沿海产盐区与非产盐区妊娠期妇女碘营养状况及甲状腺功能水平分析

目的了解福建沿海产盐区与非产盐区妊娠期妇女碘营养状况及其甲状腺功能水平,为防治碘缺乏病提供科学依据。方法选择产盐区翔安区和非产盐区集美区为调查点,每个点随机抽取60名以上妊娠期妇女作为调查对象,采集孕妇的家中盐样、尿样及血样,分别测定盐碘、尿碘及血清甲状腺激素。结果产盐区与非产盐区孕妇合格碘盐食用率分别为81.69%和100.00%;产盐区与非产盐区孕妇尿碘的中位数分别为120.55μg/L和153.35μg/L,尿碘〈150μg/L的比例分别为62.2%和46.8%,孕早期尿碘水平〉孕中期〉孕晚期;产盐区与非产盐区孕妇的甲状腺过氧化物酶抗体（thyroid peroxidase antibody,TPOAb）,抗甲状腺球蛋白抗体（antithyroid glubulin antibody,TgAb）,总三碘甲状腺原氨酸（total-triiodothyronine,TT3）,总甲状腺素（total thyroxine,TT4）,游离三碘甲状腺原氨酸（free triiodothyronine,FT3）,游离甲状腺素（free thyroxine,FT4）,促甲状腺激素（thyroid stimulating hormone,TSH）,甲状腺球蛋白（tryroglobulin,Tg）中位数均在正常范围,产盐区与非产盐区孕妇的FT3、FT4、TSH之间差异均有统计学意义,产盐区孕妇的FT3、FT4均低于非产盐区,而产盐区孕妇的TSH则高于非产盐区。结论孕妇是易缺碘人群,产盐区孕妇相对非产盐区碘缺乏更为严重。应对孕妇开展常规碘营养和甲状腺功能监测,进一步做好碘营养知识的宣传教育工作,控制碘缺乏病的发生。     

厦门市地氟病防治效果调查分析

[目的]了解厦门市控制饮水型地氟病情况。[方法]在病区改造饮用水后按全国地氟病监测方案对地氟病区饮用水氟、目标人群尿氟、氟斑牙和氟骨症4个指标进行评估。[结果]7个病区村全部改用低氟饮用水,饮用水氟含量合格率达100%,病区儿童氟斑牙患病率为4.8%,尿氟含量均数0.58mg/L。[结论]地氟病区饮用水改造取得了明显效果,本地地氟病得到有效控制。     

沿海产盐区与非产盐区哺乳期妇女碘营养水平和甲状腺功能调查

目的了解福建沿海产盐区与非产盐区哺乳期妇女碘营养状况及其甲状腺功能水平,为科学防治碘缺乏病提供依据。方法选择产盐区翔安区和非产盐区集美区为调查点,调查居民饮用水水碘含量,哺乳期妇女家中的碘盐覆盖率、合格碘盐食用率及其尿碘水平和血清甲状腺激素水平。结果产盐区、非产盐区哺乳期妇女家中合格碘盐食用率分别为91.18%和96.67%,尿碘中位数分别为131.20μg/L和104.35μg/L,尿碘<100μg/L的比例分别为35.29%和46.66%;产盐区与非产盐区哺乳期妇女的甲状腺激素TPOAb、TGA、TT3、TT4、FT3、FT4、TSH、Tg的中位数均在正常范围,两区均有部份哺乳期妇女存在甲状腺功能减退倾向,产盐区较非产盐区更为严重。结论目前的盐碘浓度对产盐区和非产盐区哺乳期妇女总体是适宜的,产盐区和非产盐区均有部分哺乳期妇女存在碘营养不足和甲状腺功能减退倾向。应对哺乳期妇女开展常规碘营养和甲状腺功能监测,采取针对性补碘措施,以控制碘缺乏病的发生。     

回顾性分析15例脐尿管癌的诊断、治疗和预后

脐尿管癌是来源于脐尿管上皮罕见的恶性肿瘤,由于发生部位特殊,早期诊治比较困难。本研究探讨脐尿管癌的临床特点、诊断、治疗方式及预后因素。结论 ：脐尿管癌发病位隐匿,术前诊断较为困难,治疗采取扩大性膀胱部分切除术或根治性全膀胱切除,辅以全身化疗、放疗为主的综合治疗可能有助于延长患者生存期。本病的预后很差,临床分期与预后密切相关。     

横纹肌溶解致急性肾损伤一例并文献复习

患者 男,29岁,2012-10-30因"发现血肌酐升高伴间断腹痛6d"入院.入院前5d患者剧烈运动后出现乏力、呕吐、腹痛,停止排便、排气,因腹部平片示不完全肠梗阻不除外,先收住于普外科,同时出现无尿,短期内血肌酐由259μmol/L上升至622 μmol/L,合并肌酸激酶、肌红蛋白、尿酸升高,期间自服NSAIDs药物,在普外科通便、灌肠、胃肠减压对症治疗,复查血肌酐、肌酸激酶、肌红蛋白进一步升高,连续两日少尿,给于静脉利尿后全天尿量1000 ml左右,发病后测血压最高达210/140 mm Hg,行两次血液透析后转入肾内科.     

2008年福建省厦门市水源性高碘村及相邻村流行病学调查

Objective To investigate the current conditions of water iodine,childrens'iodine nutrition and residents'edible circumstance of iodized salt in the villages with high iodine in drinking water and the adjacent three villages in Xiamen city of Fujian province.Methods Four natural villages of Qianbian,Donglian,Dazhong and Dongshan of Xiangan county were chosen as survey spots in 2008.In each village,one running water sample and all well water samples were collected to obtain the benchmark for each location.All children aged 7-13 year in the four villages underwent thyroid palpation and were selected to measure the urine iodine and the salt iodine.The water iodine and urine iodine were determined by As3+-Ce4+ catalytic spectrophotometry digestion,salt iodine was determined by direct titration.Results In four investigated villages,iodine of four running water samples were all 1.5μg/L.The range of 237 well water iodine samples was from 0.1 μg/L to 506.0 μg/L.There were 18.6% (44/237)specimens in which the well water iodine less than 10 μg/L,73.4%(174/237)between 10 μg/L and 150 μg/L and 8%(19/237)more than 150μg/L.The median of urinary iodine was 153.3 μg/L in 79 urine samples,which was 114%(9/79)more than 200μg/L and less than 300μg/L,12.7%(10/79)equal or more than 300 μg/L and less than 500μg/L,7.6%(6/79)equal or more than 500μg/L and less than 800 μg/L in all samples.Seventy-nine students were examined by palpation and the total goiter rate of children measured was 11.4% (9/79).Seventy-one samples of iodine salt were detected and the coverage rate of iodized salt was 77.5%(55/71).Conclusions The well water iodine contents have a wide distribution in the investigated villages.We should enhance the community awareness by educating them on the damage of iodine excess and iodine deficiency.     

2008年福建省厦门市水源性高碘村及相邻村流行病学调查

目的 了解福建省厦门市水源性高碘村及相邻村水碘、学生碘营养状况及家中食用盐含碘量,为制订科学防治措施提供依据.方法 2008年,在厦门市选择水源性高碘村翔安区洪前行政村前边村及相邻的东莲村、东山村、大中村共4个自然村为调查点,4个自然村每村各采集1份自来水厂末梢水样和村民家中的所有井水水样.测定水碘,按统一设计的登记表在采水样时同时记录采样点基本情况;对4个村7～13岁所有在校学生进行甲状腺触诊检查,并采集尿样和家中盐样,采用砷铈催化分光光度法测定尿碘,采用直接滴定法测定盐碘.结果 在4个调查村,共采集4份自来水厂末梢水,水碘均为1.5μg/L;共有水井237 口,水碘范围为0.1～506.0μg/L;水碘<10μg/L的井占18.6%(44/237);水碘在10～150μg/L的井占73.4%(174/237);水碘>150μg/L的井占8%(19/237).共检测学生尿样79份,尿碘中位数为153.3μg/L.尿碘>200～<300 μg/L 的占11.4%(9/79),300～<500μg/L的占12.7%(10/79),500～<800μg/L的占7.6%(6/79).触诊法检查学生79名,甲状腺肿大率为11.4%(9/79);检测学生家中盐样71份,碘盐覆盖率为77.5%(55/71).结论 调查村井水水碘分布范围大;要针对不同人群分别采取宣传高碘危害和碘缺乏危害的知识,不断提高其健康意识.     

真性红细胞增多症合并脑梗塞1例报告

真性红细胞增多症是一种较少见且原因不明的慢性进行性骨髓增生性疾病,也称原发性红细胞增高症。据报导本病引起神经系统并发症约占1/3左右。本文报道真红合并皮层多发梗塞一例。患者,女,55岁,因进行性头昏、头痛、乏力、皮肤红紫7年,加重伴肢体无力4个月于90年1月入院。查体:T36.5c、P88次/分、R21次/分、Bp20/13kPa。面如醉酒容,皮肤、粘膜呈暗红色,以口唇、手掌、眼结膜明显。神志清,表浅淋巴结未扪及。心、肺听诊未见异常。肝剑下3cm,脾肋下4.5cm,胸及四肢骨无压疼。肌力、肌张力正常,无深浅感觉障碍。化验:HB:180g/L、RBC:8.64×1O~(12)/L、WVBC:2.1×1O~9/L、pc:45×1O~9/L、RBC压积:72％、血沉:1小时未下降1毫米,N-ALP:阳性率90％、积分:320分。骨髓:红系增生明显活跃,形态正常。成熟红细胞呈缗钱样排列。粒系:提示核左移、巨核细胞40只/全片、血小板多见。可见畸型血小板。微循环观察:有严重淤滞。脑CT:大脑皮层区可见3个<1.5cm低密度灶,提示“皮层多发性梗塞”。     

吴江市某镇企业离退休职工体检500例心电图分析

目的:了解江苏省吴江市某镇企业离、退休职工的体检心电图状况,说明心电图检查对心血管疾病的早诊断、早治疗有重要意义。方法:采用北京福田FX3010六道自动分析心电图机,在体检者安静休息状态以常规12导描记。结果:500例心电图检测中,正常302例(占60.7%),异常198例(39.6%)。异常心电图检出率随年龄增高而递增。结论:心电图检测心血管疾病是最为经济、简便和安全的方法,检出率高、重复性强。亦是体检中不可缺少的检查方法。