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目的分析天津市高碘性甲状腺肿的影响因素,为采取干预措施提供科学依据。方法根据水质监测结果和高碘地区的判定标准,对高碘地区和高碘病区的儿童进行尿碘和甲状腺检查,并对学生家庭食用盐碘进行检测。结果高碘地区儿童甲肿率为8.1%,高碘病区为5.8%,高碘地区儿童甲肿率高于高碘病区,但差异无统计学意义(χ2=2.50,P=0.114);高碘地区和高碘病区不同性别及年龄儿童甲肿率差异均无统计学意义;高碘地区和高碘病区甲状腺肿组饮用水中碘含量均明显高于非甲状腺肿组。高碘病区合格碘盐食用率明显低于高碘地区合格碘盐食用率(χ2=21.97,P=0.000);饮水水碘含量和食盐含碘量是影响当地儿童甲状腺肿的主要因素,且食盐含碘量对甲状腺肿的影响更大。结论在天津市水源性高碘地区可以采取以停供碘盐为主的干预措施,同时考虑改水。
Objective To analyze the influencing factors of hyperiodic goiter in Tianjin and provide scientific basis for the intervention. Methods According to the results of water quality monitoring and the criteria of high iodine area, urine iodine and thyroid were examined in children with high iodine and high iodine disease areas. Salt iodine was also detected in the students’ families. Results The rate of goiter in children with high iodine was 8.1% and that in children with high iodine was 5.8%. The rate of children with high iodine was higher than that in children with iodine. (Χ2 = 2.50, P = 0.114). There was no significant difference in the rate of thyroid edema in children with high iodine and iodine in different sexes and ages. The iodine content in drinking water in those with high iodine and high iodine disease was significantly higher than that in non-goiters. The prevalence of qualified iodized salt in high-iodine disease area was significantly lower than that of iodized salt in high-iodine area (χ2 = 21.97, P = 0.000). The iodine content in drinking water and the iodine content in salt solution were the main factors affecting goiter of local children Salt iodine content of the greater impact on goiter. Conclusion In Tianjin, water-rich areas with high iodine can take stop for iodized salt-based interventions, taking into account the water.