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目的检测食用核黄素强化碘盐后食管癌高发区人群体内核黄素营养水平和食管粘膜状况,为进一步推广核黄素强化碘盐提供科学依据。方法选择食管癌高发现场—河化省磁县固义乡21个村,对所有居民采用核黄素强化碘盐方式进行干预观察。干预组服用核黄素强化碘盐(核黄素100~150 mg/kg);对照组服用未添加核黄素的普通碘盐。2组共随机抽取275人,测定血液中红细胞谷胱甘肽还原酶活性系数(EGRAC),评价核黄素营养状况。对40~69岁居民进行食管和全胃电子纤维胃镜检查,食管粘膜加碘染色指示性多点活检,观察记录食管粘膜状况。收集普查中发现的食管癌病例血液样本18例,在同一普查队列选取与病例年龄相差±2岁,标本采集间隔时间<2周,居住同村并且无其他重大疾病非食管癌居民各2例,进行体内核黄素水平与食管癌危险性关系的嵌套病例对照研究。结果干预组血液中红细胞谷胱甘肽还原酶活性系数平均值为1.452,低于对照组的1.606,差异有统计学意义(P<0.01)。胃镜检查结果显示,干预组食管粘膜状况明显优于对照组(P<0.01)。单因素分析结果表明,肿瘤家族史(OR=20.94,95%CI=1.37~321.28)和核黄素缺乏(OR=15.51,95%CI=1.54~156.08)可能是食管癌危险因素,且二者具有交互作用。结论核黄素强化碘盐能显著改善人体核黄素营养状况,进而改善食管粘膜状况,是食管癌高发区经济、简便和有效的营养干预手段。
Objective To detect the riboflavin nutrition status and esophageal mucosa status in the crowd of high esophageal cancer patients after eating riboflavin-fortified iodized salt, and provide a scientific basis for the further promotion of riboflavin-fortified iodized salt. Methods 21 high-incidence sites of esophageal cancer were selected in Guyi County, Cixi County, Heilongjiang Province. All residents were treated with riboflavin-fortified iodized salt for intervention. The intervention group took riboflavin enhanced iodized salt (riboflavin 100 ~ 150 mg / kg); the control group took ordinary iodine salt without added riboflavin. A total of 275 patients were randomly selected from the two groups, and the erythrocyte glutathione reductase activity coefficient (EGRAC) in the blood was measured to evaluate the nutritional status of riboflavin. Esophageal and total stomach electron microscopy gastroscopy was performed on residents aged 40-69 years, and multi-biopsies of esophageal mucosal iodine staining were observed. The esophageal mucosa was observed and recorded. Eighteen cases of esophageal cancer blood samples were collected during the census. The difference was ± 2 years between the age of the selected cases and the age of the patients in the same census cohort. The specimens were collected at intervals of 2 weeks. Two residents living in the same village with no other major diseases and 2 non- A nested case - control study on the relationship between riboflavin level and esophageal cancer risk in. Results The mean value of erythrocyte glutathione reductase activity in the intervention group was 1.452, which was lower than that in the control group (1.606), the difference was statistically significant (P <0.01). Gastroscopy showed that the intervention group esophageal mucosa was significantly better than the control group (P <0.01). Univariate analysis showed that family history of cancer (OR = 20.94, 95% CI = 1.37-321.28) and riboflavin deficiency (OR = 15.51, 95% CI 1.54-156.08) were risk factors for esophageal cancer, Interaction. Conclusion Riboflavin enhanced iodized salt can significantly improve the human riboflavin nutritional status, thereby improving the status of esophageal mucosa, esophageal cancer is an economic, simple and effective means of nutritional intervention.