本文選題：碘缺乏病 + 碘營(yíng)養(yǎng)��； 參考：《大理大學(xué)》2017年碩士論文

【摘要】：目的:本課題擬調(diào)查新標(biāo)準(zhǔn)碘鹽全面覆蓋后,云南省大理市外環(huán)境碘含量、居民戶碘鹽食用情況、不同人群尿碘水平、重點(diǎn)人群碘營(yíng)養(yǎng)來源等,重點(diǎn)了解人群的甲狀腺功能和甲狀腺疾病流行情況。探索甲狀腺球蛋白作為孕婦碘營(yíng)養(yǎng)生物標(biāo)記物的可行性,以及尿碘孕婦中位數(shù)在100~150μg/L時(shí),能否滿足母體的需要。以評(píng)估目前云南省不同人群的碘營(yíng)養(yǎng)水平及防治碘缺乏病的科學(xué)性和有效性,為全省碘缺乏病監(jiān)測(cè)和防治提供科學(xué)依據(jù)。方法:1.以行政村為單位,在大理市每個(gè)行政村調(diào)查一個(gè)飲用人數(shù)最多水源的水碘含量;調(diào)查2012-2015年居民戶食用碘鹽情況;計(jì)算水碘、鹽碘中位數(shù),碘鹽覆蓋率、碘鹽合格率、合格碘鹽食用率等。2.在大理市抽取孕婦、乳婦、學(xué)齡兒童、普通成年人群、0~4歲嬰幼兒和兒童,對(duì)研究對(duì)象進(jìn)行問卷調(diào)查、尿碘濃度檢測(cè)、甲狀腺B超、甲狀腺功能、甲狀腺球蛋白等內(nèi)容的橫斷面調(diào)查。計(jì)算大理市不同人群尿碘中位數(shù)以及甲狀腺疾病的患病率。分析甲狀腺球蛋白(Tg)),促甲狀腺激素(TSH)作為孕婦碘營(yíng)養(yǎng)生物標(biāo)記物的可行性。結(jié)果:1.大理市飲用水碘含量中位數(shù)為0.62μg/L,水碘含量范圍為0~9.92μg/L,所有飲用水碘含量10μg/L。2.大理市2012-2015年居民戶食鹽合格碘鹽食用率每年在90%以上,鹽碘中位數(shù)由2012年的29.38mg/kg下降至2015年的24.96mg/kg。3.不同人群的尿碘中位數(shù),孕婦為136.85μg/L,乳婦102.63μg/L,普通成年人群164.03μg/L,8~10歲兒童209.61μg/L,2歲兒童157.27μg/L,2~4歲兒童134.08μg/L。4.孕、乳婦富碘海產(chǎn)品的平均攝入頻次為1.1次/月,僅有1.99%的人群通過多維元素制劑來補(bǔ)碘。5.孕婦、乳婦、育齡婦女TSH中位數(shù)分別為1.995、2.345、2.565m IU/L;孕早、中、晚期TSH中位數(shù)分別為1.850、2.030、2.235 mIU/L。6.大理市成年人群甲狀腺結(jié)節(jié)總檢出率為14.70%,甲腫率為1.6%,甲亢、亞甲亢的患病率分別為0.16%、0.47%,甲減、亞甲減的患病率分別為0.47%、7.09%,成年人群TPOAb、TgAb陽性率都為9.22%。7.孕婦、乳婦、育齡婦女Tg中位數(shù)分別為10.49、9.28、9.66μg/L,均小于13μg/L;大于40μg/L的比例分別為1.90%、1.79%、2.08%,均小于3%。8.孕早、中、晚期Tg中位數(shù)分別為10.56、10.78、10.08μg/L,均小于13μg/L,大于40μg/L的比例分別為0、2.38%、3.28%,孕晚期的比例3%。結(jié)論:1.大理市外環(huán)境普遍缺碘,人群碘攝入主要依賴于加碘食鹽。2.大理市按期實(shí)現(xiàn)了鹽碘含量的下調(diào)。3.鹽碘含量下調(diào)后,大理市乳婦、育齡婦女、普通成年人群、2歲兒童都處于碘營(yíng)養(yǎng)適宜水平,學(xué)生處于高于適宜量水平。4.作為孕婦碘營(yíng)養(yǎng)評(píng)價(jià)指標(biāo),Tg好于TSH。5.以Tg來評(píng)價(jià),結(jié)合近年來90%以上的合格碘鹽食用率,大理市孕婦尿碘中位數(shù)在100-150μg/L之間,孕婦總體碘營(yíng)養(yǎng)缺乏的風(fēng)險(xiǎn)不大。但近幾年大理市非碘鹽沖銷和鹽業(yè)體制改革,需關(guān)注孕、乳婦個(gè)體碘營(yíng)養(yǎng)狀況。6.碘含量下調(diào)后,大理市處于持續(xù)消除碘缺乏病狀態(tài),人群甲狀腺疾病總體處于較低水平。
[Abstract]:Objective: to investigate the content of iodine in the environment of Dali, Yunnan Province, the consumption of iodized salt in households, the level of urinary iodine in different population groups, and the sources of iodine nutrition of the key population after the comprehensive coverage of the new standard iodized salt.Focus on the thyroid function of the population and the prevalence of thyroid diseases.To explore the feasibility of using thyroglobulin as a biomarker of iodine nutrition in pregnant women and whether the maternal needs can be satisfied when the median of pregnant women with urinary iodine is 100 ~ 150 渭 g / L.In order to evaluate the iodine nutrition level of different population in Yunnan Province and to provide scientific basis for the monitoring and prevention of iodine deficiency disorders in Yunnan province.Method 1: 1.Take the administrative village as the unit, investigate the water iodine content of one of the most potable water sources in each administrative village in Dali city; investigate the consumption of iodized salt by households from 2012 to 2015; calculate the water iodine, salt iodine median, iodized salt coverage rate and iodized salt qualified rate.Qualified iodized salt consumption rate, etc.Pregnant women, breast-wives, school-age children and children were selected from Dali city. The subjects were investigated by questionnaire, urinary iodine concentration, thyroid B ultrasound, thyroid function.Cross-sectional investigation of thyroid globulin and other contents.The median urinary iodine and the prevalence of thyroid disease were calculated in Dali.To analyze the feasibility of thyroglobulin (TG) and thyrotropin (TSH) as biological markers of iodine nutrition in pregnant women.The result is 1: 1.The median iodine content in drinking water in Dali is 0.62 渭 g / L, the iodine content in water is in the range of 0 ~ 9.92 渭 g / L, and the iodine content in all drinking water is 10 渭 g / L 路L. 2.In Dali City, the annual consumption rate of household salt qualified iodized salt was more than 90% between 2012 and 2015, and the median salt iodine consumption rate fell from 2012 to 24.96 mg / kg 路3 in 2015.The median urinary iodine was 136.85 渭 g / L for pregnant women, 102.63 渭 g / L for nursing women, 209.61 渭 g / L / L for children aged 10 years, 209.61 渭 g / L / L for children aged 2 to 2 years old, 134.08 渭 g / L 路L / L for children of 4 years old.During pregnancy, the average intake frequency of iodine rich seafood was 1.1 times per month. Only 1.99% of the population supplemented iodine by multi-dimensional preparation.The median TSH of pregnant women, nursing women and women of childbearing age were 1.995U 2.345v 2.565m IUs / L and 1.850,2.030m / 2.235m / L 路L ~ (-1) of TSH in early, middle and late pregnancy, respectively.The total detection rate of thyroid nodules in adult population of Dali was 14.70, the rate of thyroid swelling was 1.6, the prevalence of hyperthyroidism and subthyroidism was 0.16, the prevalence of hypothyroidism and subthyroidism was 0.477.09, and the positive rate of TPOAb-TgAb was 9.22.The median TG of pregnant women, breast-wives and women of childbearing age was 10.49 / 9.280.66 渭 g / L, respectively, and the proportion of pregnant women > 40 渭 g / L was 1.90 and 1.79 / L, respectively.The median of TG in the early, middle and late trimester of pregnancy was 10.56 鹵10.78 鹵10.08 渭 g / L, respectively, which were less than 13 渭 g / L, and the proportion greater than 40 渭 g / L was 0.2.38 / L and 3.28, respectively.Conclusion 1.Iodine deficiency is common in the outside environment of Dali, and iodine intake mainly depends on iodized salt. 2.In Dali City, the iodine content of salt has been reduced by 3. 3 on schedule.After the decrease of salt iodine content, the suckling women, women of childbearing age, and general adults were all in the suitable level of iodine nutrition, and the students were above the appropriate level. 4.As an evaluation index of iodine nutrition in pregnant women, TG was better than that of TSH.5.According to TG, combined with the consumption rate of 90% of qualified iodized salt in recent years, the median urinary iodine of pregnant women in Dali was between 100-150 渭 g / L, and the risk of total iodine deficiency of pregnant women was not significant.However, in recent years, the non-iodized salt sterilisation and salt industry system reform in Dali city need to pay attention to the iodine nutrition status.After the decrease of iodine content, Dali is in the condition of eliminating iodine deficiency disorders, and the thyroid diseases in the population are generally at a low level.
【學(xué)位授予單位】：大理大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R599

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