摘要
目的了解西藏牧区人群碘营养水平、碘缺乏病病情和育龄妇女甲状腺功能。方法2009年，在拉萨市当雄县牧区和曲水县农区各抽取30户家庭采集饮用水样和盐样检测含碘量；抽取8—10岁儿童、18—49岁育龄妇女和18—60岁成年男子3类人群，每类人群至少50人，检测尿碘，并对儿童和育龄妇女进行甲状腺触诊检查，检测育龄妇女血清甲状腺激素水平，并诊断个体甲状腺功能状态。盐碘测定用直接滴定法（GB／T13025．7—1999）；水碘测定用砷铈氧化还原法（GB／T5750．1-2006）；尿碘测定用过硫酸铵消化——砷铈催化分光光度法（WS／r107—2006）；甲状腺检查按照《地方性甲状腺肿诊断标准》（WS276—2007）执行。结果牧区和农区水碘中位数分别为1．3、0．7μg／L，二者比较差异无统计学意义（Z=-1．809，P〉0．05）。牧区居民全部食用非碘盐；农区居民碘盐覆盖率为90．0％（27／30）。牧区人群尿碘中位数（50．2Ixg／L）低于农区（193．2μg／L，Z=-10．48，P〈0．01）；牧区儿童和育龄妇女甲状腺肿大率[1．0％（1／100）]低于农区[18．0％（18／100），x2=16．8，P〈0．01]。牧区育龄妇女血清n、n水平[（14．0±2．0）pmol／L、（85．6±17．5）nmol／L]显著低于农区[（16．2±6．3）pmol／L、（95．4±21．1）nmol／L，t值分别为-2．06、-2．20，P均〈0．05]；牧区育龄妇女甲状腺功能异常率[5．9％（2／34）]显著低于农区[25．5％（12／47），x2=5．328，P〈0．05]，亚临床甲状腺功能减退的发生率[2．9％（1／34）]显著低于农区[21_3％（10／47），x2=5．651，P〈0．05]。结论牧区人群碘摄入量明显低于农区，尿碘水平反映牧区人群存在严重碘缺乏，但血液生化和甲状腺肿大率与尿碘不符，仅表现为隐性碘饥饿，未构成甲状腺肿大流行。
Objective To explore the iodine nutrition level of people, prevalence of iodine deficiency disorders and the thyroid function of women of childbearing age in pasturing areas of Tibet. Methods Thirty families were selected respectively in pastoral Dangxiong county and agricuhural Qushui county of Lhasa in 2009, drinking water and edible salt samples were collected to test iodine content; at least 50 people from each crowd of the following populations including children aged 8 - 10, women of childbearing age of 18 - 49 old and male adults aged 18 - 60 were randomly sampled and to measure their urinary iodine content and for thyroid palpation. Direct titrimetric method was used to test salt iodine （GB/T 13025.7-1999）; As3＋-Ce4＋ oxidation reduction process to test water iodine （GB/T 5750.1-2006）; As3＋-Ce4＋ catalytic spectrophotometry using ammonium persulfate digestion to test urine iodine（WS/T 107-2006）, and goiter examination was based on ＂Diagnostic and Classificatory Criteria of Endemic Goiter＂ （WS 276-2007）. Results The median of water iodine was 1.3 μg/L in pasturing area and 0.7μg/L in agricultural areas, there was no statistical significant difference between them（Z = - 1.809, P 〉 0.05）. There was no iodized salt used in pastoral people, but iodized salt coverage rate was 90.0%（27/30） in agricultural residents. The median of urinary iodine among people of pasturing areas was 50.2μg/L, lower than that of agricultural areas （193.2 μg/L, Z = - 10.48, P 〈 0.01 ）. However, the goiter rate in pasturing area[ 1.0% （I/100）] was significantly lower than that of agricultural areas[ 18.0%（18/100）, x2 = 16.8, P 〈 0.01 ]. Serum level of FT, and Tr4 in pastoral population[ （14.0 ± 2.0）pmol/L, （85.6 ± 17.5）nmol/Ll was significantly lower than that of agricultural areas[ （16.2 ± 6.3）pmol/L, （95.4 ± 21.1）nmol/L, t = - 2.06, - 2.20, all P 〈 0.051. The thyroid dysfunction rate [5.9% （2/34）] and subclinical hypothyroidism rate [2.9% （1/34）] in pastoral population was significantly lower than that of agricultural areas[25.5%（12/47）, 21.3%（10/47）, X2 = 5.328, 5.651, all P 〈 0.05]. Conclusions Pastoral areas of iodine intake is significantly lower than the agricultural areas, urinary iodine levels reflect a serious iodine deficiency in pastoral people, but the blood biochemical and urinary iodine and goiter rate does not match, and shows hidden iodine hunger, which does not constitute a goiter epidemic.
出处
《中国地方病学杂志》
CAS
CSCD
北大核心
2011年第5期535-538,共4页
Chinese Jouranl of Endemiology
关键词
碘
缺乏症
尿
甲状腺激素类
Iodine
Deficiency diseases
Urine
Thyroid hormones
