【摘要】 目的 通过描述性分析2000—2024年青海省各级(省、地市、县级)碘缺乏病(IDD)实验室不同检测项目(尿碘、盐碘、水碘)的外质控考核结果，掌握实验室检测能力现状及变化趋势，提出下一步工作重点。方法 尿碘考核在2000—2019年采用“Z比评分法”，在2020—2024年采用“参考值±不确定度范围”进行检测结果的统计学评价;盐碘考核期间均采用“参考值±不确定度范围”进行评价;水碘考核在2014—2017年采用“Z比评分法”，在2018—2024年采用“参考值±不确定度范围”进行评价。结果 由国家碘缺乏病参照实验室(NRL)进行结果判定。将考核结果按照不同层级、不同检测项目和不同年份的顺序依次分析，省级尿碘有4年的考核结果被NRL判定为Z分值“2<|Z|<3”，揭示需检查系统误差和注意避免随机误差，其余的21年期间考核结果均为“合格”;省级盐碘、水碘实验室考核结果均在不确定度范围内，具备可靠的检测能力。8个地市级尿碘实验室合格率由2000年的50.0%(4/8)提高到2024年的87.5%(7/8)，盐碘实验室合格率由2000年的37.5%(3/8)上升至2024年的100.0%(8/8)，水碘实验室除2016年合格率为87.5%(7/8)以外，其余10年合格率均为100.0%(8/8)。县级盐碘考核合格率由2000年的6.7%(2/30)上升至2024年的97.7%(42/43)，但是县级从2017年开始参加尿碘考核以来，合格率波动较大，最低为83.7%，最高可达100.0%。结论 青海省IDD实验室检测能力整体提升，省级实验室能力稳定领先，地市级提升显著，县级盐碘检测能力进步明显，但尿碘检测仍为薄弱环节，提示今后需继续开展多种形式的尿碘检测培训工作，并持续加强县级实验室能力建设与质量管理。更多还原

【Abstract】 Objective Through descriptive analysis of the external quality control assessment results of different testing items(urine iodine,salt iodine,water iodine) in iodine deficiency disorders(IDD) laboratories at all levels(provincial,prefectural and county levels) in Qinghai Province from 2000 to 2024, to grasp the current status and changing trends of laboratory testing capabilities,and to propose the key points of the next step of work. Methods The “ Z-ratio scoring method” was used for the assessment of urinary iodine from 2000 to 2019, and the “ reference value ± uncertainty range” was used for the statistical evaluation of the test results from 2020 to 2024.During the salt iodine assessment period,the evaluation was conducted using the“reference value ± uncertainty range”.The water iodine assessment was conducted using the “Z-ratio scoring method” from 2014 to 2017,and the “ reference value ± uncertainty range” from 2018 to 2024.Results The results were determined by the National Iodine Deficiency Disorders Reference Laboratory(NRL).The assessment results were analyzed in sequence according to different levels,different testing items and different years.The provincial urine iodine assessment results for four years were determined by NRL as a Z-score of "2< | Z | <3",indicating that systematic errors needed to be checked and random errors should be avoided.The assessment results for the remaining 21 years were all “ qualified”. The assessment results of the provincial salt iodine and water iodine laboratories were all within the range of uncertainty,demonstrating reliable testing capabilities. The qualified rate of urine iodine laboratories in 8 prefectural-level cities increased from 50. 0%(4/8) in 2000 to 87. 5%(7/8) in 2024, and the qualified rate of salt iodine laboratories rose from 37.5%(3/8) in 2000 to 100.0%(8/8) in 2024.Except for the qualified rate of 87.5%(7/8) in 2016,the qualified rate of the water iodine laboratory was 100.0%(8/8) in the other 10 years.The pass rate of salt iodine assessment at the county level rose from 6.7%(2/30) in 2000 to 97.7%(42/43) in 2024.However,since the county began to participate in urine iodine assessment in 2017,the pass rate has fluctuated greatly,with the lowest being 83.7% and the highest reaching 100.0%.Conclusion The overall testing capacity of IDD laboratories in Qinghai Province has been enhanced.The capacity of provincial laboratories remains stable and leading,while that of prefectural-level laboratories has improved significantly.The salt iodine testing capacity of county-level laboratories has made notable progress,but urine iodine testing remains a weak link. This suggests that in the future,various forms of urine iodine testing training should be continued to be carried out,and the capacity building and quality management of county-level laboratories should be strengthened continuously.更多还原