本文選題：農(nóng)村地區(qū)　切入點：學(xué)齡兒童　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:了解河北省農(nóng)村地區(qū)學(xué)齡兒童的營養(yǎng)狀況和智力發(fā)育情況,并探討影響學(xué)齡兒童智力發(fā)育的相關(guān)因素。方法:采用整群隨機抽樣方法,在河北省石家莊市行唐縣中隨機抽取3所全日制寄宿小學(xué)確定為研究現(xiàn)場,將這3所學(xué)校2~6年級的學(xué)生作為調(diào)查對象。研究項目包括問卷調(diào)查、膳食調(diào)查、體格測量、智力測試等,以及血液生化指標(biāo)、維生素水平等檢測。結(jié)果:1調(diào)查樣本基本特征三所學(xué)校參加調(diào)查的學(xué)齡兒童共894人,實際完成調(diào)查學(xué)生人數(shù)795人,完成率88.93%;其中男生376人,女生419人。照顧兒童普遍有母親參與,但存在一定比例的留守兒童;家庭年人均收入水平以5000元以下為主,占84.40%;父母受教育程度以初中為主。2兒童在校期間膳食情況畜肉類食品攝入量不足,豆類、堅果類、奶類攝入量很少,魚蝦類食品幾乎未攝入,而食鹽攝入過多,其他類型食品攝入基本達(dá)到推薦量;平均每人每日的硫胺素、煙酰胺、抗壞血酸及鐵元素攝入基本滿足推薦量,蛋白質(zhì)攝入總量略顯不足,而視黃醇、核黃素、鈣元素的攝入量明顯不足。3體格發(fā)育情況生長遲緩22人,總體生長遲緩率為2.77%,男生、女生分別為3.19%和2.39%,差異無統(tǒng)計學(xué)意義;消瘦20人,總消瘦率為2.52%,男生、女生分別為3.19%和1.90%,差異無統(tǒng)計學(xué)意義;超重119人,總超重率為14.97%,男生、女生分別為11.17%和18.38%,差異有統(tǒng)計學(xué)意義;肥胖61人,總肥胖率為7.67%,男生、女生分別為7.71%和7.64%,差異無統(tǒng)計學(xué)意義;中心性肥胖96人,占總?cè)藬?shù)的12.08%,男生、女生分別為9.04%和14.80%,差異有統(tǒng)計學(xué)意義。4智力發(fā)育水平得分等級的優(yōu)秀、良好、中等、中下和低下構(gòu)成比分別為3.32%、29.91%、47.25%、15.17%和4.34%,男生的平均智力等級高于女生,但差異無統(tǒng)計學(xué)意義;第二年重復(fù)施測的結(jié)果差異無統(tǒng)計學(xué)意義。5血清生化指標(biāo)水平及相關(guān)患病情況血紅蛋白(hemoglobin,hb)濃度平均水平為142.94±11.87g/l,總貧血患病率為2.86%,男生、女生分別為2.45%和3.23%,差異無統(tǒng)計學(xué)意義。白蛋白(albumin,alb)濃度平均水平為47.00±2.33g/l,男生、女生分別為46.75±2.31g/l和47.22±2.32g/l,差異有統(tǒng)計學(xué)意義,未發(fā)現(xiàn)血清白蛋白水平低下的兒童;總蛋白(totalprotein,tp)濃度平均水平為72.63±4.87g/l,男生、女生分別為72.18±5.00g/l和73.00±4.73g/l,差異有統(tǒng)計學(xué)意義。甘油三酯(triglyceride,tg)濃度平均水平為0.68±0.41mmol/l,男生、女生分別為0.64±0.41mmol/l和0.71±0.42mmol/l,差異有統(tǒng)計學(xué)意義,共發(fā)現(xiàn)16名血清甘油三酯濃度過高的兒童,占2.80%;總膽固醇(totalcholestrol,tc)濃度平均水平為3.74±0.73mmol/l,男生、女生分別為3.67±0.62mmol/l和3.80±0.80mmol/l,差異無統(tǒng)計學(xué)意義,共發(fā)現(xiàn)14名血清總膽固醇濃度過高的兒童,占2.36%;低密度脂蛋白(lowdensitylipoproteincholesterol,ldl-c)濃度平均水平為1.97±0.55mmol/l,男生、女生分別為1.92±0.51mmol/l和2.02±0.59mmol/l,差異有統(tǒng)計學(xué)意義,共發(fā)現(xiàn)6名血清低密度脂蛋白濃度過高的兒童,占1.01%;高密度脂蛋白(highdensitylipoproteincholesterol,hdl-c)濃度平均水平為1.47±0.33mmol/l,男生、女生分別為1.50±0.38mmol/l和1.45±0.29mmol/l,差異無統(tǒng)計學(xué)意義,共發(fā)現(xiàn)30名血清高密度脂蛋白濃度過低的兒童,占5.05%。尿酸(uricacid,sua)濃度平均水平為292.67±67.95μmol/l,男生、女生分別為290.13±67.27μmol/l和294.73±68.53μmol/l,差異無統(tǒng)計學(xué)意義,共發(fā)現(xiàn)31名高尿酸血癥的兒童,占5.20%。鐵蛋白(serumferritin,sf)濃度平均水平為36.06±16.75μg/l,男生、女生分別為35.32±16.82μg/l和36.66±16.71μg/l,差異無統(tǒng)計學(xué)意義,共發(fā)現(xiàn)22名鐵缺乏的兒童,占總?cè)藬?shù)的3.71%。載脂蛋白a濃度平均水平為1.57±0.36g/l,男生、女生分別為1.58±0.36g/l和1.56±0.37g/l,差異無統(tǒng)計學(xué)意義;其中水平過高的占11.99%,水平過低的占1.86%。載脂蛋白b濃度平均水平為0.60±0.20g/l,男生、女生分別為0.56±0.19g/l和0.61±0.19g/l,差異有統(tǒng)計學(xué)意義;其中水平過高的占2.84%,水平過低的占10.18%。6血清維生素水平血清維生素a平均水平為0.74±0.27μmol/l,男生、女生分別為0.72±0.25μmol/l和0.75±0.28μmol/l,差異無統(tǒng)計學(xué)意義;血清維生素a水平缺乏(vitaminadeficiency,vad)的兒童有356名,占總?cè)藬?shù)的46.54%,邊緣性缺乏(subclinicalvitaminadeficiency,svad)的兒童有335名,占總?cè)藬?shù)的43.79%。血清25(oh)d3平均濃度為45.57±18.27nmol/l,男生、女生分別為45.79±16.36nmol/l和45.31±20.32nmol/l,差異無統(tǒng)計學(xué)意義;缺乏的63人,占8.75%,水平不足的419人,占58.19%,水平正常的196人,占27.22%,水平充足的42人,占5.83%。血清維生素b1平均水平為58.53±41.44nmol/l,男生、女生分別為56.52±32.86nmol/l和60.43±48.56nmol/l,差異有統(tǒng)計學(xué)意義;血清維生素b2平均水平為0.68±0.46nmol/l,男生、女生分別為0.65±0.40nmol/l和0.69±0.51nmol/l,差異無統(tǒng)計學(xué)意義;煙酰胺平均水平為6.27±4.22ng/ml,男生、女生分別為6.11±3.93ng/l和6.38±4.40ng/l,差異無統(tǒng)計學(xué)意義。7學(xué)齡兒童智力發(fā)育與多種維生素水平相關(guān)性研究本研究發(fā)現(xiàn),排除混雜因素后,血清維生素d與智力水平呈正相關(guān),血清維生素a、維生素b1、維生素b2、煙酰胺與智力水平無相關(guān)性。血清維生素d濃度隨智力等級的升高而遞增,除智力良好和中等、中等和中下組間差異無統(tǒng)計學(xué)意義外,其他各組間差異均有統(tǒng)計學(xué)意義。結(jié)論:1河北省農(nóng)村地區(qū)仍存在學(xué)齡兒童膳食結(jié)構(gòu)不合理、部分微量營養(yǎng)素攝入不足等問題。2河北省農(nóng)村地區(qū)學(xué)齡兒童體格發(fā)育良好,但超重、肥胖問題不容忽視。3河北省農(nóng)村地區(qū)學(xué)齡兒童血清生化指標(biāo)檢測結(jié)果比較良好,但部分兒童的營養(yǎng)缺乏癥患病情況仍需關(guān)注。4河北省農(nóng)村地區(qū)學(xué)齡兒童智力水平相對較好,學(xué)齡兒童智力發(fā)育水平與血清維生素D水平存在正相關(guān)關(guān)系,其他維生素水平未發(fā)現(xiàn)與智力水平存在相關(guān)性。
[Abstract]:Objective: to understand the nutritional status and intelligence of school-age children in rural areas of Hebei province's development, and explore the influencing factors of school-age children's mental development. Methods: using cluster random sampling method, in Hebei province Xingtang County in Shijiazhuang city were randomly selected from 3 full-time boarding elementary school as the research site, the 3 schools 2~6 grade students as the research object. Research projects including questionnaire survey, dietary survey, physical examination, intelligence test, and blood biochemical indexes, detection of vitamin levels. Results: the basic characteristics of 1 survey samples of three schools participated in the survey of school-age children in a total of 894 people, the actual completion of the investigation with 795 students, the completion rate of 88.93%; there were 376 boys and 419 girls. Take care of children generally have a mother to participate, but there is a certain proportion of left-behind children; family per capita income level to 5000 yuan, accounting for 84.40% of the father; The parent education level of junior high school.2 children during the period of school dietary intake status of animal meat, beans, nuts, milk intake rarely, fish food almost no intake, and excessive intake of salt, other types of food intake reached the recommended amount; the daily average thiamine, nicotinamide, ascorbic acid and iron intake meet the recommended amount, the total protein intake is insufficient, and retinol, riboflavin, calcium intake was significantly less than.3 physical development retardation of growth of 22, the overall growth rate of 2.77%, boys and girls were 3.19% and 2.39%, the difference was not statistically significant; weight loss of 20 people, the total weight loss rate was 2.52%, boys and girls were 3.19% and 1.90%, the difference was not statistically significant; overweight 119 people, the total rate of overweight was 14.97%, boys and girls were 11.17% and 18.38%, the difference was statistically significant; 61 obese people In total, the obesity rate was 7.67%, boys and girls were 7.71% and 7.64%, the difference was not statistically significant; central obesity is 96 people, accounting for 12.08% of the total number of boys and girls, respectively 9.04% and 14.80%, there was a significant difference between the.4 level of intellectual development level of excellent, good, medium, middle and low proportion were 3.32%, 29.91%, 47.25%, 15.17% and 4.34%, the average intelligence level of boys were higher than girls, but the difference was not statistically significant; second years after the results showed no statistical significance and biochemical indexes of serum.5 level and related prevalence of hemoglobin (hemoglobin, HB) the average concentration was 142.94 + 11.87g/l, the total prevalence rate of anemia 2.86%, boys and girls were 2.45% and 3.23%, the difference was not statistically significant. Albumin (albumin, ALB) the average concentration was 47 + 2.33g/l, boys, girls were 46.75 + 2.31g/l and 47.22 + 2.32g/l, difference There was a significant correlation, not low serum albumin level in children; total protein (totalprotein, TP) the average concentration was 72.63 + 4.87g/l, boys, girls were 72.18 + 5.00g/l and 73 + 4.73g/l, the difference was statistically significant (triglyceride, TG). Triglyceride concentration average was 0.68 + 0.41mmol/l, boys and girls were 0.64 + 0.41mmol/l and 0.71 + 0.42mmol/l, there were statistically significant differences were found in 16 patients, serum triglyceride concentration is too high for children, accounted for 2.80%; the total cholesterol (totalcholestrol, TC) the average concentration was 3.74 + 0.73mmol/l, boys, girls were 3.67 + 0.62mmol/l and 3.80 + 0.80mmol/l, there was no significant difference in total. The discovery of 14 serum total cholesterol concentration in children, accounting for 2.36%; low density lipoprotein (lowdensitylipoproteincholesterol, LDL-C) average concentration was 1.97 + 0.55mmol/l, boys and girls Were 1.92 + 0.51mmol/l and 2.02 + 0.59mmol/l, there were statistically significant differences were found in 6 patients, serum low density lipoprotein concentrations in children, accounting for 1.01%; high density lipoprotein (highdensitylipoproteincholesterol, HDL-C) the average concentration was 1.47 + 0.33mmol/l, male students, girls were 1.50 + 0.38mmol/l and 1.45 + 0.29mmol/l, difference no statistical significance were found in 30 serum high density lipoprotein concentration in children, accounting for 5.05%. of uric acid (uricacid, SUA) the average concentration was 292.67 + 67.95 mol/l, boys, girls were 290.13 + 67.27 and 294.73 + mol/l 68.53 mol/l, and no significant differences were found in 31 hyperuricemia children, accounting for 5.20%. of ferritin (serumferritin, SF) the average concentration was 36.06 + 16.75 g/l, boys, girls were 35.32 + 16.82 and 36.66 + g/l 16.71 g/l, and no significant differences were found in 2 2 of iron deficiency in children, the total number of 3.71%. apolipoprotein A concentration level was 1.57 + 0.36g/l, boys, girls were 1.58 + 0.36g/l and 1.56 + 0.37g/l, the difference was not statistically significant; the high level accounted for 11.99%, 1.86%. accounted for the low level of the average level of apolipoprotein B concentration was 0.60. 0.20g/l, boys, girls were 0.56 + 0.19g/l and 0.61 + 0.19g/l, the difference was statistically significant; the high level accounted for 2.84%, accounting for the low level of the serum vitamin 10.18%.6 level in serum vitamin A levels of 0.74 + 0.27 mol/l, boys, girls were 0.72 + 0.25 and 0.75 + 0.28 mol/l mol/l. There was no statistically significant difference; the level of serum vitamin A deficiency (vitaminadeficiency, VAD) of the 356 children, accounting for 46.54% of the total number, marginal deficiency (subclinicalvitaminadeficiency, svad) of the 335 Children, the total number of 43.79%. blood 25 (OH) D3 average concentration was 45.57 + 18.27nmol/l, boys, girls were 45.79 + 16.36nmol/l and 45.31 + 20.32nmol/l, the difference was not statistically significant; the lack of 63 people, accounted for 8.75%, 419 people, inadequate levels accounted for 58.19% of the normal level of 196 people, accounted for 27.22%, 42 level is sufficient. 5.83%. serum vitamin B1 levels were 58.53 + 41.44nmol/l, boys, girls were 56.52 + 32.86nmol/l and 60.43 + 48.56nmol/l, the difference was statistically significant; the average level of serum vitamin B2 was 0.68 + 0.46nmol/l, boys, girls were 0.65 + 0.40nmol/l and 0.69 + 0.51nmol/l, the difference was not statistically significant; the average level of nicotinamide was 6.27. 4.22ng/ml, boys, girls were 6.11 + 3.93ng/l and 6.38 + 4.40ng/l, there was no significant difference in.7 between school-age children's mental development and various levels of vitamin research this research found that the confounding factors, serum Vitamin D and positively related to intellectual level, serum vitamin A, vitamin B1, vitamin B2, nicotinamide and intelligence level. No correlation between serum vitamin D concentration with intelligence levels increased, in addition to good intelligence and medium, there was no significant difference between middle and lower groups, meaning between the other groups were statistically significant. Conclusion: 1 Hebei province rural areas still exist in school-age children's diet is not reasonable, the physical part of school-age children micronutrient intake of.2 in Hebei province rural area development is good, but overweight, obesity problems can not be ignored biochemical indexes in serum of school-age children in rural areas of Hebei province.3 detection result is good, but some children nutrition deficiency prevalence the intelligence level of school-age children still need to pay attention to.4 in rural areas of Hebei province is relatively good, school-age children's intelligence development level and the level of serum vitamin D Positive correlation, other vitamin levels were not found to be associated with the level of intelligence.

【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R153.2

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本文編號：1630638