卫生研究

目的了解喀什维吾尔族孕妇膳食营养摄入状况,探讨其体内叶酸水平及其影响因素。方法于2014—2015年,以喀什地区358例维吾尔族孕妇为研究对象,采取3天24小时膳食回顾法进行膳食营养调查并采集血液标本;采用氰化高铁血红蛋白法测定血红蛋白(Hb),使用生物素双抗体夹心酶联免疫吸附法(ELISA)检测体内叶酸。将资料用V2.7.13营养计算器软件处理,与2013版《中国居民膳食营养素参考摄入量(DRIs)》进行比较。结果粮谷类、畜禽类和油脂摄入量基本达标,蔬菜水果类、蛋类、奶及奶制品和大豆及坚果类摄入偏低,鱼虾类摄入为(0.18±3.95)g,盐摄入偏高(9.03±3.97)。孕早期能量(101.19%)、蛋白质(107.87%)、钙(32.48%)、铁(195.30%)、锌(106.63%)、硒(55.77%)、碘(15.54%),维生素B1(87.50%)、维生素B2(60.00%)、维生素C(65.69%)、叶酸(13.21%);孕晚期能量(84.29%)、蛋白质(72.44%)、钙(27.77%)、铁(180.38%)、锌(121.16%)、硒(53.11%)、碘(11.26%),维生素B1(75.33%)、维生素B2(49.33%)、维生素C(57.37%)、叶酸(13.15%)。孕妇贫血总检出率为18.89%,血红蛋白平均值为(119.42±13.90)g/L。孕妇在早期与晚期的Hb水平和贫血检出率差异均有统计学意义(P<0.05);叶酸总缺乏检出率为75.42%,平均叶酸水平为(9.15±4.22)nmol/L,孕妇在早期和晚期的叶酸水平和叶酸缺乏检出率比较差异均有统计学意义(P<0.05)。结论喀什维吾尔族孕妇的膳食构成欠合理,蔬菜水果摄入不足,鱼虾类摄入严重缺乏,盐类摄入偏高。三大营养素供能比在适宜比例范围内;孕晚期的能量和蛋白质摄入低于DRIs,孕妇铁、锌摄入偏高,硒、维生素B2和C摄入不足,钙、碘和叶酸严重缺乏;孕妇贫血晚期较早期严重,孕期叶酸水平低、孕晚期低于早期。

Objective To understand the dietary intake situation of Uighur pregnant women,investigate folic acid level and its influencing factors,to provide evidence for health education of maternal nutrition and implementation of proper nutrition,balanceddiet guidance. Methods 358 cases of Uighur trimester pregnant women for the study,took the method of 3 d 24 h dietary recall to survey their dietary and collect blood samples.The Hb was detected by the cyanide methemoglobinmethod. The content of folic acid was determined by a double antibody biotin sandwich enzyme-linked immunosorbent assay( ELISA) method. The data processing used V2. 7. 13 nutrition calculator software,and compare with "DRIs"in 2013. Results Diet composition and nutrient intake: Grains,livestock,poultry,fats and oils intake almost reached the standards,vegetables,fruits,eggs,milk and beans intake were below standards,the intake of fish and shrimp were( 0. 18 ± 3. 95) g, high salt intake( 9. 03 ± 3. 97). In early pregnancy, energy( 101. 19%), protein( 107. 87%), calcium( 32. 48%), iron( 195. 30%), zinc( 106. 63%),selenium( 55. 77%),iodine( 15. 54%),vitamin B1( 87. 50%) vitamin B2( 60. 00%),vitamin C( 65. 69%),folic acid( 13. 21%). The late pregnant energy( 84. 29%),protein( 72. 44%),calcium( 27. 77%),iron( 180. 38%),zinc( 121. 16%),selenium( 53. 11%),iodine( 11. 26%),vitamin B1( 75. 33%),vitamin B2( 49. 33%),vitamin C( 57. 37%),folic acid( 13. 15%). The total detection rate of anemia in pregnant women was 18. 89%,mean of Hb was( 119. 42 ± 13. 90) g/L.Comparison of Hb levels( P < 0. 05) and anemia detection rate( P < 0. 05) in the early and late pregnant women,the difference was significant; total lack of folic acid detection rate was 75. 42%,the average folate levels( 9. 15 ± 4. 22) nmol/L,compare folate levels( P < 0. 05) and folate deficiency detection rate( P < 0. 05) in early and late pregnant women,the difference was significant. Conclusion The dietary structure of pregnant women is less irrational. The intake of fruits and vegetables are inadequate and the intake of fish and shrimp is serious lack. The intake of salt is high. The proportion of three heat nutrients are in a suitable ratio range. The energy and protein intake are below the DRIs in the late pregnant,iron and zinc intake are high. The selenium,vitamin B2 and C intake are inadequate,a serious lack of calcium,iodine and folic acid in whole pregnancy. The anemia in late pregnant is more serious than early pregnant,during pregnancy folate level is low and late pregnant is lower than early.