疾病预防控制通报

1991, (02) 66-72

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新疆高氟低碘环境与亚临床型克汀病
High-fluoride and Low-iodine Environment and Subclinical Cretinism in Xinjiang

林法福,艾海提,赵洪新,林津,蒋继勇,马丽,买买提·吐尔逊,艾肯,耿波

摘要:

本文对和田不同类型的碘缺乏病区,采用瑞文联合型中国农村智力常模表,分别随机抽样检查了7~14岁学生130名,并同步检查了听力、四项精神运动及甲状腺功能。高氟低碘病区儿童平均IQ71.09±6.84,平均听阈24.08±13.18dB,骨龄发育落后检出率28.5%,24小时甲状腺吸I~(131)”率59.87±14.63%,TSH 21.09±9.43μU/ml,亚克汀病患病率15.71%;低碘病区平均IQ 77.32±11.54,平均听阈19.91±7.23 dB,骨龄发育落后检出率13.5%,甲状腺吸I~(131)率50.26±19.25%,TSH 11.05±11.49μU/ml,亚克汀病患病率9.36%。补碘对照区平均IQ 95.76±17.52,平均听阈16.08±3.21 dB,骨龄发育落后检出率3.88%,甲状腺吸I~(131)率23.61±11.71%,TSH6.26±2.88μU/mL,亚克汀病患病率为3.20%。上述各项参数和病区之间,均有显著差异。说明在缺碘病区同时并存高氟摄入时,氟可加剧由缺碘而引起的中枢神经损害和体躯发育障碍。在104例精神轻度发育迟泄的儿童中,亚克汀病的检出率69.23%。

关键词: 缺碘性疾病;氟;智商;听力;精神运动

Abstract: One hundred and thirty schoolchildren aged 7-14 years were tested by random stratified sampling method with Combined Raven's test—The Rural in China (CRT-RC) in different types of iodine-deficient areas in Hetian District, and their hearing, 4 psychomotilities and thyroid function were examined in the mean time. In affected areas with high-fluoride and low-iodine levels, the average IQ was 71.09±6.84, the average auditory threshold 24.08±13.18dB, the detection rate of bone age retardation 28.5%, the thyroid 131I uptake 59.87±14.63%, the TSH level 21.09±9.43/μU/ml, and the prevalence rate of subclinical cretinism 15.71; in those areas with low-iodine level, the corresponding figures were 77.32±11.54, 19.91±7.23dB, 13.5%, 50.26±19.25%, 11.05±11.49μU/ml and 9.36%, respectively; and in control areas with iodine supplementation, the corresponding figures were 95.76±17.52, 16.08±3.21dB, 3.88%, 23.61±,11.71%, 6.26±2.08/μU/ml and 3.20%, respectively. Statistically significant differences existed between these areas, suggesting that in low-iodine environment with concurrent high-fluoride intake, the fluoride could exacerbate central nervous lesions and somatic developmental disturbance of iodinfe deficiency origin. The detection rate of subclinical cretinism in 104 children with mild mental retardation was found to be 69.23%.

Keywords: Iodine deficiency disorder (IDD); Fluoride; Intelligence quotient (IQ); Hear-ing; Psychomotor

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