目的 了解山东省高碘水源分布和儿童甲状腺肿流行情况,探讨高碘对人体的危害.方法 在山东省郓城、嘉祥、东昌府3个县(区)的每个乡(镇)各抽取5个自然村,采集饮用水样检测含碘量,水碘测定采用砷铈氧化还原法.在饮水含碘量为150～300μg/L的13个乡(镇),每个乡分别选200名8～10岁儿童进行甲状腺触诊检查,从中选100例做尿碘检查,尿碘检测采用硫酸铵消化砷铈催化分光光度法,再从100例中选50例进行甲状腺B超检查.结果 3个县(区)均有高水碘乡(镇)存在,全部56个乡(镇)中,水碘超过150μg/L的乡(镇)有30个,其中水碘为150～300μg/L的乡(镇)有17个.在13个高碘调查乡(镇)中,有11个乡(镇)尿碘中位数超过400μg/L,其中3个已超过800μg/L;8～10岁儿童甲状腺肿大率触诊法有11个乡镇>5%,B超法有9个乡镇>5%,4个乡镇<5%.结论 黄河下游山东省境内存在着水源性高碘地区和地方性高碘甲状腺肿病区,表明水源性高碘对这一地区已经形成了较为严重的危害.应采取积极措施对这一地方性疾病进行有效地控制.%Objective To investigate the danger of iodine excess for people in the downstream area of Yellow River in Shandong Province by describing the distribution of iodine excess water and the gorer of children Methods Water samples were collected from 5 villages of every town of Yuncheng,Jiaxiang and Dongchangfu Counties to determine the iodine of the water using arsenic cerium oxidation reduction method.In the 5 towns having water iodine in the range of 150～300μg/L,200 students aged from 8～10 years received the paJpation of thyroid,half of them were also measured of urinary iodine with As3+-Ce4+ catalytic spectrophotometry using ammonium persulfate digestion method,and 50 of the 100 students further underwent thyroid B-ultrasound.Results Three counties all have high iodine towns.The medium of urinary iodine of 30 town8 in 56 towns was higher than 150μg/L Urinary iodine and sign detection were performed in 13 towns,where water iodine was between 150～ 300μg/L;the medium ofurinary iodine of 11 towns were higherthan 400μg/L,and 3 of the 11 towns were higher than 800μg/L.In all 13 towns,the goiter rate of the students aged 8 to 10 years exceeded 5%by palpation in 11 towns:exceeded 5% by B-ultrasound method in 9 towns.Conclusions There are areas of iodine excess in drinking water and iodine-excess endemic goiter prevails in downstream area of the Yellow River in Shandong Province.It indicates that iodine excess in drinking water has done severe harm in these areas. Active managementrnshould be taken to control this endemic disease.
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