目的 调查江西省南昌市东湖区孕妇2022—2024年碘营养状况与盐碘监测情况,为区域干预提供依据。方法 将江西省南昌市东湖区划分为东、南、西、北、中5个片区,每个片区随机抽取一个街道(管理处),于每年5月份随机抽取各街道(管理处)20名孕妇,每年共抽取100名孕妇,3年共计300名孕妇,采集其尿液样本和家中食用盐样本检测碘含量,以统计学方法进行分析。结果 3年来孕妇家庭食用盐碘含量中位数为23.02 mg/kg,碘盐覆盖率为98.67%,碘盐合格率为95.33%,3年的食用盐碘含量比较差异有统计学意义(H=38.545,P<0.05)。孕妇的尿碘水平中位数为115.15 μg/mL,3年来孕妇的尿碘水平中位数均低于150 μg/mL,有62.67%的孕妇碘缺乏,3年间的尿碘水平比较差异有统计学意义(H=9.392,P<0.05),其中2024年的尿碘水平中位数为140.00 μg/mL,校正后高于2022年(Z=2.693,P<0.0167)和2023年(Z=2.590,P<0.0167)。Spearman相关性分析结果显示孕妇尿碘水平与盐碘含量及碘盐质量均无相关性(均P>0.05),孕妇碘营养状况与盐碘含量及碘盐质量均无相关性(均P>0.05),孕妇尿碘水平与碘营养状况正相关(rs=0.857,P<0.05),盐碘含量与碘盐质量正相关(rs=0.314,P<0.05)。结论 江西省南昌市东湖区2024年孕妇碘缺乏有所改善,但整体形势严峻,超半数的孕妇碘缺乏,食用碘盐基本符合国家消除碘缺乏病标准,但仍需改进。卫生部门要强化孕妇碘营养监测,向孕妇科普碘缺乏病知识,增强补碘意识,促其科学补碘。盐业监管部门需加大监管,严控碘盐质量,确保东湖区居民食盐合格。
Objective To investigate the iodine nutrition status of pregnant women and iodined salt monitoring in Donghu District,Nanchang City,Jiangxi Province from 2022 to 2024,and provide a basis for regional intervention.Methods Donghu District was divided into five areas:East,South,West,North,and Central.A street(management office)was randomly selected from each area,and 20 pregnant women were randomly selected from each street(management office)in May each year.A total of 100 pregnant women were selected each year,for a total of 300 pregnant women over three years.Urine samples and household salt samples were collected to detect iodine content,and statistical analysis was conducted.Results Over the past three years,the median iodine content in the cooking salt consumed by pregnant women’s families was 23.02 mg/kg,the iodized salt coverage rate was 98.67%,and the iodized salt qualification rate was 95.33%.There were differences in the iodine content of cooking salt in the three years(H=38.545,P<0.05).The median urinary iodine level of pregnant women was 115.15 μg/mL.In the past three years,the median urinary iodine levels of pregnant women were all lower than 150 μg/ml,and 62.67% of pregnant women were iodine-deficient.There were differences in the urinary iodine levels in the three years(H=9.392,P<0.05).Among them,the median urinary iodine level in 2024 was 140.00 μg/mL,which was significantly higher than that in 2022(Z=2.693,P<0.0167)and 2023(Z=2.590,P<0.0167)after correcting the significance level.Spearman correlation analysis results showed that there was no correlation between the urinary iodine level of pregnant women with the iodine content and quality of iodized salt(all P>0.05),and there was no correlation between the iodine nutritional status of pregnant women with the iodine content and quality of iodized salt(all P>0.05).The urinary iodine level in pregnant women is positively correlated with their iodine nutritional status(rs=0.857,P<0.05),and the iodine content in salt is positively correlated with the quality of iodized salt(rs=0.314,P<0.05).Conclusions In 2024,the iodine deficiency among pregnant women in Donghu District,Nanchang City,Jiangxi Province was improved,but the overall situation is still severe.More than half of pregnant women were iodine-deficient.The consumption of iodized salt basically met the national standards for eliminating iodine deficiency disorders,but still needed to be improved.The health department should strengthen the monitoring of iodine nutrition among pregnant women,popularize knowledge about iodine deficiency disorders to pregnant women,enhance their awareness of iodine supplementation,and promote their scientific iodine supplementation.The salt industry supervision department needs to strengthen supervision,strictly control the quality of iodized salt,and ensure that the cooking salt of residents in Donghu District is qualified.
目的 探讨降钙素原(PCT)联合营养指标对肝硬化营养状况的评定价值。方法 选取2021年2月—2022年3月在右江民族医学院附属医院感染科住院的140例肝硬化患者,根据营养风险筛查2002(NRS 2002)将其分为有营养风险组和无营养风险组。比较两组肝硬化患者中营养指标体质指数(BMI)、血红蛋白(HGB)、前白蛋白(PA)、白蛋白(ALB)、视黄醇结合蛋白(RBP)水平, 并分析它们与PCT的相关性。结果 BMI、HGB、ALB、PA及RBP水平低于低营养风险组(P<0.05); 营养指标(BMI、HGB、ALB、PA、RBP)与PCT呈负相关(P<0.05)。二元Logistics回归分析发现ALB、PCT是肝硬化患者营养风险的危险因素(P<0.05)。ROC结果显示PCT与ALB的联合营养指标评定肝硬化营养不良的曲线下面积为0.984,(95%CI:0.964~1.000), 灵敏度98.8%, 特异度93.3%, 约登指数0.921; ALB、PCT的AUC分别为0.919、0.974。结论 肝硬化患者PCT水平与其营养状况密切相关, 对营养状况的评定有一定的价值, 联合评定能有效提高其评定价值。
Objective To explore the value of procalcitonin(PCT)combined with nutritional indexes in evaluating the nutritional status of liver cirrhosis.Methods A total of 140 patients with cirrhosis admitted to the Department of Infection of the Affiliated Hospital of Youjiang Medical College for Nationalities from February 2021 to March 2022, they were selected and divided into with and without nutritional risk group according to nutritional risk screening 2002(NRS 2002).The levels of body mass index(BMI), hemoglobin(HGB), prealbumin(PA), albumin(ALB)and retinol binding protein(RBP)in two groups of patients with cirrhosis were compared, and the correlation between them and PCT was analyzed.Results The levels of BMI, HGB, ALB, PA and RBP were lower than those of low nutritional risk group(P<0.05).The nutritional indices(BMI, HGB, ALB, PA, RBP)were negatively correlated with PCT(P<0.05).Binary Logistics regression analysis showed that ALB and PCT were risk factors affecting nutritional risk in patients with cirrhosis(P<0.05).ROC results showed that the area under the curve was 0.984(95% confidence interval:0.964 ~ 1.000), sensitivity 98.8%, specificity 93.3%, and Yoden index 0.921 for the combined PCT and ALB indexes predicting malnutrition in cirrhosis.The AUC of ALB and PCT were 0.919 and 0.974, respectively.Conclusions The level of PCT in patients with cirrhosis is closely related to their nutritional status, which has certain value in the evaluation of nutritional status, and combined prediction can effectively improve the evaluation value.
目的 应用中国膳食平衡指数(DBI-07)对活动期溃疡性结肠炎(Ulcerative Colitis,UC)患者进行膳食质量评价,并分析其与营养指标、活动度等的关系,为UC患者制订科学的营养干预措施提供依据。方法 选取我院符合纳入标准的82例UC患者进行研究,用食物频率法对患者进行膳食调查,应用膳食平衡指数DBI-07评分系统进行评价,同时进行人体测量及营养指标测定。数据用SPSS 17.0软件进行处理分析。结果 本研究中68.3%的UC患者体质量近半年有不同程度降低,40.2%的患者存低白蛋白血症,34.1%的合并贫血。UC患者TS平均值-20.02±7.97; LBS平均值-22.15±6.78, 其中54.9%存在轻度膳食摄入不足、37.8%存在中度摄入不足;DQD平均值24.27±6.21,其中轻、中度失衡分别占80.5%、17.1%。LBS绝对值与体质量减轻程度呈正相关,P<0.05,与血清白蛋白负相关,P<0.01;DQD与白蛋白呈负相关,P<0.01;4 UC患者LBS绝对值与UC活动度呈正相关,P<0.01;DQD值与UC活动度负相关,P<0.01。结论 以中国膳食平衡指数DBI-07评价UC患者膳食质量,92.7%的患者存在低、中度摄入不足,97.6%的UC患者存在膳食失衡,均明显高于健康人群。摄入不足是UC患者营养不良的重要原因,应对UC患者进行营养补充或营养支持。
Objective To survey the diet quality of UC patients using Chinese diet balance index(DBI-07) and explore their relationship with nutritional index and activity of disease, thereby to provide evidences of nutritional therapy for UC patients. Methods 82 adult UC patients who met the inclusion criteria were included in our study. They were investigated with food frequency questionnaires(FFQ) and diet quality was assessed with DBI-07. Anthropometric measurement and blood examinations were done. Data were analyzed with SPSS 17 software. Results 68.3% of the UC patients loss their weight during the recent 6 months. 40.2% of the patients were found hypoalbuminemia and 34.1% were complicated with anemia. The mean TS,LBS and DQD were -20.02±7.97, -22.15±6.78 and 24.27±6.21 respectively. Percentage of patients in slightly or moderately deficit of food intake were 54.9% and 37.8%. Percentage of the UC patients in slightly or moderately dietary imbalance were 80.5% and 17.1%.The absolute value of LBS and DQD were negatively correlated with serum albumin respectively, and both of them were positively correlated with activity of UC. Conclusion Evaluating the quality of UC with DBI-07,92.7% of UC patients were in slightly or moderately deficit of food intake,97.6% were in slightly or moderately dietary imbalance. These percentages were higher than that of healthy people. It indicated that deficit of food intake is an important reason resulting in malnutrition. Nutrition therapy is essential for UC patients.
目的 探讨加味六君子汤联合经口营养补充对COPD稳定期伴营养不良患者营养状况和肺功能的影响。方法 收集呼吸内科COPD稳定期并伴营养不良的患者40例,分为试验组和对照组各20例。试验组在对照组基础上再给予加味六君子汤和经口营养补充,观察治疗前、治疗后3月的营养相关指标和肺功能指标,然后进行统计分析。结果 ①治疗后3月,试验组的体质量、白蛋白、前白蛋白和肺功能指标较治疗前均明显改善(P<0.05)。②与对照组比较,试验组的白蛋白、前白蛋白、血红蛋白均明显升高(P<0.05),肺功能亦有显著改善(P<0.05)。③上臂肌围(MAMC)、三头肌皮褶厚度(TSF)在治疗后的组内及组间比较差异均无统计学意义(P>0.05)。结论 加味六君子汤联合经口营养补充有助于COPD稳定期伴营养不良患者体质量增加、蛋白升高,营养状况好转,从而增加呼吸肌储备,改善患者肺功能。
Objective To observe the influence of modified-liujunzi-decoction combined with Oral nutritional supplements(ONS) on the nutrition status and lung function in patients with chronic obstructive pulmonary disease(COPD). Methods 40 patients of COPD stable phase with malnutrition were divided into two groups and each group with 20 cases. On the basis of the control group, the experimental group was given again modified-liujunzi-decoction and ONS. All cases were tested before and 3 months after treatment, for detecting the nutrition related index and lung function index; T-test was used for data statistical analysis. Results ①3 months after treatment, the body weight, serum albumin, prealbumin and lung function index of the experimental group were significantly improved compared with those before treatment (P<0.05). ②Compared with the control group, the serum albumin, prealbumin and hemoglobin were significantly increased in the experimental group (P<0.05), and lung function was also significantly improved (P<0.05). ③After treatment, the mid-arm muscle circumference (MAMC), triceps skinfold thickness (TSF) comparison of intra group and intra group differences were not statistically significant(P>0.05). Conclusion Modified-liujunzi -decoction combined with oral nutritional supplements help to increase body weight, protein, and improve nutritional status in patients of COPD stable phase with malnutrition, thereby increasing their respiratory muscle reserve and improving lung function.
目的 探讨早期肠内营养集束治疗对重型颅脑损伤患者营养状态及体液免疫功能的影响。方法 42例重型颅脑损伤患者按病人住院号分为两组,单号延迟普通营养治疗组(PT组,21例),双号早期营养集束治疗组(JS组,21例)。于营养治疗开始的第1、7、14天观察营养相关指标、免疫功能指标和ICU住院时间,采用t检验进行统计分析。结果 ①JS组患者血清白蛋白、前白蛋白、血红蛋白与PT组比较均明显升高,有统计学意义(P<0.05),且各营养指标较治疗前亦明显升高(P<0.05)。②JS组患者IgG、IgM、IgA、外周淋巴细胞计数(TLC)与PT组比较均明显升高,有统计学意义(P<0.05),并且较治疗前均有明显改善(P<0.05)。③JS组患者在ICU的住院时间比PT组减少约1天,但两组比较无统计学意义(P>0.05)。结论 重型颅脑损伤可出现营养不良和免疫功能下降,规范的早期肠内营养集束治疗可改善病人营养状况,提高体液免疫功能。
Objective To study the changes in the nutritional status and humoral immunity after early enteral-nutrition bundle treatment in patients with severe traumatic brain injury. Methods 42 patients with severe traumatic brain injury were randomly divided into two groups,i.e. delayed common nutrition group (PT- group,21 cases),and early bundle nutrition group(JS-group,21 cases). All cases were tested at day1, day 7,day 14 of nutrition treatment, for detecting the nutrition related index, humoral immune index and ICU monitoring time, T-test was used for datastatistical analysis. Results ①Compared with PT-group, the serum albumin,prealbumin and hemoglobin in JS-group were significantly higher(P<0.05), also had significant increase compared with before treatment in JS-group (P<0.05). ②The serum levels of IgG, IgM, IgA and total lymphocyte count(TLC) were significantly higher in JS-group than those in PT-group(P<0.05), and significantly improved compared with before treatment in JS-group(P<0.05). ③The ICU monitoring time of patients in JS-group was one-day less than that in PT-group, but there was no statistical significant difference between them(P>0.05). Conclusion There had malnutrition and immune function decline in the patients with severe traumatic brain injury, in whom early enteral-nutrition bundle treatment can improve nutritional status and enhance the humoral immune function.