CAJ | 학술논문

目的评价脑发育关键期碘营养干预对婴幼儿发育商改善的效果.方法在甘肃省临夏回族自治州(临夏州),向孕期、哺乳期妇女和断乳后3岁内婴幼儿实施补充碘油干预措施.分别于干预前后(2006年、2007-2010年),在临夏州8个县(市)按照东、西、南、北、中5个方位各抽取1个乡,每个乡抽取1个村,每个村抽取0～3岁婴幼儿、孕妇及哺乳期妇女各20名(不足者从邻近村庄补足),采集尿样,用砷铈催化分光光度法测定尿碘.另于2006、2010年根据《0～6岁小儿神经精神发育量表》测定干预前后0～3岁婴幼儿发育商(DQ).结果干预前(2006年)孕妇、哺乳期妇女、0～3岁婴幼儿尿碘中位数分别为89.3、84.9、107.3 μg/L.干预后(2007-2010年)孕妇各年度尿碘中位数分别为136.0、187.8、118.2、175.8 μg/L;哺乳期妇女尿碘中位数分别为135.2、159.8、187.5、163.5 μg/L;0 ～3岁婴幼儿尿碘中位数分别为139.6、174.7、190.7、168.4 μg/L.干预前(2006年)0～3岁婴幼儿DQ总值为92.8±16.3,5个能力区域(大运动、精细运动、适应能力、语言、社交行为)得分分别为93.7±20.0、91.4±20.0、92.4±19.0、90.3±20.0、96.4±22.1,干预后(2010年)DQ总值为104.3±13.8,5个能力区域得分分别为104.8±21.5、104.1±17.2、104.8±16.1、99.9±19.1、108.0±22.7,均较干预前明显提高(t值分别为-10.43、-10.77、-13.78、-14.28、-9.96、-15.33,P均＜0.01).结论脑发育关键期碘营养不足可影响婴幼儿智能发育各个能区,通过脑发育关键期碘营养干预能使婴幼儿获得充足的碘营养,从而有效防止碘缺乏造成的智能发育障碍.
목적 평개뇌발육관건기전영양간예대영유인발육상개선적효과.방법 재감숙성림하회족자치주(림하주),향잉기、포유기부녀화단유후3세내영유인실시보충전유간예조시.분별우간예전후(2006년、2007-2010년),재림하주8개현(시)안조동、서、남、북、중5개방위각추취1개향,매개향추취1개촌,매개촌추취0～3세영유인、잉부급포유기부녀각20명(불족자종린근촌장보족),채집뇨양,용신시최화분광광도법측정뇨전.령우2006、2010년근거《0～6세소인신경정신발육량표》측정간예전후0～3세영유인발육상(DQ).결과 간예전(2006년)잉부、포유기부녀、0～3세영유인뇨전중위수분별위89.3、84.9、107.3 μg/L.간예후(2007-2010년)잉부각년도뇨전중위수분별위136.0、187.8、118.2、175.8 μg/L;포유기부녀뇨전중위수분별위135.2、159.8、187.5、163.5 μg/L;0 ～3세영유인뇨전중위수분별위139.6、174.7、190.7、168.4 μg/L.간예전(2006년)0～3세영유인DQ총치위92.8±16.3,5개능력구역(대운동、정세운동、괄응능력、어언、사교행위)득분분별위93.7±20.0、91.4±20.0、92.4±19.0、90.3±20.0、96.4±22.1,간예후(2010년)DQ총치위104.3±13.8,5개능력구역득분분별위104.8±21.5、104.1±17.2、104.8±16.1、99.9±19.1、108.0±22.7,균교간예전명현제고(t치분별위-10.43、-10.77、-13.78、-14.28、-9.96、-15.33,P균＜0.01).결론 뇌발육관건기전영양불족가영향영유인지능발육각개능구,통과뇌발육관건기전영양간예능사영유인획득충족적전영양,종이유효방지전결핍조성적지능발육장애.
Objective To evaluate the effect of iodine supplementation on improvement of developmental quotient (DQ) at the critical period of infant brain development.Methods Pregnant,lactating women and infants less than 3 years old were supplemented with iodized oil in Linxia Hui Autonomous Prefecture(Linxia Prefecture) Gansu Province in 2006-2010.Before and after the intervention(2006,2007-2010),five townships were randomly selected in the north,the south,the east,the west and the center of eight counties(cities) of Linxia.One village was chosen from each of those townships and 20 infants,20 pregnant women and 20 lactating women were randomly selected in each village(insufficient was made up from the neighboring villages).Urinary iodine(UI) level of the infants,pregnant and lactating women were determined by arsenic cerium catalytic spectrophotometry.DQ value of infants was measured before and after supplementation of iodized oil in 2006 and 2010.UI value of pregnant,lactating women and infants was monitored every year after iodine supplementation.Results Before iodine supplementation(2006),the median UI level of pregnant,lactating women and infants was 89.28,84.85,107.3 μg/L,respectively.After iodine supplementation,the medians UI level in 2007,2008,2009 and 2010 were,respectively,pregnant women:136.0,187.8,118.2,175.8 μg/L; lactating women:135.2,159.8,187.5,163.5 μ g/L; infants:139.6,174.7,190.7,168.4 μg/L.Before iodine supplementation,the DQ value of infants was 92.8 ± 16.3,and the average score of gross motor,fine motor,adaptive capacity,language and social behavior was 93.7 ± 20.0,91.4 ± 20.0,92.4 ± 19.0,90.3 ± 20.0,96.4 ± 22.1,respectively.After iodine supplementation,the DQ value of infants was 104.3 ± 13.8,and the average score of gross motor,fine motor,adaptive capacity,language and social behavior was 104.8 ± 21.5,104.1 ± 17.2,104.8 ± 16.1,99.9 ± 19.1,108.0 ± 22.7,respectively,which were higher than that before iodine supplementation (t =-10.43,-10.77,-13.78,-14.28,-9.96,-15.33,all P ＜ 0.01).Conclusions Iodine deficiency at the critical period of brain development can affect the intellectual development of infants and young children at all functional areas of intelligence.Iodine supplementation at the critical period of brain development can prevent mental retardation caused by iodine deficiency disorders.