黄丽+邹淑蓉+汪正园

摘要：目的 掌握碘鹽标准下调后上海市松江区居民碘营养状况，为今后科学补碘提供依据。

方法 在上海市松江区按分层随机抽样的方法抽取8～10 岁儿童450 名，男女各半；抽取孕妇200名，孕早、中、晚期各1/3，采集所有调查对象的日间随机一次尿液10 mL及其家中食用盐30 g，定量测定尿碘及盐碘含量。采用触诊法检查抽中的250名儿童甲状腺肿大情况。

结果 全面食用盐碘浓度下调后，上海市松江区8～10岁儿童甲状腺肿大率为3.20%，82.66%的儿童碘营养处于适宜状态（100～299 μg/L），12.67%的儿童尿碘浓度大于300 μg/L；尿碘及盐碘中位数分别为 200.05 μg/L和24.85 mg/L，不同性别、年龄组间尿碘水平差异有统计学意义（P<0.05）。孕妇尿碘及盐碘中位数分别为165.90 μg/L和25.40 mg/L。60.00%的孕妇碘营养处于适宜状态（150～499 μg/L），碘缺乏的比例远超过碘过量的比例，在不同地域碘缺乏比例显著高于碘过量比例（P<0.05）。

结论 上海市松江区一般人群碘营养水平稍高于适宜范围，孕妇碘营养水平处于适宜范围的下限，孕妇存在碘营养缺乏的风险，需在专业人员的指导下适当补充含碘食品，保证其碘营养水平。

关键词： 儿童； 孕妇； 碘营养； 尿碘； 调查中图分类号： R 155 文献标志码： A

Abstract： Objective To investigate the iodine nutrition status after down regulation of the standard of iodized salt in optimal iodine regions among residents in Shanghai Songjiang district，and provide a scientific basis for future scientific iodine supplement.

Methods A total of 450 children from 8 to 10 years old （half boys and half girls）and 200 pregnant women（in early， middle， and late pregnancies， each 1 / 3） were selected according to stratified random sampling extraction， and their urine and edible salt of all respondents were collected， while the quantitative determination was used for the urine iodine and salt iodine content. Palpation method was used to check the goiter in 250 children.

Results After overall consumption of lower standard of iodized salt，the goiter rate of children was 3.20%； the median of urinary iodine and salt iodine among the children were 200.05 μg/L， 24.85 mg/L，respectively；82.66% of children had their iodine nutrition in suitable condition （100～299 μg/L）， 12.67% of children had their urinary iodine concentration over 300 μg/L； there were significant differences of urine iodine frequency distribution between different gender and age groups （P<0.05）.The median of urinary iodine and salt iodine among the pregnant women were 165.90 μg/L，25.40 mg/L，respectively； 60.00% of pregnant women iodine nutrition was appropriate （150～499 μg/L）； the proportion of iodine deficiency was far more than the proportion of iodine excess， and there were significant differences among different direction（P<0.05）.

Conclusion The iodine nutrition level of children is slightly higher than the appropriate range， while the iodine nutrition level of pregnant women is at lower limit of iodine nutrition level in a suitable range. There is a lack of iodine nutrition risk in pregnant women， so richer iodine food is needed under professional guidance for them to ensure their iodine nutrition levels.

Keywords： children； pregnant women； iodine nutrition； urine iodine； investigate

碘是人体必需的微量元素，摄入不足可导致碘缺乏病，过量则可引起高碘性疾病，这两类疾病均会对人群健康造成多种危害。碘缺乏病的本质是外环境长期的缺碘，机体在没有外源性碘供应的情况下，体内储备的碘仅够维持2～3个月。自1996年4月上海市全面启动食盐加碘政策以来，市民的碘营养水平不断得到改善[1-2]。……