本文選題：四類人群 + 碘營(yíng)養(yǎng)��； 參考：《安徽醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的了解在當(dāng)前食用鹽加碘濃度（35±15mg/kg）下，合肥市四類人群0-2歲嬰幼兒、8-10歲學(xué)齡兒童、哺乳期婦女和孕婦的碘營(yíng)養(yǎng)水平現(xiàn)狀，評(píng)價(jià)8-10歲學(xué)齡兒童碘營(yíng)養(yǎng)水平能否代表合肥市四類人群的碘營(yíng)養(yǎng)水平，以及孕期及哺乳期婦女碘營(yíng)養(yǎng)水平對(duì)垂體-甲狀腺功能以及其子代碘營(yíng)養(yǎng)水平的影響，探討8-10歲學(xué)齡兒童和0-2歲嬰幼兒的碘營(yíng)養(yǎng)水平與其生長(zhǎng)發(fā)育指標(biāo)的關(guān)系，為科學(xué)防治碘缺乏病提供理論依據(jù)。 方法整群抽取合肥市包河區(qū)和長(zhǎng)豐縣，按照東南西北中5個(gè)方位抽取5個(gè)鄉(xiāng)，每鄉(xiāng)隨機(jī)抽取2所小學(xué)，在每所小學(xué)隨機(jī)抽取40名以上8-10歲學(xué)齡兒童（數(shù)量不足可從最臨近的學(xué)校補(bǔ)足），年齡組8，9，10歲均衡分布，男女各半。在每所抽樣小學(xué)附近的街道、鄉(xiāng)村分別抽取10名以上孕婦、哺乳期婦女及其0-2歲嬰幼兒、18-45歲育齡婦女（對(duì)照人群）。采集四類人群一次性隨機(jī)尿樣，8-10歲兒童、孕婦和哺乳期婦女家庭食用鹽樣、水樣，孕婦和哺乳期婦女血樣以及哺乳期婦女乳汁樣，并對(duì)8-10歲學(xué)齡兒童和0-2歲嬰幼兒生長(zhǎng)發(fā)育指標(biāo)進(jìn)行測(cè)量。對(duì)碘鹽合格率、水碘濃度、尿碘濃度、乳碘濃度、甲狀腺功能指標(biāo)（TSH、FT4、TT4和TT3）以及生長(zhǎng)發(fā)育指標(biāo)等進(jìn)行分析。 結(jié)果合肥市居民戶鹽碘中位數(shù)為28.3mg/kg，碘鹽覆蓋率98.2%，居民戶合格碘鹽食用率95.1%，城區(qū)高于農(nóng)村，城鄉(xiāng)居民戶合格碘鹽食用率差異有統(tǒng)計(jì)學(xué)意義（χ2=6.172，P=0.013）；飲用水水碘濃度7.7μg/L，農(nóng)村高于城區(qū)，差異有統(tǒng)計(jì)學(xué)意義（Z＝-8.276，P0.001）；四類人群0-2歲嬰幼兒、8-10歲學(xué)齡兒童、哺乳期婦女和孕婦尿碘中位數(shù)分別為303.7μg/L,358.1μg/L,209.1μg/L和161.8μg/L，哺乳期婦女和0-2歲嬰幼兒尿碘處于良好和適宜的水平，孕婦尿碘處于不足水平，8-10歲學(xué)齡兒童尿碘超過適宜水平，8-10歲學(xué)齡兒童尿碘明顯高于其他三類人群，四類人群尿碘水平組間差異有統(tǒng)計(jì)學(xué)意義（χ2=211.857，P0.001）；城區(qū)8-10歲兒童尿碘中位數(shù)明顯高于農(nóng)村，而城區(qū)孕婦尿碘中位數(shù)顯著低于農(nóng)村，，城鄉(xiāng)尿碘水平差異均有統(tǒng)計(jì)學(xué)意義（Z=-1.990和-3.192，P0.05）；18-45歲育齡婦女尿碘中位數(shù)高于哺乳期婦女和孕婦，差異有統(tǒng)計(jì)學(xué)意義（χ2=55.435P0.001）；高尿碘組和適宜尿碘組8-10歲學(xué)齡兒童身高和體重都大于低尿碘組，其差異有統(tǒng)計(jì)學(xué)意義（F=8.115和4.544，P0.05），低尿碘組嬰幼兒體重和頭圍均小于適宜尿碘組和高尿碘組，三組之間頭圍差異有統(tǒng)計(jì)學(xué)意義（F=3.313,P 0.05）；城鄉(xiāng)孕婦FT4、TT4和TT3差異均有統(tǒng)計(jì)學(xué)意義（t=5.28、6.49和9.99，P0.001），不同尿碘水平FT4和TT3組間差異均有統(tǒng)計(jì)學(xué)意義（χ2=6.14和7.64，P0.05）；城鄉(xiāng)哺乳期婦女TT4和TT3差異均有統(tǒng)計(jì)學(xué)意義（t=-10.627和2.548，P0.05），不同尿碘水平TSH和FT3組間差異均有統(tǒng)計(jì)學(xué)意義（χ2=10.155和29.900，P0.05）；哺乳期婦女尿碘水平與其嬰幼兒尿碘水平相關(guān)性有統(tǒng)計(jì)學(xué)意義（r尿-尿＝0.466，P0.001）。 結(jié)論合肥市四類人群中孕婦碘營(yíng)養(yǎng)處于不足水平，8-10歲學(xué)齡兒童超過適宜水平；8-10歲學(xué)齡兒童碘營(yíng)養(yǎng)水平不能完全代表其他三類人群的碘營(yíng)養(yǎng)水平，孕期及哺乳期婦女碘營(yíng)養(yǎng)水平對(duì)其垂體-甲狀腺功能有一定的影響，哺乳期婦女尿碘水平與其嬰幼兒尿碘水平之間呈相關(guān)性，8-10歲學(xué)齡兒童和0-2歲嬰幼兒碘營(yíng)養(yǎng)水平對(duì)其生長(zhǎng)發(fā)育指標(biāo)有影響。建議今后碘缺乏病防治監(jiān)測(cè)應(yīng)綜合考慮以上四類人群的碘營(yíng)養(yǎng)水平，以便更好地預(yù)防和控制碘缺乏病。
[Abstract]:Objective to understand the status of iodine nutrition level of 0-2 year old children, 8-10 year old school age children, lactating women and pregnant women under the current salt iodine concentration (35 + 15mg/kg), and to evaluate iodine nutrition level of four class of people in Hefei city and the iodine nutrition water of pregnant and lactating women in 8-10 year old children. The relationship between the iodine nutrition level of 8-10 year old children and 0-2 year old infants and their growth and development indexes was discussed in order to provide a theoretical basis for the scientific prevention and treatment of iodine deficiency.
Methods a group of Hefei and Changfeng counties were selected to extract 5 townships in 5 places in the Middle East and West. 2 primary schools were randomly selected from each township in each township. At each primary school, 40 or more 8-10 year old school-age children were randomly selected. The age group was in a balanced distribution of 8,9,10 years old. In the streets and villages, 10 or more pregnant women, breast-feeding women and their 0-2 year old infants and 18-45 year old women of childbearing age (control crowd) were collected, and four groups of people were collected for one time random urine sample, 8-10 year old children, pregnant women and lactation women's families to eat salt samples, water samples, pregnant women and lactation women's blood samples and lactating women's milk samples, and 8-10 year old school age. The growth and development indexes of children and 0-2 year old infants were measured. The qualification rate of iodized salt, iodine concentration, iodine concentration, iodine concentration, thyroid function index (TSH, FT4, TT4 and TT3), and growth and development indexes were analyzed.
Results the median of salt iodine was 28.3mg/kg, the coverage rate of iodized salt was 98.2%, the consumption rate of qualified iodized salt was 95.1%, and the urban area was higher than that in the rural area. The difference of the qualified iodized salt consumption rate of urban and rural residents was statistically significant (x 2=6.172, P=0.013); the iodine concentration of drinking water was 7.7 g/L, and the difference was statistically significant (Z = -8.276, P0.0). 01); four groups of 0-2 year old children, 8-10 year old school age children, breast-feeding women and pregnant women urine iodine median of 303.7 mu g/L, 358.1 mu g/L, 209.1 g/L and 161.8 mu g/L, breast-feeding women and 0-2 years of infant urine iodine in good and appropriate level, pregnant women's urine iodine is not at the level, 8-10 years of school age children urine iodine exceeds the appropriate level, 8-10 iodine level, 8-10. The urine iodine of school age children was significantly higher than that of the other three groups, and the difference of urine iodine level between the four groups was statistically significant (2=211.857, P0.001); the median urine iodine number of 8-10 year old children in the urban area was significantly higher than that in the rural areas, while the median urine iodine in the urban areas was significantly lower than that in the rural areas. The difference in the level of urine iodine in urban and rural areas was statistically significant (Z=-1.990 and -3.192, P0.0 5): the median urine iodine number of women of childbearing age at 18-45 years was higher than that of lactating women and pregnant women, the difference was statistically significant (x 2=55.435P0.001). The height and weight of the high urine iodine group and the suitable iodine group at 8-10 year old school age children were higher than those of the low urinary iodine group. The difference was statistically significant (F=8.115 and 4.544, P0.05), and the weight and head circumference of the low urinary iodine group were less than those of the low urine iodine group. The difference in head circumference between the three groups was statistically significant (F=3.313, P 0.05). The differences in FT4, TT4 and TT3 between urban and rural pregnant women were statistically significant (t=5.28,6.49 and 9.99, P0.001), and there were significant differences between the groups of FT4 and TT3 (x 2=6.14 and 7.64, P0.05). There were statistical significance (t=-10.627 and 2.548, P0.05). There was significant difference between TSH and FT3 in different levels of urine iodine (x 2=10.155 and 29.900, P0.05), and the correlation between urine iodine level and urine iodine level in breast feeding women was statistically significant (r urine - urine = 0.466, P0.001).
Conclusion the iodine nutrition of pregnant women in the four groups of Hefei is inadequate, and the 8-10 year old school age children exceed the appropriate level. The iodine nutrition level of 8-10 year old children can not fully represent the iodine nutrition level of the other three groups. The iodine nutrition level of the pregnant and lactation women has certain influence on the pituitary thyroid gland function and the lactation period women's urine. Iodine level is related to the level of urine iodine in infants and young children. Iodine nutrition levels of 8-10 year old children and 0-2 year old children have an impact on their growth and development. It is suggested that iodine deficiency in the prevention and control of iodine deficiency diseases should be taken into consideration in order to prevent and control iodine deficiency.

【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R151.41

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