【摘要】 目的 了解阿坝藏族羌族自治州（简称“阿坝州”）孕妇碘营养状况，为民族地区孕妇碘缺乏病防治政策调整提供科学依据。方法 2022年在阿坝州所辖13县（市），每个县/市抽5个镇或街道作为监测点（这5个监测点需从不同方位抽取），再随机每个监测点抽取20名孕妇检查其随机尿样碘含量及家中食用盐碘含量。分析不同地区、不同民族、不同年龄组、不同孕期孕妇碘盐覆盖率、合格碘盐食用率及孕妇尿碘水平。用Spearman秩相关分析进行尿碘和盐碘相关性分析，率的比较使用χ~2检验。结果 2022年阿坝州13个县共监测1 302份孕妇家中盐样，盐碘中位数27.00mg/kg，碘盐覆盖率、碘盐合格率、合格碘盐食用率分别为99.85%、97.54%和97.39%。不同地区孕妇在碘盐覆盖率(χ~2=24.077,P=0.020)、碘盐合格率(χ~2=53.825,P<0.001)、合格碘盐食用率(χ~2=48.449,P<0.001)、碘盐中位数差异均有统计学意义（Z=20.675,P<0.001）；不同民族孕妇在碘盐覆盖率(χ~2=1.728,P=0.631)、碘盐合格率(χ~2=0.850,P=0.361)、合格碘盐食用率(χ~2=1.810,P=0.401)、碘盐中位数（Z=2.060,P=0.380）差异均无统计学意义；不同年龄组孕妇在碘盐合格率(χ~2=6.914,P=0.016)、合格碘盐食用率(χ~2=5.939,P=0.023)差异均有统计学意义，在碘盐覆盖率(χ~2=0.241,P=0.623)、碘盐中位数（Z=-0.382,P=0.703）差异均无统计学意义；不同孕期孕妇在盐碘中位数差异有统计学意义（Z=13.381,P<0.001），在碘盐覆盖率(χ~2=0.486,P=0.784)、碘盐合格率(χ~2=0.714,P=0.713)、合格碘盐食用率(χ~2=0.447,P=0.813)差异均无统计学意义。共采集1 302份孕妇尿样，尿碘中位数为174.5μg/L，不同地区孕妇尿碘中位数差异有统计学意义（H=133.345,P<0.001），但不同民族（H=5.436,P=0.143）、不同年龄组（H=0.183,P=0.913）和不同孕期（H=2.937,P=0.302）孕妇尿碘水平差异均无统计学意义，孕妇家中盐碘含量与其尿碘水平无相关关系（rs=0.198,P=0.659）。结论 阿坝州孕妇碘营养水平总体适宜，但较远的草地县仍存在碘缺乏风险。在今后工作中，建议针对少数民族地区孕妇开展补碘率专项调查研究，动态掌握孕期碘营养状况。必要时推广孕妇专用碘盐，精准指导孕妇科学补碘。更多还原

【Abstract】 Objective To investigate the iodine nutrition status of pregnant women in Aba Tibetan and Qiang Autonomous Prefecture(hereinafter referred to as Aba prefecture), and to provide scientific basis for the adjustment of prevention and treatment policy of iodine deficiency disorders(IDD) for pregnant women in ethnic areas. Methods In 2022, five towns or streets were selected as monitoring sites in 13 counties(cities) under the jurisdiction of Aba prefecture, and at each site 20pregnant women were randomly selected for survey on the iodine content of random urine samples and edible salt at home.The coverage rate of iodized salt, the consumption rate of qualified iodized salt, and the urinary iodine level of pregnant women in different regions, different ethnic groups, different age groups, and different gestational periods were analyzed.Spearman rank correlation analysis was used to analyze the correlation between urinary iodine and salt iodine, and χ~2test was used to compare the rates. Results A total of 1 302 salt samples were collected in 13 counties of Aba prefecture in 2022. The median of salt iodine was 27.00 mg/kg, and the coverage rate of iodized salt, the qualified rate of iodized salt, and the consumption rate of qualified iodized salt were 99.85%, 97.54%, and 97.39%, respectively. Among pregnant women in different areas, there were significant differences in the coverage rate of iodized salt(χ~2=24.077, P < 0.020), the qualified rate of iodized salt(χ~2=53.825, P < 0.001), the consumption rate of qualified iodized salt(χ~2=48.449, P < 0.001), and the median of iodized salt(Z=20.675, P < 0.001). Among pregnant women of different ethnic groups, there were no significant differences in iodized salt coverage rate(χ~2=1.728, P =0.631), qualified rate of iodized salt(χ~2=0.851, P =0.361), consumption rate of qualified iodized salt(χ~2=1.812, P=0.401), and the median of iodized salt(Z=2.060, P=0.380). Among pregnant women of different ages, there were significant differences in the qualified rate of iodized salt(χ~2=6.914, P=0.016) and the consumption rate of qualified iodized salt(χ~2=5.939, P=0.023), but there was no significant difference in the coverage rate of iodized salt(χ~2=0.241, P=0.623) and the median of iodized salt(Z=-0.382, P=0.703). Among women at different gestational periods, there was significant difference in the median of salt iodine(Z=13.381, P < 0.001), but there was no significant difference in the coverage rate of iodized salt(χ~2=0.486, P=0.784), the qualified rate of iodized salt(χ~2=0.714, P=0.713), and the consumption rate of qualified iodized salt(χ~2=0.447, P=0.813). A total of 1 302 urine samples of pregnant women were collected, and the median of urinary iodine was 174.5 μg/L. There was significant difference in urinary iodine of pregnant women in different regions(H=133.345, P < 0.001), but there was no significant difference in urinary iodine levels among different ethnic groups(H=5.436, P=0.143), age groups(H=0.183, P=0.913), and different gestational periods(H=2.937, P=0.302). There was no correlation between salt iodine content and urinary iodine level in pregnant women(rs=0.198, P =0.659). Conclusion The iodine nutrition level of pregnant women in Aba prefecture is generally appropriate, but there is still a risk of iodine deficiency in remote grassland counties. In the future, it is suggested that a special investigation and study on the iodine supplement rate of pregnant women in minority areas be carried out to dynamically grasp the iodine nutrition status during pregnancy. If necessary, it is suggested to promote special iodized salt for pregnant women and accurately guide pregnant women to supplement iodine scientifically.更多还原