【作者】 钟春梅；

【导师】 汪之顼；

【作者基本信息】 青岛大学 ， 营养与食品卫生学， 2010， 硕士

【摘要】 目的了解山东省临沂市农村地区婴幼儿维生素A和微量元素营养状况及其与乙肝病毒表面抗体水平的关系。方法通过当地镇医院计划免疫接种机构,召集该镇所有7-36月龄的婴幼儿进行调查。采用一日24小时膳食回顾调查和二日膳食记录相结合的方法,了解婴幼儿连续72小时进食的食物及数量。采用营养素计算软件,计算每人每日各种营养素的平均摄入量,并计算其占RNI或AI的百分比。采集婴幼儿静脉血2ml。血清维生素A浓度采用高效液相色普法(HPLC)测定,血清铜锌硒浓度采用电感耦合等离子质谱法(ICP-MS)测定,血清铁蛋白和高敏C-反应蛋白采用免疫增强透射比浊法测定,血清乙肝病毒表面抗体(抗-HBs)浓度采用电化学发光免疫分析法(ECLIA)测定。应用软件SPSS11.5进行统计学分析。结果大部分儿童的维生素A、铁、锌和铜摄入量皆未达到推荐摄入量或适宜摄入量；维生素A营养不良发生率为61.9%,24月龄以下的儿童的维生素A营养不良发生率高于24月龄以上的儿童(χ2=6.86,P=0.009)；铁、硒和铜缺乏率分别为46.4%、2.5%和0.7%,血清锌过低率为28.1%,24月龄以下的儿童铁缺乏症患病率高于24月龄以上的儿童(χ2=15.05,P=0.000),12月龄以下的儿童硒缺乏率高于12月龄以上的儿童(χ2=10.33,P=0.001)；抗-HBs阳性率为89.9%，随着月龄的增长逐渐下降；在校正月龄因素后,月龄在10个月-30个月的儿童,其血清维生素A水平与抗-HBs水平的偏相关系数是0.162(n=188,P=0.027)；在12-24月龄段的119名儿童中,血清硒水平与抗-HBs浓度在控制月龄后的偏相关系数是0.226(n=119,P=0.014)。结论该地婴幼儿膳食维生素A、铁、锌和铜摄入水平较低,硒摄入状况较好；维生素A缺乏较严重,缺乏率高于全国平均水平,铁锌铜的营养状况也有待改善；婴幼儿抗-HBs GMC和抗-HBs阳性率均随着月龄的增长而降低；血清维生素A和血清硒水平可能与抗-HBs有效保护水平的维持有一定关系。更多还原

【Abstract】 Objective To explore the status of vitamin A and trace elements among rural infants in Linyi area, Shandong Province, and the relationship between them and the Level of Anti-HBs.Methods Infants aged at 7 months old to 36 months old were recruited into an investigation through local vaccination service. The infants’feeding information of successive 72 hours was collected through the 24-hour dietary recall method and diet records method. The nutrients intakes were analyzed with a nutrient software for calculation. Two milliliter venous blood was drawn from each studied child. The concentration of serum vitamin A, trace elements and anti-HBs was analyzed by HPLC, ICP-MS and ECLIA, respectively. The level of serum ferritin and high C-reactive protein was analyzed by particle enchanced immunoturbidimetic assay. Software SPSS11.5 was used for statistical analysis.Results The average daily intake of vitamin A, iron, zinc and copper did not reached the recommended nutrient intakes(RNI) or adequate intakes(AI) among most children. The incidence rate of vitamin A malnutrition was 61.9%, which was higher in children under 24 months(χ2=6.86,P=0.009). The incidence rate of iron, selenium and copper deficiency was 46.4%,2.5% and 0.7%, respectively. The low incidence rate of serum zinc was 28.1%. The iron deficiency was more widespread in children under 24 month(χ2=15.05, P=0.000). The children younger than 12 months were more susceptible to selenium deficiency than their older counterparts(χ2=10.33, P=0.001). The anti-HBs positive rates was 89.9%, and which was decreased gradually with the ages increased. After controlling for the age, the partial correlation coefficient between the level of serum vitamin A and anti-HBs was 0.162 among the children 10 to 30 months old(n=188, P=0.027). In the children aged 12 to 24 months old, the partial correlation coefficient between the level of serum selenium and anti-HBs was 0.226 after controlling for the age (n=119, P=0.014).Conclusion In this area, the status of the dietary selenium intake was relatively ideal, however, the dietary intake of vitamin A, iron, zinc and copper could be lower in rural infants. The incidence of vitamin A deficiency was higher than the national average. The nutritional status of iron, zinc and copper also should be paid more attention to improve. The anti-HBs positive rates and GMC are decreased gradually with the age increased. The level of serum vitamin A and selenium may have influence on the maintenance of an effective anti-HBs level against hepatitis B virus.更多还原