發(fā)布時(shí)間：2018-08-25 08:53

【摘要】：目的 了解停供碘鹽后水源性高碘地區(qū)兒童和婦女的碘營養(yǎng)狀況及當(dāng)?shù)厝巳杭谞钕偃莘e和功能檢測(cè)情況,探討高碘地區(qū)劃定的水碘界值問題,為國家制定或調(diào)整水源性高碘地區(qū)防制策略提供科學(xué)依據(jù)。 方法 采用分層隨機(jī)抽樣方法,根據(jù)水碘含量將被調(diào)查村分為50μg/L～(A組)、100μg/L～(B組)、150gg/L～(C組)、300μg/L～(D組)4組。每組隨機(jī)選擇200名8-10歲學(xué)齡兒童和60名婦女(包括孕婦、哺乳婦女、育齡婦女各20名)作為研究對(duì)象。采集各研究對(duì)象家庭飲用水、食用鹽、和隨機(jī)一次尿樣,分別檢測(cè)水碘、鹽碘、尿碘含量。檢測(cè)8-10歲兒童甲狀腺容積。采集婦女血樣,檢測(cè)甲狀腺功能(FT3、FT4、TSH、Anti-TPO和Anti-Tg)。采用Excel和SPSS13.0進(jìn)行數(shù)據(jù)處理和統(tǒng)計(jì)分析。 結(jié)果 ①A組兒章尿碘中位數(shù)為274.3μg/L,碘營養(yǎng)水平為高于適宜量；B、C、D組兒童的尿碘中位數(shù)均大于300μg/L,碘營養(yǎng)水平為碘過量。兒童尿碘水平隨水碘值的升高而升高(H=403.66,v=3,P0.01)。 ②A、B組婦女尿碘中位數(shù)均在200～300μg/L之間,碘營養(yǎng)水平為高于適宜量。C、D組婦女,尿碘中位數(shù)均大于300μg/L,碘營養(yǎng)水平為碘過量。各階段婦女尿碘中位數(shù)均隨水碘值的升高而升高(χ2=100.27,v=3,P0.01)。 ③4組調(diào)查點(diǎn)兒童甲腫率分別為5.9%、13.0%、14.O%、11.4%,甲腫率隨著水碘水平的升高而增高。 ④A、C、D三組內(nèi),孕婦FT3、FT4水平均低于哺乳婦女、育齡婦女；且隨著各組調(diào)查點(diǎn)水碘水平的逐步升高,婦女的FT4激素水平逐漸下降,TSH水平逐漸上升。 結(jié)論 ①停供碘鹽后,水碘大于100μg/L時(shí),隨著水碘含量的升高,人群的碘營養(yǎng)水平由超過適宜量逐漸轉(zhuǎn)為碘過量,兒童甲腫率也在增大。 ②各階段婦女在不同水碘水平下,停供碘熱后其碘營養(yǎng)水平均能滿足懷孕和哺乳需求。 ③建議將高碘地區(qū)劃定標(biāo)準(zhǔn)的水碘含量切點(diǎn)值由150μg/L下調(diào)至100iμg/L ④在高碘地區(qū)應(yīng)針對(duì)不同水碘含量,因地制宜采取不同的干預(yù)措施,綜合防制高碘危害。
[Abstract]:Objective to investigate the iodine nutrition status of children and women and the thyroid volume and function of the local population in the water-source high iodine area after the discontinuation of iodized salt, and to discuss the water iodine boundary value in the high iodine area. It provides the scientific basis for the country to formulate or adjust the control strategy of water source high iodine area. Methods by stratified random sampling, the village was divided into 4 groups: group A (50 渭 g / L ~ (A) 100 渭 g / L ~ (B) and group C (300 渭 g / L ~ (C) with 300 渭 g / L ~ (D). Two hundred children aged 8 to 10 years and 60 women (including 20 pregnant women, 20 nursing women and 20 women of childbearing age) were randomly selected for each group. The contents of iodine, salt and iodine in water, salt and urine were measured. Thyroid volume was measured in children aged 8-10 years. Blood samples were collected and thyroid function (FT3,FT4,TSH,Anti-TPO and Anti-Tg) was measured. Excel and SPSS13.0 were used for data processing and statistical analysis. Results the median of urine iodine in group 1A was 274.3 渭 g / L, and the level of iodine nutrition was higher than that in group D. The median of urinary iodine in group A was more than 300 渭 g / L, and the level of iodine nutrition was iodine excess. The urinary iodine level of children increased with the increase of water iodine value (P 0.01). 2 the median of urinary iodine in group B was between 200 渭 g / L and 300 渭 g / L, and the nutritional level of iodine was higher than that in group C. the median of urinary iodine was more than 300 渭 g / L, and the nutritional level of iodine was iodine excess. The urinary iodine median of women in all stages increased with the increase of water iodine value (蠂 2100.27). The goiter rate of children in the 34 groups was 5.90.13.0 and 13.0 respectively. The goiter rate increased with the increase of water iodine level, and the rate of goiter increased with the increase of iodine level in water (P < 0.01), and the rate of goiter increased with the increase of iodine level in water (P < 0.01), and the rate of goiter increased with the increase of iodine level in water (P < 0.01). The levels of FT3,FT4 in pregnant women were lower than those in lactating women and women of childbearing age, and with the increase of iodine level in water of each group, the levels of FT4 hormones gradually decreased. Conclusion (1) when iodine in water is more than 100 渭 g / L after discontinuation of iodized salt, with the increase of iodine content in water, the iodine nutrition level of the population gradually changes from excess to excessive iodine. The rate of goiter in children is also increasing. 2 at different levels of iodine in water, The iodine nutrition level of iodine fever can meet the needs of pregnancy and lactation. 3 it is suggested that the cut point value of iodine content in water should be lowered from 150 渭 g / L to 100 I 渭 g / L 4 in high iodine area. Different intervention measures should be taken according to local conditions to prevent and control the harm of high iodine.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R172

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