新疆阿克苏地区拜城县哺乳期妇女碘与铁营养现况调查

摘要

目的 了解新疆阿克苏地区拜城县碘缺乏重病区哺乳期妇女碘与铁营养现况,为缺碘地区重点人群碘缺乏病防治工作提供依据.方法 2007年在阿克苏地区碘缺乏病重病区拜城县,选取温巴什、察尔齐、大桥、托克逊4个乡作为调查点.每个乡分别选哺乳期妇女30～40人进行人户调查,采集一次随意尿样以及当地饮用水测定含碘量.静脉穿刺采集调查对象全血,放射免疫分析方法测定血清铁蛋白(SF),亚铁嗪比色法测定血清铁(SI)、总铁结合力(TIBC),化学发光免疫分析方法测定FT3、FT4、TSH.结果 共调查137名哺乳期妇女,尿碘中位数为134.99μg/L,但4个乡中,大桥(99.73 μg/L)和托克逊(44.17μg/L)乡的哺乳期妇女尿碘中位数<100μL;察尔齐[21.1%(8/38)]、大桥[21.4%(6/28)]、托克逊[47.8%(11/23)]乡尿碘<50μg/L者所占比例均>20%.居民饮用水共采集78份,水碘中位数为2.15 μg/L.检测血清SF、SI低于正常值的各占47.6%(59/124)、16.9%(21/124),TIBC高于正常值的占20.2%(25/124),n低于正常值的占11.8%(15/127),TSH高于正常值的占10.2%(13/127).结论 阿克苏地区拜城县部分哺乳期妇女同时存在碘缺乏与铁缺乏,建议对该部分重点人群采取有效的补碘、补铁干预措施.%Objective To understand iodine and iron nutritional status of lactating women in Aksu Prefecture of Xinjing Autonomous Region, and to provide proper intervention in control of iodine deficiency disorders (IDD) combined with iron deficiency. Methods Four townships as survey points were selected in Baicheng County of Aksu, where severe iodine deficiency was confirmed, 30 to 40 lactating women were investigated for this study in each townships. Samples of urine and drinking water from their family were collected, and then the iodine concentrations were determined. Whole blood was collected by venipuncture for determinations on serum ferritin (SF), serum iron (SI), total-iron-binding capacity(TIBC), and their thyroid function, including FT3, FT4, TSH. Results Median urinary iodine concentration in 137 lactating women was 134.99 μg/L, however, median urinary iodine in lactating women in Daqiao (99.73 μg/L), Tuokexun(44.17 μg/L) of 4 townships was below 100 μg/L. The proportion of urinary iodine below 50 μg/L was higher than 20% in Chaerqi [21.1% (8/38)], Daqiao [21.4% (6/28)], Tuokexun [47.8% (11/25)]. The medium of iodine concentration in drinking water, that was collected from 78 resident families, was 2.15 μg/L. Lactating women of serum SF, SI, FT4, that lower than the normal value, was accounted for 47.6% (59/124), 16.9%(21/124), 11.8% (15/127)respectively. Lactating women of serum TIBC, TSH, that higher than the normal value, was accounted for 20.2% (25/124),10.2% (13/127). Conclusion There is existence in of the combination severe iodine and iron deficiency in a historical serious IDD endemic area in Aksu Prefecture of Xinjiang Autonomous Region, and iron deficiency may be another important environmental factor for the deterioration of IDD prevalence.