学龄前儿童尿碘与感觉统合失调关系的调查研究  

Association between Urinary Iodine Levels and Sensory Integration Dysfunction in Preschool Children

作　　者：李冬 李菊 李莉[2] 郭怀兰 王静[3,4,5] LI Dong;LI Ju;LI Li;GUO Huailan;WANG Jing(1.School of Nursing,Hubei University of Medicine,Shiyan 442000,China;Department of Nursing,Shiyan Renmin Hospital,Shiyan 442000,China;Department of Endocrinology,Shiyan Renmin Hospital,Shiyan 442000,China;School of Public Health and Management,Hubei University of Medicine,Shiyan 442000,China;Center for Environment and Health in Water Source Area of South-North Water Diversion,Hubei University of Medicine,Shiyan 442000,China)

机构地区：[1]湖北医药学院护理学院,湖北省十堰市442000 [2]湖北省十堰市人民医院护理部,442000 [3]湖北省十堰市人民医院内分泌科,442000 [4]湖北医药学院公共卫生与管理学院,湖北省十堰市442000 [5]湖北医药学院南水北调水源区环境与健康研究中心,湖北省十堰市442000

出　　处：《中国全科医学》2019年第26期3222-3226,3232,共6页Chinese General Practice

基　　金：国家自然科学基金资助项目(81872698);湖北省科技厅自然科学基金资助项目(2017CFC856);湖北医药学院基金资助项目(2016QDJZR12);阿里巴巴公益基金

摘　　要：背景碘是甲状腺激素合成中的主要元素,胎儿期发生碘缺乏,会造成低甲状腺素血症及不可逆转的神经损伤和认知障碍。而感觉统合失调(SID)易造成儿童学习困难和行为障碍,且目前国内关于碘和SID之间关系的研究较少。目的了解学龄前儿童尿碘情况与SID之间的关系,为学龄前儿童感觉统合能力健康发展提供理论依据。方法2017年10-11月采用整群抽样的方法在湖北省十堰市郧西县城区抽取5所幼儿园,对抽中的幼儿园中3~6岁儿童进行晨尿尿碘测定,采用流行病学调查问卷调查其基本信息,采用《儿童感觉统合能力发展评定量表》对其感觉统合能力进行测试。比较不同性别、年龄学龄前儿童尿碘、SID情况。采用多因素Logistic回归分析学龄前儿童感觉统合情况的影响因素。结果共发放问卷及采集尿标本800份,问卷有效且尿标本合格的有710份,有效率为88.8%。不同性别学龄前儿童间出生体质量、BMI、是否顺产、尿碘、SID情况比较,差异均有统计学意义(P<0.05)。学龄前儿童尿碘192(144,271)μg/L,碘不足者占9.4%(67/710),碘适宜者占42.8%(304/710),碘超适宜量者占30.4%(216/710),碘过量者占17.3%(123/710)。不同性别学龄前儿童尿碘情况比较,差异有统计学意义(P<0.05);不同年龄段学龄前儿童尿碘情况比较,差异无统计学意义(P>0.05)。SID发生率为55.8%(396/710),其中轻度SID发生率为30.3%(215/710),重度SID发生率为25.5%(181/710)。不同性别学龄前儿童SID发生情况比较,差异有统计学意义(P<0.05);其中男童总SID发生率、重度SID发生率高于女童(P<0.05)。不同年龄段学龄前儿童SID发生情况比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,学龄前儿童尿碘情况是前庭平衡功能失调[OR=1.250,95%CI(1.018,1.534),P=0.033]、本体感觉失调[OR=1.247,95%CI(1.015,1.531),P=0.035]的影响因素。结论学龄前儿童的尿碘情况可能影�Background Iodine is the main element in the synthesis of thyroid hormone.Iodine deficiency in fetus can cause hypothyroidemia and irreversible neurological damage and cognitive impairment.And sensory integration dysfunction(SID)is susceptible to cause learning difficulties and behavioral disorders in children,but there are few studies on the relationship between iodine and SID in China.Objective To investigate the association between urinary iodine levels and SID in preschool children and provide scientific evidence to improve the development of children’s sensory integration.Methods Five kindergartens were selected by cluster sampling in Yunxi County,Shiyan City,Hubei Province from October to November 2017.The urinary iodine of children aged 3-6 years in kindergartens was measured in the morning.The basic information was investigated by epidemiological questionnaires.The sensory integration ability of children was tested by the Children Sensory Integration Development Assessment Scale.The urinary iodine and SID of preschool children in different genders and age were compared.Multivariate logistic regression was used to analyze the influencing factors of sensory integration in preschool children.Results A total of 800 questionnaires and urine samples were sent out.710 valid questionnaires and qualified urine samples were obtained,with the effective rate of 88.8%.There were significant differences in birth weight,BMI,spontaneous delivery,urinary iodine and SID between different sex subjects(P<0.05).The urinary iodine of preschool children was 192(144,271)μg/L,9.4%(67/710)of who were deficient in iodine,42.8%(304/710)of who were iodine-replete,30.4%(216/710)of who had mild and moderate iodine excess and 17.3%(123/710)of who had extreme iodine excess.There was significant difference in urinary iodine level between preschool children in different genders(P<0.05),and there was no significant difference in urinary iodine level between preschool children in different age groups(P>0.05).The incidence of SID was 55.8%

关 键 词：心理生理性障碍 尿碘 感觉统合失调 儿童 学龄前 调查 

分 类 号：R749.92[医药卫生—神经病学与精神病学]