 ~ 299μg / L, ≥300μg / L and 9 villages were selected for each iodine level to develop goiter and urine Investigation of iodine content, urinary iodine content of pregnant women in the village where the school is located. At the same time, children aged from 8 to 10 years and pregnant women were collected for semi-quantitative detection, excluding iodized salt samples. Results A total of 837 children aged 8-10 years were examined by B-mode ultrasonography. Twenty patients with goiter were found, with an average rate of 2.4%. According to the stratification of water iodine, the rate of goiter was 4% when the water iodine was 50 ~ 99μg / L and the water iodine≥300μg / L. A total of 1 184 urinary iodine were detected in children aged 8-10 years. The median urinary iodine was 342.4 μg / L. Urinary iodine 543 pregnant women were investigated, urinary iodine median 318.2μg / L. In each group with water iodine more than 99μg / L, the urinary iodine median in both children and pregnant women was more than 300μg / L, and the proportion more than 300μg / L exceeded 60%. The median urinary iodine in children and pregnant women was less than 300.0μg / L when the water iodine was lower than 100μg / L, which was significantly lower than that of other pregnant women with water iodine above 100μg / L. Conclusions In the high iodine area, the iodized salt prevention and treatment measures are stopped, the high iodine goiter has been less than 5%, in the water iodine greater than 100μg / L, urine iodine in children and pregnant women in iodine excess. Tip in high-iodine areas in addition to the implementation of the supply of iodized salt also need to divert water to take iodine reduction measures.