碘缺乏轻病区与非病区儿童的智力水平和精神运动功能状况调查

用CRT－C2和CRT－RC2测验、判定儿童智商,JPB和T分公式检测、计算确定儿童精神运动功能。智测IDD轻病区和非病区儿童智商均值分别为94．3和102．1,轻度智力落后率分别为7．5％和2．1％;轻病区儿童商均值显著低于非病区、轻度智力后率显著高于非病区（P＜0．005）。JPB检测两地儿童精神运动正常率显著低于非病区（P＜0．005）;两地轻度智力落后儿童精神运动障碍率分别为41．2％、25％,轻病区的轻度智力落后儿童精神运动障碍率明显高于非病区。表明轻度缺碘所造成的亚临床损伤程度明显重于非缺碘因素所致亚临床损伤程度,证实CRT－C2和JPB是临床同轻度脑发育障碍所致轻度智力落后和精神运动功能障碍的有效检测方法。     

碘缺乏病区不同智商儿童精神运动功能状况

目的　评价不同程度碘缺乏病区学龄儿童智商和精神运动水平。方法　用中国联合型瑞文测验图册(CRT -RC2 )、农村儿童智商常模 (CRT -C2 )和天津医学院精神运动成套测验 (JPB) ,对学龄儿童进行智商和精神运动测验。结果　重、中、轻病区儿童智商等级分布有显著性差异 (P <0 0 1) ,儿童智力落后率分别为 2 34% ,4 5 2 % ,0 99% ,重、中病区儿童智力落后率明显高于轻病区 (P <0 0 1)。重、中、轻病区T分数检出的异常率显著不同 ,其中轻病区异常率为 4 93% ,而重、中病区异常率分别为 12 89% ,13 5 7%。重、中、轻病区不同智商等级T分数检出的异常率具有显著性差异 (P <0 0 1) ,且异常率随智商的下降而呈上升趋势。结论　重、中病区学龄儿童智商和精神运动水平显著低于轻病区。智力水平越低精神运动功能损伤率越高。     

碘缺乏病区儿童智力低下及亚临床损伤调查

碘缺乏病（IDD）是由于人类生存环境中缺少人体必需微量元素碘所造成的一组疾病.本次调查选择沈阳市农村不同程度碘缺乏病区,用中国联合型瑞测检图册（CRT-RC2）、农村儿童智商常模（CRT-C2）测验判定儿童智商,用天津医学院精神运动成套测验（JPB）等进行测定,以评价农村不同程度碘缺乏病区学龄儿童轻度智力低下及亚临床损伤流行程度,为亚临床克汀病的防治提供依据.     

碘缺乏病轻病区供应碘盐与否与儿童亚临床损伤的研究

目的：了解和比较未供应碘盐与供应碘盐IDD轻病区同期出生儿童的智商、亚临床损伤程度及儿童人群的亚克汀病患病率。方法：采用CRT－C2测验判定儿童智商，JPB、测听仪、X射线片、身高及体重判定儿童精神运动和听力障碍、骨龄和体格发育落后情况，按我国卫生行业标准诊断亚克汀病。结果：未供应碘盐轻病区儿童人群智商均值为96．8，轻度智力落后率7．5％；供应碘盐轻病区为100．9、3．5％。未供碘盐病区各智力水平儿童的精神运动和听力障碍率、骨龄和体格发育落后率均较供碘盐病区高。轻度智力落后儿童的亚临床损伤率，未供碘盐区为60．1％，供碘区为40．2％；定量计算儿童亚克汀病患病率，未供碘盐区为4．5％，供碘区为1．4％。结论：IDD轻病区供应碘盐后出生的轻度智力落后儿童亚临床损伤率及儿童人群亚克汀病患病率，均显著低于未供应碘盐轻病区，食用碘盐是预防子代亚临床损伤的有效措施。     

福建省城市学龄儿童智力发育水平现状研究

[目的]了解福建省城市学龄儿童的智力发育水平及影响因素。[方法]用中国联合型瑞文测验(CRT C2)测 定我省不同城市儿童智商(IQ)。[结果]我省城市儿童智商平均水平为102.4±14.6,轻度智力落后的患病率仅为1.7%; 不同城市之间儿童智力发育水平和轻度智力落后的患病率差异有显著性;沿海城市儿童的平均智商高于山区儿童,二者 轻度智力落后的患病率分别为1.1%和2.5%;不同年龄间儿童的智商差异有显著性,不同性别间儿童智商则类似;非碘 缺乏病区的城市儿童,平均智商高于碘缺乏病区,居住在碘缺乏重病区的儿童,轻度智力发育落后的患病率高于居住在 碘缺乏轻病区和非碘缺乏病区。[结论]我省儿童智力发育水平正常,影响城市儿童智力发育的主要因素是当地碘营养 状况和社会经济文化水平。     

绥中县农村碘缺乏病病区部分7～14岁儿童智商水平调查

[目的 ]了解碘缺乏对儿童智商的影响 ,指导碘缺乏病 (IDD)防治工作。 [方法 ] 2 0 0 1年用CRT C图册和CRT LNR进行测试、判定绥中县农村IDD重、中、轻病区 7～ 14岁儿童的智商 (IQ)。 [结果 ]重、中、轻IDD病区儿童智商值分别为 95 4± 15 7、96 1± 15 8、98 3± 15 5 ;IQ≤ 89儿童所占比例重病区 >中度病区 >轻病区 ,IQ≥ 110儿童所占比例重病区 <中度病区 <轻病区 ;重、中、轻病区儿童的轻度智力落后率分别为 6 7%、6 1%、4 1%。 [结论 ]碘缺乏对病区儿童智力发育有一定的不良影响 ,应引起重视     

包头市地方性氟中毒对病区儿童智力发育的影响

目的:探讨包头市地方性氟中毒对儿童智力发育的影响。方法:对包头地方性氟中毒病区儿童群体抽样,使用瑞文测验——联合型图册(中国农村版)测试智商。结果:病区儿童IQ均值92.07,低于对照区;智力落后率10.83％,明显高于对照区;与全国农村儿童智商理论值相比,IQ均值低7.93,智力落后率高8个百分点,差别具高度显著性。病区氟斑牙患病儿童IQ均值88.67％,比病区正常儿童IQ均值(96.79)低8.12;智力落后率11.69％,比正常儿童高3个百分点。表明地方性氟中毒病区儿童智力发育障碍,智力损伤较明显。     

碘缺乏病区儿童精神运动成套测验的T分值分析

津医精神运动成套测验 (JPB)是检测由各种因素所致脑功能受损 ,而引发中枢神经功能的速度和准确性改变的方法〔1〕。JPB对筛选因轻度缺碘和补碘不足引起的轻度神经系统损伤有较高的灵敏性和特异性 ,为诊断亚临床克汀病提供了有效、可信的测验方法。为进一步明确精神运动功能与智商水平的关系 ,我们将碘缺乏病区 7～ 14岁不同智商水平儿童的JPB检测T分值进行分析。1　对象和方法1 1　对象 :在辽宁省地处丘陵地区 ,已经供应碘盐30多年的开原、凤城两市农村碘缺乏中、重病区 ,选择出生并居住当地的 7～ 14岁儿童为调查对象。1 2　方法1 2 …     

孕妇口服碘油预防子代亚临床损伤效果的研究

目的了解和比较重度缺碘地区口服碘油孕妇的子代与重度缺碘地区仅食用碘盐孕妇的子代和轻度缺碘地区未补碘孕妇的子代亚临床损伤状况.方法采取CRT-C2、JPB、测听仪、拍X线片、标准度衡器具检测同期出生的3组7～13岁儿童的智商、精神运动功能、听力、骨龄和身高、体重.结果碘油预防组、碘盐预防组、未补碘组儿童的智商均值分别为98.2±15.3,93.5±15.7,94.2±16.2,IQ50～69者分别占2.3%,7.1%,7.5%;3组儿童JPB异常率为1.0%,4.5%,4.4%,听力减退率为1.9%,5.4%,5.6%,骨龄落后率为4.4%,7.4%,7.8%,身高落后率为4.2%,7.1%,7.3%,体重落后率为2.4%,4.3%,4.4%.统计碘油预防组儿童智商均值显著高于碘盐预防组和未补碘组儿童(P＜0.001),碘油预防组儿童的轻度智力落后率、JPB异常率、听力减退率、骨龄和身高落后率则显著低于另两组儿童(P＜0.05),而碘盐预防组与末补碘组儿童各项亚临床损伤率差异无显著性意义(P＞0.1).结论孕妇服用碘油预防子代亚临床损伤的效果为佳,在尚未普及合格碘盐的重度缺碘地区对孕妇投服碘油是必要和可行的.     

1991和2001年绥中县农村碘缺乏病区儿童智力水平的调查

目的　了解和比较绥中县农村碘缺乏病区供应 1/ 5万碘盐后相隔 10年出生的儿童智力水平 ,评价同浓度碘盐在不同缺碘程度病区预防子代智力损伤的效果。　方法　 1991和 2 0 0 1年在山区、丘陵、平原农村各 3所学校 ,用 CRT- C图册和 CRT- RC2 测试判定儿童智商 (IQ )。　结果　 1991和 2 0 0 1年农村 (山区、丘陵、平原 )儿童平均智商分别为90 .5± 13.9、96 .6± 15 .1,2 0 0 1年显著高于 1991年 (P<0 .0 0 1) ;IQ≤ 6 9比率分别为 6 .3%、4 .9% ,2 0 0 1年显著低于 1991年 (P<0 .0 2 5 )。两次测试山区农村儿童平均智商显著低于丘陵农村儿童 (P<0 .0 0 2 ) ,山区和丘陵农村儿童平均智商均显著低于平原农村儿童 (P<0 .0 0 1) ;IQ≤ 6 9比率山区农村较丘陵和平原农村、丘陵农村较平原农村为高 ,其中山区、丘陵农村均显著高于平原农村 (P<0 .0 5 )。　结论　随着碘盐的普及 ,农村出生的儿童智力水平有了明显提高 ;但山区和丘陵农村儿童智力状况仍未达到非缺碘农村儿童的智力水平 ,今后需适当提高碘盐浓度     

Iodine supply in different geographical areas of Switzerland: comparison between rural and urban populations in the Berne and the Ticino regions.

OBJECTIVE: We studied the question of possible regional differences of iodine intake in the population of rural and urban areas north and south of the Alps. DESIGN: Transversal study. SETTING: Six different regions from northern (Canton Berne) and southern Switzerland (Canton Ticino). SUBJECTS: For each region 30 individuals were studied. RESULTS: While significant differences of urinary iodine between some regions were found (range from 79 microg iodine/g creatinine in Chiasso to 130 microg iodine/g creatinine in the Maggia Valley), no significant differences between rural and urban populations of north and south of Switzerland were observed. Mild iodine deficiency affected 35%, moderate iodine deficiency 12% and severe iodine deficiency 0.6% of the total population investigated. CONCLUSIONS: 49% of this population showed at least mild or moderate iodine deficiency. The mean urinary iodine was just at the lower recommended limits. Significant differences were found between individual regions (such as Chiasso and the Valley of Maggia), but not generally between rural and urban areas in the north and south of the Alps.     

沈阳市城区0～6岁儿童VitA缺乏与贫血的关系

目的 :了解 Vit A缺乏 (VAD)和贫血之间的关系。方法 :随机整群分层抽取 0～ 6岁儿童共 10 784名 ,采用微量荧光光度法检测 Vit A含量。氰化高铁法检测血红蛋白含量。结果 :血红蛋白正常、轻度、中度、重度贫血组儿童 VAD患病率分别为9.98%、2 0 .19%、2 1.88%、4 2 .86 % ;随血红蛋白水平下降显著增加 ,Vit A正常、可疑 SVAD及 SVAD组儿童贫血患病率分别为2 .96 %、7.4 0 %、10 .12 % ;随血清 Vit A水平下降不仅贫血患病率增加 ,而且贫血程度增加。结论 :VAD与铁缺乏之间存在互相影响的关系。     

Safe use of iodized oil to prevent iodine deficiency in pregnant women. A statement by the World Health Organization.

The risks and expected benefits from iodized oil, given orally or by injection, to pregnant women in areas of severe iodine deficiency where iodized salt is not available were evaluated. The conclusions, which were approved by the International Council for Control of Iodine Deficiency Disorders (ICCIDD), showed that for preventing and controlling moderate and severe iodine deficiency, the giving of iodized oil is safe at any time during pregnancy. Maximum protection against endemic cretinism and neonatal hypothyroidism will be achieved when iodized oil is given before conception. The potential benefits greatly outweigh the potential risks in areas of moderate and severe iodine deficiency disorders, where iodized salt is not available and is unlikely to be made available in the short term (1-2 years).     

Epidemiologie von Schilddrüsenerkrankungen in Deutschland

Background

Germany is an iodine-deficient region. Iodine deficiency was classified as moderate in the North and as severe in mountain regions in Southern Germany. Improved legislation involving the iodization of table salt became effective during the 1990s. This legislation has contributed considerably to an increase in the use of iodized salt for food production.

Current results

The population is currently supplied with iodine at a lower recommended level. From an epidemiological point of view, Germany is a region characterized by the change from iodine deficiency to iodine sufficiency. Typical for this transformation, one might expect a low prevalence of goitre among children and adolescents, while there would still be a high prevalence of goitre, thyroid nodules, and subclinical hyperthyroidism among the elderly. In a representative German sample of children and adolescents, however, relatively large thyroid volumes have been found.

Conclusion

Systematic monitoring programs for thyroid disorders, including measurements of urinary iodine excretion in population samples, allow the detection of deviations in the iodine supply and are thus an obligatory precondition for the effective prevention of iodine deficiency.     

Assessment of iodine deficiency in district Bikaner,Rajasthan

The prevalence of iodine deficiency in the Bikaner district of Rajasthan, India, was estimated in a 1995 pilot project involving 527 children 6-12 years of age recruited from three high schools. Goiter, as detected by palpation, was present in 20.5% of these children. A goiter prevalence above 5% is considered indicative of endemic iodine deficiency. According to urine analyses, 3% of children had severe iodine deficiency (urinary excretion levels under 2 mcg/ml), 9% had moderate deficiency (2.0-4.9 mcg/ml), 18% had mild deficiency (5.0-9.9 mcg/ml), and the remaining 70% had adequate iodine levels (10 mcg/ml and above). 32% of families were using salt with no iodine content; another 8% consumed salt with less than 15 ppm of iodine. These findings indicate that iodine deficiency is a serious public health problem in this district and suggest a need to strengthen monitoring of the quality of salt procured.     

津医精神运动成套测验应用价值的探讨

目的 :分析津医精神运动成套测验 (JPB)有关影响因素及应用价值。方法 :在碘缺乏已纠正地区 ,用JPB测定 392例学龄儿童精神运动发育状况。结果 :JPB水平与语文和数学成绩呈正相关关系。精神运动障碍率随语文和数学成绩的下降而上升。语文、数学低成绩和差评语组与语文、数学高成绩和好评语组相比 ,精神运动障碍相对危险度分别为 6 .7、5 .1和 9.8。结论 :JPB用于评估精神运动发育是有价值的     

114例言语发育延迟儿童听力学检测分析

目的:分析言语发育延迟患儿听功能改变特点,听觉脑干诱发电位(ABR)、畸变产物耳声发射(DPOAE)测试的意义及应用价值。方法:对5岁以下114例言语发育延迟患儿进行ABR测试,与各年龄组正常标准值比较,并对异常ABR患儿同时进行DPOAE测试,与标准值比较。结果:ABR测试显示语迟患儿V波反应阈在正常范围者78例(68.4%),异常升高者36例(31.6%)。在36例听力障碍患儿中双耳听力障碍者33例,单耳听力障碍者3例。双耳听力障碍者中有17例(14.9%)无反应,10例(8.8%)重度听力障碍,中度、轻度听力障碍者各3例(2.6%)。3例(2.6%)单耳均为轻度听力障碍。对36例ABR测试异常患儿行DPOAE检查,其中双耳听力障碍的33例患儿共66耳中,有62耳DPOAE反应缺失,与ABR检查结果一致,考虑为耳蜗性聋;1例双耳DPOAE正常,而ABR无反应,该患儿有围产期重度窒息史,考虑为蜗后性聋,另1例轻度听力障碍患儿双耳和其它3例单耳轻度听力障碍患儿DPOAE幅值、信噪比(SNR)低频区正常,中高频区(3~8KHz)下降、SNR<6。结论:言语发育延迟患儿听功能改变以双耳重度神经性耳聋为特点,ABR、DPOAE对于言语和语言障碍儿童的听力损害提供客观定位和频率特性。     

Moderate to severe iodine deficiency in three endemic goitre areas from the Black Sea region and the capital of Turkey

Endemic goitre is still an important and underestimated health concern in Turkey. The overall prevalence had been calculated as 30.3% by palpation in a national survey conducted in 1995. However, direct evidence that iodine deficiency (ID) is the major cause of the endemic were lacking until now. We measured sonographic thyroid volumes (STV), urinary iodine concentrations (UIC) in 1226 school age children (SAC) (9–11 year old) from Ankara the capital of Turkey located in the central Anatolia, and three highly endemic goitre areas of the Black Sea region. A considerable number of school age children (SAC) were found to have STV exceeding the recommended upper normal limits for their age and gender obtained from iodine-replete European children (i.e. 26.7, 40.3, 44.8 and 51.7% of children from Ankara, Kastamonu, Bayburt and Trabzon respectively). UIC indicated moderate to severe ID in these areas with median concentrations of 25.5, 30.5, 16.0 and 14 g/L respectively. This study showed severe to moderate ID as the primary etiological factor for the goitre endemic observed in Ankara and the Black Sea region of Turkey.     

Iodine deficiency disorders in Europe

Recent data on iodine excretion in the urine of adults, adolescents and newborns and on the iodine content of breast milk indicate a high prevalence of iodine deficiency (moderate in many cases and severe in a few) in many European countries. These cases may manifest as subclinical hypothyroidism in neonates and as goitre in adolescents and adults. Lack of iodine causes not only goitre, but also mental deficiency, hearing loss and other neurological impairments, and short stature due to thyroid insufficiency during fetal development and childhood. Although iodinated salt is available theoretically in most countries where it is needed, its quality and share of the market are often unsatisfactory. In many countries where only household salt is iodinated the iodine content has been set too low owing to an overestimation of household salt consumption. Governments are therefore urged to pass legislation and provide means for efficient iodination of salt wherever this is necessary.