丹参多酚酸盐注射液治疗慢性阻塞性肺疾病急性加重期的临床研究

目的观察注射用丹参多酚酸盐对慢性阻塞性肺疾病患者急性加重期的临床疗效。方法选取上海市嘉定区南翔医院2014年4月—2015年4月收治的慢性阻塞性肺病患者76例,随机分为对照组和治疗组,每组各38例。对照组患者给予常规治疗,治疗组患者在对照组治疗基础上加用注射用丹参多酚酸盐200 mg,溶于5%葡萄糖注射液250 m L中,静脉滴注,1次/d。两组患者均连续治疗14 d。评价两组患者治疗后的临床疗效,并比较两组治疗前后的各血清炎性因子水平和平均肺动脉压。结果治疗后,治疗组患者的总有效率为81.6%,显著高于对照组的70.1%,两组总有效率比较差异具有统计学意义(P0.05)。治疗后两组血清白介素-18(IL-18)、C反应蛋白(CRP)水平均较治疗前显著降低,差异具有统计学意义(P0.05);与对照组比较,治疗组血清IL-18、CRP水平降低程度均显著优于对照组(P0.05)。治疗后两组肺动脉压水平均显著下降,差异具有统计学意义(P0.05);且治疗组治疗后的下降程度明显高于对照组,差异具有统计学意义(P0.05)。结论注射用丹参多酚酸盐治疗COPD急性加重期具有很好的临床疗效,可降低血清炎症因子IL-18和CRP水平以及平均肺动脉压,具有一定的临床推广应用价值。     

高盐负荷上调SHR胸主动脉、肠系膜上动脉壁AT1和AT2受体表达实验研究

目的:以自发性高血压大鼠(SHR)为研究对象,探讨动脉血管壁胶原成分、血管紧张素Ⅱ受体(ATR)AT1和AT2亚型蛋白表达的增龄性改变及高盐负荷对它们的影响。方法:雄性SHR60只,随机分为低盐组(0.4%NaCl,n=30)和高盐饮食组(4%NaCl,n=30)干预3周,测量血压后;胸主动脉及肠系膜上动脉石蜡切片Mallory染色法观察壁纤维化程度,免疫组化SABC法测定ATR蛋白表达。结果:高盐负荷后SHR大鼠的血压呈现明显升高(P<0.05);胸主动脉和肠系膜上动脉壁Ⅰ型和Ⅲ型胶原纤维沉积亦随增龄增多,高盐负荷会加重这一趋势(P<0.05);高盐负荷均能显著增加动脉壁AT1和AT2表达(P<0.01),而以肠系膜上动脉壁改变较为显著,但是对AT1/AT2比值无影响(P>0.05)。结论:高盐负荷可导致SHR大鼠血管壁重塑,血管壁局部ATR的改变可能是SHR大鼠血管壁重塑的机制之一,减少盐的摄入对预防高血压动脉病变的发生和发展有着重要的意义。     

2005年我国居民户食用非碘盐状况分析

目的分析全国居民户食用非碘盐状况和非碘盐问题地区。方法盐碘检测采用GB／T13025．7—1999直接滴定法。非碘盐判定标准为盐碘〈5mg／kg；非碘盐问题地区判定标准为碘盐覆盖率〈90％。结果发现非碘盐问题省份7个；与2002年监测结果比较，非碘盐率上升的有13个省份；非碘盐问题地区新增加3个省份。调查出的3081份非碘盐样本中，以精制盐、粉碎原盐和其他盐种占居民户食用盐主导地位．其中非碘精制盐分布广泛，覆盖全国27个省份，其他非碘盐品种则呈区域性分布。结论无论是数量上还是分布上，非碘盐率均在增加，非碘盐问题较为严重，有些省份病情反弹与非碘盐问题密切相关，提示应对这些地区的非碘盐问题予以高度重视。     

2008年青海省循化县碘缺乏病监测结果分析

目的 了解和掌握循化县碘缺乏病防治现状,为今后制定防治措施和策略提供参考依据.方法 根据循化县碘缺乏病的历史资料,2008年在清水、白庄、红旗、街子和尕愣5个乡(镇)分别调查1所乡中心小学和1所村级小学,共调查9所小学校(尕愣乡只有1所学校).在每所小学抽取40名8～10岁学生采用触诊法检查甲状腺大小,检测其中20名学生的尿碘水平和家中食用盐的含碘量,人数不足时,从邻近的学校补足.每所中心小学抽取30名五年级学生进行健康教育问卷调查;在每所小学所在村,调查10名家庭主妇对碘缺乏病防治知识的认知情况,并检测其家中食盐的含碘量.结果 8～10岁儿童甲状腺肿大率7.9%(30/378),其中,白庄和尕愣乡最高(11.9%,5/42),清水乡最低(2.4%,1/42);8～10岁儿童尿碘水平的尿碘中位数196.5μg/L,尿碘<50μg/L的占5.3%(11/208),尕愣乡<50μg/L的占25.0%(5/20);居民合格碘盐食用率91.4%(159/174),街子镇查家村、团结村和白庄乡的民主村合格碘盐食用率分别为79.0%(15/19)、83.3%(15/18)和89.5%(17/19);碘缺乏病防治知识问卷调查,家庭主妇和五年级学生的平均分分别为2.8、2.1分.结论 循化县通过多年碘缺乏病防治,取得了显著的成绩,但仍需要加强碘盐监测和碘缺乏病防治知识宣传等方面的工作.     

2010年青海省碘盐监测结果分析

目的 分析青海省碘盐覆盖情况和质量,为碘缺乏病防治工作提供理论依据.方法 2010年,按照《全国碘缺乏病监测方案(试行)》中的抽样和检测方法,在随机抽样中选择37个县(市、区),在重点抽样中按20％的比例选择6个县(市),对上述县(市、区)进行碘盐监测.随机抽样监测采用直接滴定法(GB/T 13025.7-1999)定量测定盐碘;重点抽样监测采用半定量法检测盐碘.结果 全省共检测居民户食用盐样10999份,其中合格碘盐10525份,不合格碘盐269份,非碘盐205份,碘盐覆盖率为98.14％(10794/10999),碘盐合格率为97.51％(10525/ 10794),合格碘盐食用率为95.69％(10525/10999),非碘盐率为1.86％(205/10999).重点抽样监测中的6个县(市)共检测1800份居民户盐样,其中碘盐1712份,非碘盐88份,碘盐覆盖率为95.11％(1712/1800),非碘盐率为4.89％(88/1800),格尔木市、乌兰县、久治县非碘盐率分别为10.00％(30/300)、6.33％(19/300)、5.33％(16/300).结论 青海省碘缺乏病防治工作取得一些成效,但还存在一些问题,部分地区要建立健全盐政执法机构,完善碘盐销售网点,健全碘盐管理网络,强化健康教育等措施.     

2008-2010年包头市碘盐监测结果分析

目的 了解包头市居民食用碘盐状况,及时发现问题并采取相应干预措施,为进一步巩固防治成果,加强和完善持续消除碘缺乏病工作提供科学依据.方法 2008-2010年,在包头市盐业公司东河批发部及青昆盐业批发部,每季抽取3批次,54份盐样;对达茂旗、白云区、青山区按东、西、南、北、中划分为5个抽样区,每个抽样区抽取1所学校,每所学校抽取30名8～10岁学生,抽取家中食用盐;采用直接滴定法(GB/T 13025.7-1999)检测盐碘.结果 2008-2010年盐业批发部碘盐合格率为100%(378/378),盐碘均值为30.4 mg/kg;居民户碘盐合格率为99.8%(2417/2421),盐碘均值为30.4 mg/kg,碘盐覆盖率为99.6%(2421/2430),合格碘盐食用率为99.4%(2417/2430).结论 碘盐合格率、碘盐覆盖率、合格碘盐食用率均在90%以上,达到碘缺乏病可持续消除状态.

Abstract：

Objective To find out the consumption situation of iodized salt in Baotou, identify problems and take appropriate intervention measures, and to provide scientific basis for further consolidating the results of control measures, strengthening and improving the sustainable elimination of iodine deficiency disorders. Methods Three batches of each quarter, 54 salt samples were sampled in Donghe wholesale division and Qingkun wholesale division in Baotou city salt company during 2008 - 2010; each place of Damaoqi, Baiyun district, and Qingshan district were divided into five sampling areas according to the direction of east, west, south, north, and central position, one school was selected in each district, 30 students aged 8 to 10 from each school were selected, and home salt samples were taken, and salt iodine was tested by direct titration(GB/T 13025.7-1999). Results Qualified rate of wholesale iodized salt was 100%(378/378) during 2008 - 2010, and mean salt iodine was 30.4 mg/kg;qualified rate of household iodized salt was 99.8%(2417/2421 ), and mean salt iodine was 30.4 mg/kg; iodized salt coverage rate was 99.6% (2421/2430) and consumption rate of qualified iodized salt was 99.4% (2417/2430).Conclusions Qualified rate of iodized salt, coverage rate of qualified iodized salt and consumption rate of qualified iodized salt are 90% or more, which has reached the standard of sustainable elimination of iodine deficiency disorders.     

2009年西宁市碘缺乏病防治效果调查

目的 掌握西宁市基本达到消除碘缺乏病阶段目标后,碘缺乏病的防治效果及人群碘营养状况.方法 2009年调查西宁市7个县(区),每个县(区)按东、西、南、北、中抽取5个乡(镇),每个乡(镇)抽取1所学校,每所学校抽取80名8～10岁学生,采用触诊法检查儿童甲状腺肿大情况,采用过硫酸铵消化砷铈催化分光光度法测定儿童尿碘,采用直接滴定法测定学生家中食用盐含碘量.结果 共抽检2919名8～10岁儿童,检出甲状腺肿大31名,甲状腺肿大率为1.06%(31/2919).共检测儿童尿样1078份,尿碘中位数为205.3μg/L,＜20 μg/L的占1.9%(20/1078),＜50 μg/L的占4.5%(48/1078).共检测2079份盐样,盐碘中位数为32.80 mg/kg,非碘盐率为0.87%(18/2079),碘盐覆盖率为99.13%(2061/2079),碘盐合格率为98.64%(2033/2061),合格碘盐食用率为97.79%(2033/2079).结论 西宁市碘缺乏病防治工作取得了明显成效,各项指标均达到国家碘缺乏病消除标准.

Abstract：

Objective To master iodine nutritional status of people after universal salt iodization in Xining that reached the stage goal of elimination iodine deficiency disorders. Methods In the 7 counties investigated of Xining in 2009, 5 towns were randomly selected in each county, and one school was randomly selected in each town, 80 children aged 8 to 10 were randomly selected in each school, and goiter were examined, urinary iodine and salt iodine were tested. Thyroid gland goiter of children was detected by thyroid palpation, children's urinary iodine was tested by As( Ⅲ )-Ce4+ catalytic spectrophotometry, and salt iodine was tested by direct titration. Results A total of 2919 children aged 8 to 10 were examined, 31 goiter was detected, goiter rate was 1.06%(31/2919).One thousand and seventy-eight urine samples were detected, urinary iodine median was 205.3 μg/L, that lower than 20 μg/L accounted for 1.9% (20/1078), lower than 50 μg/L accounted for 4.5%(48/1078). Two thousand and seventy-nine salt samples were detected, median of salt iodine was 32.80 mg/kg, the rate of non-iodized salt was 0.87%(18/2079), the coverage rate of iodized salt was 99.13%(2061/2079), the qualified rate of iodized salt was 98.64% (2033/2061), the consumption rate of qualified iodized salt was 97.79% (2033/2079). Conclusions Prevention and control of iodine deficiency disorders has achieved remarkable results in Xining city, all indicators have reached the national standard to eliminate iodine deficiency disorders.     

停供碘盐对不同水碘含量地区重点人群尿碘水平的影响

目的 观察停供碘盐后不同水含碘量地区重点人群尿碘水平的变化,为科学补碘提供依据.方法 在江苏省、内蒙古和山东省,分别选择水碘较高、而且变化范围较大睢宁县、土右旗和高青县作为调查地点,采用现场干预方法,对学龄儿童和育龄妇女采取停供碘盐的干预措施.以居民户水碘、学龄儿童和育龄妇女尿含碘量为调查内容,分别在干预前与干预后第1、2个月采集随意尿样进行尿含碘量测定,以尿含碘量为因变量进行相关回归分析.结果 调查对象的家庭生活饮用水水碘中位数为99.4μg/L,水碘范围为5.0～867.6 μg/L.干预前除水碘<30、30μg/L组外,学龄儿童和育龄妇女尿碘中位数均>300μg/L.水碘140μg/L组,在干预后第2个月,学龄儿童的尿碘中位数范围为188.5～308.2μg/L,较干预前(287.9～514.2μg/L)均明显下降(P均<0.01);育龄妇女的尿碘中位数范围为181.1～301.7μg/L.较干预前(299.9～632.2 μg/L)均明显下降(P均<0.01).水碘>150μg/L组,干预后第2个月,学龄儿童和育龄妇女尿碘中位数均>400μg/L,与干预前(484.5、401.9μg/L)比较,差异无统计学意义(X~2值分别为2.684、1.742,P均>0.05).干预后第2个月,学龄儿童、育龄妇女组尿碘中位数随水碘的升高而升高(r值分别为0.950、0.938,P均<0.05),水碘与尿碘回归方程均成立(F值分别为119.779、105.117,P均<0.01).根据回归方程,当尿碘中位数是200μg/L时,对应的水碘中位数是103.4 μg/L.结论 停供碘盐后2个月,学龄儿童、育龄妇女碘营养水平仍为正常;对于水碘均值>103.4μg/L,但≤150μg/L的地区,可以采取停供碘盐的措施;对于水碘>150μg/L的地区,除了停供碘盐外,还必须采取改水措施,有效降低水中的含碘量.     

2009年重庆市人群碘营养状况调查分析

目的 了解重庆市人群碘营养状况,为科学防治碘缺乏病提供科学依据.方法 2009年,在重庆所有40个区(县)中,每个区(县)抽取9个乡(镇),每个乡(镇)中采集40份居民食用盐,采用直接滴定法检测盐碘;每个区(县)按照东、西、南、北、中5个方位各抽取1个乡(镇),每个乡(镇)抽取20名以上8～10岁儿童,采集尿样,用砷铈催化分光光度法测定尿碘.结果 重庆市共抽取居民户食盐14 217份,含碘量中位数为29.2 mg/kg;碘盐覆盖率为98.90%(14 061/14 217),合格碘盐食用率为95.59%(13 590/14 217).共调查8～10岁儿童4050份尿样,尿碘中位数为247.20μg/L;<50μg/L者占4.60%(186/4050),50～99μg/L者占7.28%(295/4050),100～199 μg/L者占26.44%(1071/4050),200～299μg/L者占25.58%(1036/4050),300μg/L以上者占36.10%(1462/4050);各年龄组之间尿碘比较,差异无统计学意义(x2=3.77,P>0.05).以区(县)计算,尿碘中位数100～199μg/L有10个区(县),占25.00%;200～299μg/L有23个区(县),占57.50%;300μg/L以上的有7个,占17.50%;不同区(县)之间尿碘比较,差异有统计学意义(x2=441.95,P<0.01).结论 重庆市人群碘营养充足,同时存在碘过量,需降低食盐加碘量.

Abstract：

Objective To investigate the nutritional status of iodine among residents in Chongqing, and to facilitate scientific prevention and control of iodine deficiency disorders. Methods Select 9 towns in each of the 40 districts (counties) in Chongqing, and collect 40 resident edible salt samples in each of the selected town to detect salt iodine by direct titrimetry. Select 5 towns on the site of the east, west, south, north and middle of every district (county), select 20 children aged 8 to 10 in each of the selected town to collect urine samples and detect urinary iodine by As-Ce catalytic spectrophotometric assay. Results The median of iodine of 14 217 salt specimens by household was 292 mg/kg with a coverage rate of qualified iodized salt of 98.90%( 14 061/14 217). The consumption rate of qualified iodized salt was 95.59%( 13 590/14 217). The median of urinary iodine for 4050 children aged 8 to 10 was 247.20μg/L, of which < 50 μg/L accounted for 4.60%(186/4050), 50-99μg/L accounted for 7.28% (295/4050), 100 - 199 μg/L accounted for 26.44% (1071/4050), 200 - 299 μg/L accounted for 25.58% (1036/4050), 300 μg/L or more, accounted for 36.10% (1462/4050). However, no significant difference was observed between different age groups(x2 = 3.77, P > 0.05). At district (county) level, the median of urinary iodine in 10(25.00%) districts (counties) was 100 - 200 μg/L, that in other 23(57.50%) districts (counties) was 200 - 300 μg/L, and that in other 7(17.50%) districts/counties was greater than 300 μg/L, and statistical significance was observed between different districts/counties (x2 = 441.95, P < 0.01). Conclusions Current iodine nutrition among residents in Chongqing is adequate. While there is excess, need to reduce the amount of salt iodization.