Abstract: Background　Iodine is the main element in the synthesis of thyroid hormone.Iodine deficiency in fetus can cause hypothyroidemia and irreversible neurological damage and cognitive impairment.And sensory integration dysfunction（SID）is susceptible to cause learning difficulties and behavioral disorders in children，but there are few studies on the relationship between iodine and SID in China.Objective　To investigate the association between urinary iodine levels and SID in preschool children and provide scientific evidence to improve the development of children's sensory integration.Methods　Five kindergartens were selected by cluster sampling in Yunxi County，Shiyan City，Hubei Province from October to November 2017.The urinary iodine of children aged 3-6 years in kindergartens was measured in the morning.The basic information was investigated by epidemiological questionnaires.The sensory integration ability of children was tested by the Children Sensory Integration Development Assessment Scale.The urinary iodine and SID of preschool children in different genders and age were compared.Multivariate logistic regression was used to analyze the influencing factors of sensory integration in preschool children.Results　A total of 800 questionnaires and urine samples were sent out.710 valid questionnaires and qualified urine samples were obtained，with the effective rate of 88.8%.There were significant differences in birth weight，BMI，spontaneous delivery，urinary iodine and SID between different sex subjects（P<0.05）．The urinary iodine of preschool children was 192（144，271）μg/L，9.4%（67/710）of who were deficient in iodine，42.8%（304/710）of who were iodine-replete，30.4%（216/710）of who had mild and moderate iodine excess and 17.3%（123/710）of who had extreme iodine excess.There was significant difference in urinary iodine level between preschool children in different genders（P<0.05），and there was no significant difference in urinary iodine level between preschool children in different age groups（P>0.05）．The incidence of SID was 55.8%（396/710），of which 30.3%（215/710）had mild SID and 25.5%（181/710）had severe SID.There were significant differences in the  incidence of SID among preschool children of different genders（P<0.05）；and the incidence of total SID and severe SID in boys were higher than that in girlss（P<0.05）.There was no significant difference in the incidence of SID between preschool children in different age groups（P>0.05）．Multivariate Logistic regression analysis showed that urinary iodine status of preschool children was the influencing factor of vestibular imbalance 〔OR=1.250，95%CI（1.018，1.534），P=0.033〕 and proprioceptive dysesthesia〔OR=1.247，95%CI（1.015，1.531），P=0.035〕.Conclusion　Urinary iodine levels in preschool children may affect the SID，and low-level urinary iodine may increase the risk of children's vestibular imbalance and proprioceptive dysfunction.

Key words: Psychophysiologic disorders；Urinary iodine；Sensory integration dysfunction；Child, preschool；Investigation

摘要： 背景　碘是甲状腺激素合成中的主要元素，胎儿期发生碘缺乏，会造成低甲状腺素血症及不可逆转的神经损伤和认知障碍。而感觉统合失调（SID）易造成儿童学习困难和行为障碍，且目前国内关于碘和SID之间关系的研究较少。目的　了解学龄前儿童尿碘情况与SID之间的关系，为学龄前儿童感觉统合能力健康发展提供理论依据。方法　2017年10—11月采用整群抽样的方法在湖北省十堰市郧西县城区抽取5所幼儿园，对抽中的幼儿园中3~6岁儿童进行晨尿尿碘测定，采用流行病学调查问卷调查其基本信息，采用《儿童感觉统合能力发展评定量表》对其感觉统合能力进行测试。比较不同性别、年龄学龄前儿童尿碘、SID情况。采用多因素Logistic回归分析学龄前儿童感觉统合情况的影响因素。结果　共发放问卷及采集尿标本800份，问卷有效且尿标本合格的有710份，有效率为88.8%。不同性别学龄前儿童间出生体质量、BMI、是否顺产、尿碘、SID情况比较，差异均有统计学意义（P<0.05）。学龄前儿童尿碘192（144，271）μg/L，碘不足者占9.4%（67/710），碘适宜者占42.8%（304/710），碘超适宜量者占30.4%（216/710），碘过量者占17.3%（123/710）。不同性别学龄前儿童尿碘情况比较，差异有统计学意义（P<0.05）；不同年龄段学龄前儿童尿碘情况比较，差异无统计学意义（P>0.05）。SID发生率为55.8%（396/710），其中轻度SID发生率为30.3%（215/710），重度SID发生率为25.5%（181/710）。不同性别学龄前儿童SID发生情况比较，差异有统计学意义（P<0.05）；其中男童总SID发生率、重度SID发生率高于女童（P<0.05）。不同年龄段学龄前儿童SID发生情况比较，差异无统计学意义（P>0.05）。多因素Logistic回归分析结果显示，学龄前儿童尿碘情况是前庭平衡功能失调〔OR=1.250，95%CI（1.018，1.534），P=0.033〕、本体感觉失调〔OR=1.247，95%CI（1.015，1.531），P=0.035〕的影响因素。结论　学龄前儿童的尿碘情况可能影响SID，低水平尿碘可能增加学龄前儿童前庭平衡功能失调和本体感觉失调的风险。

关键词: 心理生理性障碍；尿碘；感觉统合失调；儿童, 学龄前；调查