河北省水源性高碘地区2018—2023年儿童碘营养监测结果

尹志娟; 贾丽辉; 田慎谦; 高雪洁; 徐宁; 徐栋; 马景

doi:10.16835/j.cnki.1000-9817.2025269

河北省水源性高碘地区2018—2023年儿童碘营养监测结果

doi: 10.16835/j.cnki.1000-9817.2025269

河北省疾病预防控制中心地方病防治所，石家庄 050021

基金项目:

河北省医学科学研究指导性课题 20250987

详细信息

作者简介:
尹志娟(1987-)，女，山西省人，硕士，副主任医师，主要从事地方病防治工作

通讯作者:
马景，E-mail: majinghbcdc@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R153.2 TQ124.6 R581.3
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出版历程
- 收稿日期: 2025-03-03
- 修回日期: 2025-05-28
- 网络出版日期: 2025-10-10
- 刊出日期: 2025-09-25

Monitoring results on iodine nutrition status of children in water-borne iodine-excess areas of Hebei Province from 2018 to 2023

Institution for Endemic Disease Prevention and Control, Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang 050021, Hebei Province, China

摘要

摘要: 目的了解河北省水源性高碘地区儿童碘营养状况，为科学防治水源性高碘危害提供参考依据。方法 2018—2023年每年3—9月，对河北省所辖5个市(沧州、衡水、邢台、邯郸、廊坊)39个水源性高碘县(2017年测定)开展横断面调查，调查内容包括居民生活饮用水水碘含量、儿童(6~12岁)甲状腺容积、盐碘和尿碘检测。从不同年份、性别及年龄等角度评价6~12岁儿童碘营养状况及水碘分布情况，组间比较采用Kruskal-Wallis H检验、Mann-Whitney U检验和χ²检验。结果 2018—2023年共调查38 755名儿童、1 270份生活饮用水水样，水碘质量体积浓度有随年份下降趋势(Z=-30.87，P < 0.01)。共监测儿童家中食盐38 470份，其中未加碘食用盐24 790份，未加碘食盐率为64.44%。采集8~10岁儿童尿样31 989份，尿碘中位数为245.94 μg/L；对不同年份儿童尿碘结果进行比较，2018—2023年儿童尿碘中位数分别为328.0，339.3，267.8，279.1，291.3，186.5 μg/L，差异有统计学意义(H=4 138.40，P < 0.01)；经进一步两两比较显示，2023年儿童尿碘中位数低于其他所有年份(Z=-51.59~-11.41，P值均 < 0.01)。6~12岁儿童检出甲状腺肿大1 150例，甲状腺肿大率为3.0%；其中男、女童甲状腺肿大率分别为2.8%，3.1%，差异无统计学意义(χ²=2.76，P>0.05)；不同年份、年龄间儿童甲状腺肿大率差异均有统计学意义(χ²值分别为324.02，191.61，P值均 < 0.05)。结论随着改水进程推进，河北省水源性高碘地区儿童碘营养从过量状态降低到适宜状态。应继续扩大改水降碘工程覆盖面，加强对水源性高碘地区重点人群的碘营养状况监测。
- 碘 /
- 营养状况 /
- 人群监测 /
- 儿童
Abstract: Objective To investigate the iodine nutrition status of children in water-borne iodine-excess areas in Hebei Province, so as to provide references for scientific prevention and control of water-borne iodine-excess hazards. Methods From March to September each year during 2018 to 2023, a cross-sectional survey was conducted in 39 water-borne iodine-excess counties (measured in 2017) from 5 cities (Cangzhou, Hengshui, Xingtai, Handan and Langfang) in Hebei Province. The survey included the detection of iodine content in residents' drinking water, the measurement of thyroid volume in children aged 6-12, the detection of salt iodine and urinary iodine. The iodine nutrition status and water iodine distribution of 6-12 year-old children were evaluated from different perspectives such as years, gender, and age. Kruskal-Wallis H test, Mann-Whitney U test and Chi-square test were used for group comparison. Results A total of 38 755 children were surveyed from 2018 to 2023, and 1 270 drinking water samples were tested across the province. The mass volume concentration of iodine in water showed a decreasing trend over the years (Z=-30.87, P < 0.01). Among 38 470 salt samples monitored from children 's home, 24 790 were not non-iodized salt, with a non-iodized salt rate of 64.44%. A total of 31 989 urine samples were collected from children aged 8-10 years, with the median urine iodine was 245.94 μg/L. Comparing the results of urinary iodine in children from different years, the median urinary iodine from 2018 to 2023 were 328.0, 339.3, 267.8, 279.1, 291.3, 186.5 μg/L, respectively, with statistically significant differences (H=4 138.40, P < 0.01). Further pairwise comparisons showed that the median urinary iodine of children in 2023 was lower than in all other years (Z=-51.59 to -11.41, all P < 0.01). Among children aged 6-12 years, 1 150 cases of goiter were detected and the rate of goiter was 3.0%; and the goiter rates in boys and girls were 2.8% and 3.1%, with no significant difference between the sexes (χ²=2.76, P>0.05). There were significant differences in the rate of goiter among different years and ages (χ²=324.02, 191.61, both P < 0.05). Conclusions With the progress of water reform in water-borne iodine-excess areas of Hebei Province, children's iodine nutrition has reduced from excessive state to suitable state. It is necessary to continue to expand the coverage of water-based iodine reduction projects, and strengthen the monitoring of iodine nutrition status of key populations in water-borne iodine-excess areas.
- Iodine /
- Nutritional status /
- Population surveillance /
- Child
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表 1 河北省水源性高碘县2018—2023年水碘监测结果

Table 1. Monitoring results of water iodine in water-borne iodine-excess counties of Hebei Province from 2018 to 2023

年份	份数	中位数/(μg·L^-1)	范围/(μg·L^-1)	频数分布
年份	份数	中位数/(μg·L^-1)	范围/(μg·L^-1)	< 40 μg/L	40~100 μg/L	>100~300 μg/L	>300 μg/L
2018	167	163.95	5.53~930.82	3(1.80)	21(12.57)	112(67.07)	31(18.56)
2019	180	155.25	8.05~1 018.60	9(5.00)	21(11.67)	115(63.89)	35(19.44)
2020	174	114.05	0.05~482.48	39(22.41)	37(21.26)	82(47.13)	16(9.20)
2021	248	20.35	0.68~262.80	152(61.29)	69(27.82)	27(10.89)	0
2022	197	11.00	0.05~400.00	121(61.42)	65(33.00)	8(4.06)	3(1.52)
2023	304	11.30	0.00~250.10	233(76.64)	62(20.39)	9(2.96)	0
合计	1 270	65.38	0.05~1 018.60	557(43.86)	275(21.65)	353(27.80)	85(6.69)
注：()内数字为构成比/%。

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表 2 河北省2018—2023年不同组别儿童甲状腺肿大及结节检出率比较

Table 2. Comparison of goiter and nodules detection rates in children of different groups in Hebei Province from 2018 to 2023

组别	选项	人数	甲状腺肿大		结节
组别	选项	人数	检出人数	χ²值	检出人数	χ²值
性别	男	19 942	564(2.8)	2.76	160(0.8)	0.17
	女	18 813	586(3.1)		144(0.8)
年份	2018	6 103	305(5.0)	324.02^**	34(0.6)	29.02^**
	2019	6 833	352(5.2)		43(0.6)
	2020	6 802	176(2.6)		52(0.8)
	2021	4 225	98(2.3)		60(1.4)
	2022	7 074	99(1.4)		50(0.7)
	2023	7 718	120(1.6)		65(0.8)
年龄/岁	< 8	2 223	131(5.9)	191.61^**	6(0.3)	28.33^**
	8	9 573	378(3.9)		68(0.7)
	9	12 254	398(3.2)		92(0.8)
	10	10 167	181(1.8)		76(0.7)
	>10	4 538	62(1.4)		62(1.4)
注：()内数字为检出率/%；^**P < 0.01。

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