河北省农村地区学龄儿童营养状况与智力发育水平研究

发布时间：2018-03-18 17:44

本文选题：农村地区　切入点：学龄儿童　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:了解河北省农村地区学龄儿童的营养状况和智力发育情况,并探讨影响学龄儿童智力发育的相关因素。方法:采用整群随机抽样方法,在河北省石家庄市行唐县中随机抽取3所全日制寄宿小学确定为研究现场,将这3所学校2~6年级的学生作为调查对象。研究项目包括问卷调查、膳食调查、体格测量、智力测试等,以及血液生化指标、维生素水平等检测。结果:1调查样本基本特征三所学校参加调查的学龄儿童共894人,实际完成调查学生人数795人,完成率88.93%;其中男生376人,女生419人。照顾儿童普遍有母亲参与,但存在一定比例的留守儿童;家庭年人均收入水平以5000元以下为主,占84.40%;父母受教育程度以初中为主。2儿童在校期间膳食情况畜肉类食品摄入量不足,豆类、坚果类、奶类摄入量很少,鱼虾类食品几乎未摄入,而食盐摄入过多,其他类型食品摄入基本达到推荐量;平均每人每日的硫胺素、烟酰胺、抗坏血酸及铁元素摄入基本满足推荐量,蛋白质摄入总量略显不足,而视黄醇、核黄素、钙元素的摄入量明显不足。3体格发育情况生长迟缓22人,总体生长迟缓率为2.77%,男生、女生分别为3.19%和2.39%,差异无统计学意义;消瘦20人,总消瘦率为2.52%,男生、女生分别为3.19%和1.90%,差异无统计学意义;超重119人,总超重率为14.97%,男生、女生分别为11.17%和18.38%,差异有统计学意义;肥胖61人,总肥胖率为7.67%,男生、女生分别为7.71%和7.64%,差异无统计学意义;中心性肥胖96人,占总人数的12.08%,男生、女生分别为9.04%和14.80%,差异有统计学意义。4智力发育水平得分等级的优秀、良好、中等、中下和低下构成比分别为3.32%、29.91%、47.25%、15.17%和4.34%,男生的平均智力等级高于女生,但差异无统计学意义;第二年重复施测的结果差异无统计学意义。5血清生化指标水平及相关患病情况血红蛋白(hemoglobin,hb)浓度平均水平为142.94±11.87g/l,总贫血患病率为2.86%,男生、女生分别为2.45%和3.23%,差异无统计学意义。白蛋白(albumin,alb)浓度平均水平为47.00±2.33g/l,男生、女生分别为46.75±2.31g/l和47.22±2.32g/l,差异有统计学意义,未发现血清白蛋白水平低下的儿童;总蛋白(totalprotein,tp)浓度平均水平为72.63±4.87g/l,男生、女生分别为72.18±5.00g/l和73.00±4.73g/l,差异有统计学意义。甘油三酯(triglyceride,tg)浓度平均水平为0.68±0.41mmol/l,男生、女生分别为0.64±0.41mmol/l和0.71±0.42mmol/l,差异有统计学意义,共发现16名血清甘油三酯浓度过高的儿童,占2.80%;总胆固醇(totalcholestrol,tc)浓度平均水平为3.74±0.73mmol/l,男生、女生分别为3.67±0.62mmol/l和3.80±0.80mmol/l,差异无统计学意义,共发现14名血清总胆固醇浓度过高的儿童,占2.36%;低密度脂蛋白(lowdensitylipoproteincholesterol,ldl-c)浓度平均水平为1.97±0.55mmol/l,男生、女生分别为1.92±0.51mmol/l和2.02±0.59mmol/l,差异有统计学意义,共发现6名血清低密度脂蛋白浓度过高的儿童,占1.01%;高密度脂蛋白(highdensitylipoproteincholesterol,hdl-c)浓度平均水平为1.47±0.33mmol/l,男生、女生分别为1.50±0.38mmol/l和1.45±0.29mmol/l,差异无统计学意义,共发现30名血清高密度脂蛋白浓度过低的儿童,占5.05%。尿酸(uricacid,sua)浓度平均水平为292.67±67.95μmol/l,男生、女生分别为290.13±67.27μmol/l和294.73±68.53μmol/l,差异无统计学意义,共发现31名高尿酸血症的儿童,占5.20%。铁蛋白(serumferritin,sf)浓度平均水平为36.06±16.75μg/l,男生、女生分别为35.32±16.82μg/l和36.66±16.71μg/l,差异无统计学意义,共发现22名铁缺乏的儿童,占总人数的3.71%。载脂蛋白a浓度平均水平为1.57±0.36g/l,男生、女生分别为1.58±0.36g/l和1.56±0.37g/l,差异无统计学意义;其中水平过高的占11.99%,水平过低的占1.86%。载脂蛋白b浓度平均水平为0.60±0.20g/l,男生、女生分别为0.56±0.19g/l和0.61±0.19g/l,差异有统计学意义;其中水平过高的占2.84%,水平过低的占10.18%。6血清维生素水平血清维生素a平均水平为0.74±0.27μmol/l,男生、女生分别为0.72±0.25μmol/l和0.75±0.28μmol/l,差异无统计学意义;血清维生素a水平缺乏(vitaminadeficiency,vad)的儿童有356名,占总人数的46.54%,边缘性缺乏(subclinicalvitaminadeficiency,svad)的儿童有335名,占总人数的43.79%。血清25(oh)d3平均浓度为45.57±18.27nmol/l,男生、女生分别为45.79±16.36nmol/l和45.31±20.32nmol/l,差异无统计学意义;缺乏的63人,占8.75%,水平不足的419人,占58.19%,水平正常的196人,占27.22%,水平充足的42人,占5.83%。血清维生素b1平均水平为58.53±41.44nmol/l,男生、女生分别为56.52±32.86nmol/l和60.43±48.56nmol/l,差异有统计学意义;血清维生素b2平均水平为0.68±0.46nmol/l,男生、女生分别为0.65±0.40nmol/l和0.69±0.51nmol/l,差异无统计学意义;烟酰胺平均水平为6.27±4.22ng/ml,男生、女生分别为6.11±3.93ng/l和6.38±4.40ng/l,差异无统计学意义。7学龄儿童智力发育与多种维生素水平相关性研究本研究发现,排除混杂因素后,血清维生素d与智力水平呈正相关,血清维生素a、维生素b1、维生素b2、烟酰胺与智力水平无相关性。血清维生素d浓度随智力等级的升高而递增,除智力良好和中等、中等和中下组间差异无统计学意义外,其他各组间差异均有统计学意义。结论:1河北省农村地区仍存在学龄儿童膳食结构不合理、部分微量营养素摄入不足等问题。2河北省农村地区学龄儿童体格发育良好,但超重、肥胖问题不容忽视。3河北省农村地区学龄儿童血清生化指标检测结果比较良好,但部分儿童的营养缺乏症患病情况仍需关注。4河北省农村地区学龄儿童智力水平相对较好,学龄儿童智力发育水平与血清维生素D水平存在正相关关系,其他维生素水平未发现与智力水平存在相关性。
[Abstract]:Objective: to understand the nutritional status and intelligence of school-age children in rural areas of Hebei province's development, and explore the influencing factors of school-age children's mental development. Methods: using cluster random sampling method, in Hebei province Xingtang County in Shijiazhuang city were randomly selected from 3 full-time boarding elementary school as the research site, the 3 schools 2~6 grade students as the research object. Research projects including questionnaire survey, dietary survey, physical examination, intelligence test, and blood biochemical indexes, detection of vitamin levels. Results: the basic characteristics of 1 survey samples of three schools participated in the survey of school-age children in a total of 894 people, the actual completion of the investigation with 795 students, the completion rate of 88.93%; there were 376 boys and 419 girls. Take care of children generally have a mother to participate, but there is a certain proportion of left-behind children; family per capita income level to 5000 yuan, accounting for 84.40% of the father; The parent education level of junior high school.2 children during the period of school dietary intake status of animal meat, beans, nuts, milk intake rarely, fish food almost no intake, and excessive intake of salt, other types of food intake reached the recommended amount; the daily average thiamine, nicotinamide, ascorbic acid and iron intake meet the recommended amount, the total protein intake is insufficient, and retinol, riboflavin, calcium intake was significantly less than.3 physical development retardation of growth of 22, the overall growth rate of 2.77%, boys and girls were 3.19% and 2.39%, the difference was not statistically significant; weight loss of 20 people, the total weight loss rate was 2.52%, boys and girls were 3.19% and 1.90%, the difference was not statistically significant; overweight 119 people, the total rate of overweight was 14.97%, boys and girls were 11.17% and 18.38%, the difference was statistically significant; 61 obese people In total, the obesity rate was 7.67%, boys and girls were 7.71% and 7.64%, the difference was not statistically significant; central obesity is 96 people, accounting for 12.08% of the total number of boys and girls, respectively 9.04% and 14.80%, there was a significant difference between the.4 level of intellectual development level of excellent, good, medium, middle and low proportion were 3.32%, 29.91%, 47.25%, 15.17% and 4.34%, the average intelligence level of boys were higher than girls, but the difference was not statistically significant; second years after the results showed no statistical significance and biochemical indexes of serum.5 level and related prevalence of hemoglobin (hemoglobin, HB) the average concentration was 142.94 + 11.87g/l, the total prevalence rate of anemia 2.86%, boys and girls were 2.45% and 3.23%, the difference was not statistically significant. Albumin (albumin, ALB) the average concentration was 47 + 2.33g/l, boys, girls were 46.75 + 2.31g/l and 47.22 + 2.32g/l, difference There was a significant correlation, not low serum albumin level in children; total protein (totalprotein, TP) the average concentration was 72.63 + 4.87g/l, boys, girls were 72.18 + 5.00g/l and 73 + 4.73g/l, the difference was statistically significant (triglyceride, TG). Triglyceride concentration average was 0.68 + 0.41mmol/l, boys and girls were 0.64 + 0.41mmol/l and 0.71 + 0.42mmol/l, there were statistically significant differences were found in 16 patients, serum triglyceride concentration is too high for children, accounted for 2.80%; the total cholesterol (totalcholestrol, TC) the average concentration was 3.74 + 0.73mmol/l, boys, girls were 3.67 + 0.62mmol/l and 3.80 + 0.80mmol/l, there was no significant difference in total. The discovery of 14 serum total cholesterol concentration in children, accounting for 2.36%; low density lipoprotein (lowdensitylipoproteincholesterol, LDL-C) average concentration was 1.97 + 0.55mmol/l, boys and girls Were 1.92 + 0.51mmol/l and 2.02 + 0.59mmol/l, there were statistically significant differences were found in 6 patients, serum low density lipoprotein concentrations in children, accounting for 1.01%; high density lipoprotein (highdensitylipoproteincholesterol, HDL-C) the average concentration was 1.47 + 0.33mmol/l, male students, girls were 1.50 + 0.38mmol/l and 1.45 + 0.29mmol/l, difference no statistical significance were found in 30 serum high density lipoprotein concentration in children, accounting for 5.05%. of uric acid (uricacid, SUA) the average concentration was 292.67 + 67.95 mol/l, boys, girls were 290.13 + 67.27 and 294.73 + mol/l 68.53 mol/l, and no significant differences were found in 31 hyperuricemia children, accounting for 5.20%. of ferritin (serumferritin, SF) the average concentration was 36.06 + 16.75 g/l, boys, girls were 35.32 + 16.82 and 36.66 + g/l 16.71 g/l, and no significant differences were found in 2 2 of iron deficiency in children, the total number of 3.71%. apolipoprotein A concentration level was 1.57 + 0.36g/l, boys, girls were 1.58 + 0.36g/l and 1.56 + 0.37g/l, the difference was not statistically significant; the high level accounted for 11.99%, 1.86%. accounted for the low level of the average level of apolipoprotein B concentration was 0.60. 0.20g/l, boys, girls were 0.56 + 0.19g/l and 0.61 + 0.19g/l, the difference was statistically significant; the high level accounted for 2.84%, accounting for the low level of the serum vitamin 10.18%.6 level in serum vitamin A levels of 0.74 + 0.27 mol/l, boys, girls were 0.72 + 0.25 and 0.75 + 0.28 mol/l mol/l. There was no statistically significant difference; the level of serum vitamin A deficiency (vitaminadeficiency, VAD) of the 356 children, accounting for 46.54% of the total number, marginal deficiency (subclinicalvitaminadeficiency, svad) of the 335 Children, the total number of 43.79%. blood 25 (OH) D3 average concentration was 45.57 + 18.27nmol/l, boys, girls were 45.79 + 16.36nmol/l and 45.31 + 20.32nmol/l, the difference was not statistically significant; the lack of 63 people, accounted for 8.75%, 419 people, inadequate levels accounted for 58.19% of the normal level of 196 people, accounted for 27.22%, 42 level is sufficient. 5.83%. serum vitamin B1 levels were 58.53 + 41.44nmol/l, boys, girls were 56.52 + 32.86nmol/l and 60.43 + 48.56nmol/l, the difference was statistically significant; the average level of serum vitamin B2 was 0.68 + 0.46nmol/l, boys, girls were 0.65 + 0.40nmol/l and 0.69 + 0.51nmol/l, the difference was not statistically significant; the average level of nicotinamide was 6.27. 4.22ng/ml, boys, girls were 6.11 + 3.93ng/l and 6.38 + 4.40ng/l, there was no significant difference in.7 between school-age children's mental development and various levels of vitamin research this research found that the confounding factors, serum Vitamin D and positively related to intellectual level, serum vitamin A, vitamin B1, vitamin B2, nicotinamide and intelligence level. No correlation between serum vitamin D concentration with intelligence levels increased, in addition to good intelligence and medium, there was no significant difference between middle and lower groups, meaning between the other groups were statistically significant. Conclusion: 1 Hebei province rural areas still exist in school-age children's diet is not reasonable, the physical part of school-age children micronutrient intake of.2 in Hebei province rural area development is good, but overweight, obesity problems can not be ignored biochemical indexes in serum of school-age children in rural areas of Hebei province.3 detection result is good, but some children nutrition deficiency prevalence the intelligence level of school-age children still need to pay attention to.4 in rural areas of Hebei province is relatively good, school-age children's intelligence development level and the level of serum vitamin D Positive correlation, other vitamin levels were not found to be associated with the level of intelligence.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R153.2

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