การให้ยาเม็ดเสริมไอโอดีนต่อระดับไอโอดีนในปัสสาวะ และความร่วมมือในการรับประทานยาของหญิงตั้งครรภ์

∫ ∑ «‘ ∑ ¬ “ ° “ √

∫ ∑ «‘ ∑ ¬ “ ° “ √ º≈¢Õß°“√„À⬓‡¡Á¥‡ √‘¡‰Õ‚Õ¥’π (Triferdine) µàÕ√–¥—∫‰Õ‚Õ¥’π„π ªí “«–·≈–§«“¡√à«¡¡◊Õ„π°“√√—∫ª√–∑“𠬓¢ÕßÀ≠‘ßµ—Èߧ√√¿å∑’Ë¡“Ω“°§√√¿å∑’Ë‚√ß æ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ »Ÿπ¬åÕπ“¡—¬∑’Ë 1 æ.∫.

¬ß¬ À—∂æ√ «√√§å °“𥓫 ’ ¡“≈’«ß…å »Ÿπ¬åÕπ“¡—¬∑’Ë 1 °√ÿ߇∑æœ π—π∑¬“ ®ß„®‡∑» ”π—°‚¿™π“°“√ °√¡Õπ“¡—¬

∫∑§—¥¬àÕ ¿Ÿ¡À‘ ≈—ß ‚√§¢“¥ “√‰Õ‚Õ¥’π ‡°‘¥®“°°“√‰¥â√∫— “√‰Õ‚Õ¥’π‰¡à‡æ’¬ßæÕ°—∫§«“¡µâÕß°“√¢Õß√à“ß°“¡“√¥“∑’Ë¢“¥‰Õ‚Õ¥’π„π√–À«à“ß°“√µ—Èߧ√√¿å Õ“®∑”„À⇰‘¥§«“¡∫°æ√àÕß„π°“√æ—≤π“ ¡ÕߢÕ߇¥Á° Õ“®®– ∑”„ÀâÀ≠‘ßµ—Èߧ√√¿å·∑âß∫ÿµ√ À√◊Õ§≈Õ¥º‘¥ª°µ‘·µà°”‡π‘¥ °√–∑√«ß “∏“√≥ ÿ¢¡’π‚¬∫“¬„π‡√◊ËÕß°“√ªÑÕß°—π ‚√§¢“¥ “√‰Õ‚Õ¥’π ‚¥¬¡’¡“µ√°“√ π—∫ πÿπ°“√„™â‡°≈◊Õ‡ √‘¡‰Õ‚Õ¥’π„π§√—«‡√◊Õπ ·≈–„ÀâÀ≠‘ßµ—Èߧ√√¿å‰¥â √—∫¬“«‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π (Triferdine) «—µ∂ÿª√– ß§å ‡æ◊ËÕ»÷°…“√–¥—∫‰Õ‚Õ¥’π„πªí “«–„πÀ≠‘ßµ—Èߧ√√¿å ∑’Ë¡“Ω“°§√√¿å∑’Ë ‚√ß欓∫“≈ à߇ √‘¡ ÿ¢¿“æ °àÕπ·≈–À≈—ß√—∫ª√–∑“𬓫‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π( Triferdine ) ·≈–§«“¡√à«¡¡◊Õ „π°“√√—∫ª√–∑“𬓫‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π (Triferdine) «— ¥ÿ·≈–«‘∏°’ “√ °≈ÿ¡à µ—«Õ¬à“ß ‡ªìπ À≠‘ßµ—Èߧ√√¿å∑’Ë¡“Ω“°§√√¿å„π‚√ß欓∫“≈ à߇ √‘¡ ÿ¢¿“æ »Ÿπ¬åÕπ“¡—¬∑’Ë 1 °√ÿ߇∑æœ ®”π«π 299 §π ¡’ °“√‡°Á∫ªí “«–‡æ◊ËÕµ√«®À“√–¥—∫‰Õ‚Õ¥’π°àÕπ·≈–À≈—ß√—∫ª√–∑“𬓫‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π °≈ÿࡵ—«Õ¬à“ß∑ÿ° √“¬ ®–‰¥â√—∫°“√ª√–‡¡‘πªí®®—¬µà“ßÊ∑’Ë¡’º≈°—∫√–¥—∫‰Õ‚Õ¥’π®“°·∫∫ Õ∫∂“¡ ¢âÕ¡Ÿ≈µà“ßÊ®–∂Ÿ°π”¡“ «‘‡§√“–Àå∑“ß ∂‘µ‘ º≈°“√»÷°…“ æ∫«à“ À≠‘ßµ—Èߧ√√¿å à«π„À≠à ¡’§à“√–¥—∫‰Õ‚Õ¥’π„πªí “«–∑—Èß°àÕπ·≈– À≈—ß√—∫ª√–∑“𬓫‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π Õ¬Ÿ„à π‡°≥±å∑‰’Ë ¡à¢“¥ “√‰Õ‚Õ¥’π(≥ 150 ‰¡‚§√°√—¡ / ≈‘µ√) §◊Õ √âÕ≈– 83.3·≈– 61.6 µ“¡≈”¥—∫ ·≈–‰¡àæ∫«à“¡’§«“¡ —¡æ—π∏åÕ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘√–À«à“ßªí®®—¬µà“ßÊ∑’Ë ‡°’ˬ«°—∫°“√√—∫ª√–∑“πÕ“À“√·≈–‡°≈◊Õ°—∫√–¥—∫‰Õ‚Õ¥’π„πªí “«–°àÕπ√—∫ª√–∑“𬓠√ÿª À≠‘ßµ—Èߧ√√¿å à«π„À≠à ¡’§à“√–¥—∫‰Õ‚Õ¥’π„πªí “«–∑—Èß°àÕπ·≈–À≈—ß√—∫ª√–∑“𬓫‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π Õ¬Ÿà„π‡°≥±å∑’ˉ¡à ¢“¥ “√‰Õ‚Õ¥’π

118 ‡¡…“¬π - ¡‘∂ÿπ“¬π 2555 °√¡Õπ“¡—¬

à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒

º≈¢Õß°“√„À⬓‡¡Á¥‡ √‘¡‰Õ‚Õ¥’π (Triferdine) µàÕ√–¥—∫‰Õ‚Õ¥’π„πªí “«–·≈–§«“¡√à«¡¡◊Õ„π°“√√—∫ª√–∑“π¬“œ

Effect of Triferdine Supplement to Urine Iodine Level and Compliance in Pregnant who Attend ANC Clinic at Health Promoting Hospital Region 1 Yongyot Hattapornsawan M.D. Kandavasee Maleevong Dr. Public Health Nutrition Health Promoting Hospital Region 1, Bangkok.

Nuntaya Chongchaithet Medical Scientist.

Bureau of Nutrition, Department of Health.

Abstract Background : Iodine deficiency disorders is caused by inadequate maternal dietary intake of iodine during pregnancy and can lead to abnormal production of thyroid hormones during pregnancy, mental retardation, irreversible fetal brain damage in infants and abortion. The Ministry of Public Health, Thailand has a policy that all pregnant women should consume iodized salt and receive an iodinecontaining vitamin supplement (Triferdine). Objectives : 1) To estimate the urine iodine concentration of pregnant women that reflects before and after iodine-containing vitamin supplement ( Triferdine ). 2) To assess compliance of pregnant women for iodine-containing vitamin supplement. Methods : Urine samples were collected from 299 pregnant women who attended in ANC clinic of the Health Promoting Hospital Region 1 .Urine iodine concentration were measured by sandell kolthoff method before and after iodinecontaining vitamin supplement. Seafoo and Iodized salt intake were assessed by a questionnaire. Demographic data were analyzed using descriptive statistics and the correlations between factors and urine iodine level were analyzed by using chi-square. Results : Urine iodine concentration of pregnant women before and after iodine supplementation were 83.3 % and 61.6 % respectively, had within the range of normal established by the Ministry of Public Health (≥ 150 mcg /l ), No relationship between several factors and urine iodine level was found. Conclusion : The study found that most urine iodine concentration before and after iodine supplement had above deficiency level

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

April - June 2012

119

∫ ∑ «‘ ∑ ¬ “ ° “ √ ∫∑π” ‚√§¢“¥ “√‰Õ‚Õ¥’π(Iodine Deficiency Disorders :IDD) ‡ªì π ªí ≠ À“ “∏“√≥ ÿ ¢ ∑’Ë ”§—≠¢Õß‚≈°(1-3) ‡©æ“–ª√–‡∑»∑’°Ë ”≈—ßæ—≤π“ „π ª√–‡∑»‰∑¬æ∫¿“«–¢“¥‰Õ‚Õ¥’π „π∑’ËÀà“߉°≈ ∑–‡≈ „π·∂∫∂‘Ëπ¿Ÿ‡¢“ ‚√§¢“¥ “√‰Õ‚Õ¥’π ‡°‘¥ ®“°°“√‰¥â √— ∫ “√‰Õ‚Õ¥’ π ‰¡à ‡ æ’ ¬ ßæÕ°— ∫ §«“¡ µâÕß°“√¢Õß√à“ß°“¬ ®“°Õ“À“√∑’Ë√—∫ª√–∑“π„π ·µà≈–«—π º≈¢Õß¿“«–¢“¥‰Õ‚Õ¥’π ¡’º≈∑”„À⇰‘¥ §«“¡º‘¥ª°µ‘µà“ßÊ ·≈–‡ªì𠓇ÀµÿÀ≈—°¢Õß°“√ ‡°‘¥§«“¡æ‘°“√∑“ß ¡Õß(4-5) ·≈–°“√æ—≤π“∑“ß √à“ß°“¬‰¡à‡µÁ¡∑’Ë„π‡¥Á°‡≈Á° ‚¥¬§«“¡º‘¥ª°µ‘®– ¢÷Èπ°—∫§«“¡√ÿπ·√ß·≈–√–¬–‡«≈“∑’ˇ°‘¥¿“«–¢“¥ ‰Õ‚Õ¥’ π º≈∑’Ë ‡ °‘ ¥ ¢÷È π Õ“®‡π◊Ë Õ ß®“°¿“«–¢“¥ ‰Õ‚Õ¥’π‚¥¬µ√ß ·≈–‡°‘¥®“°¿“«–æ√àÕ߉∑√Õ¬¥å ŒÕ√å‚¡π ‚¥¬¡“√¥“∑’Ë¢“¥‰Õ‚Õ¥’π„π√–À«à“ß°“√ µ—Èߧ√√¿å(6-12)Õ“®∑”„À⇰‘¥§«“¡∫°æ√àÕß„π°“√ æ—≤π“ ¡ÕߢÕ߇¥Á° ≈Ÿ°∑’˧≈Õ¥ÕÕ°¡“®–¡’¿“«– ŒÕ√å‚¡π∏—¬√Õ¬¥åµË”µ—Èß·µà·√°‡°‘¥ Õ“®®–∑”„Àâ ∑“√°µ“¬ µ—Èß·µàÕ¬Ÿà„π§√√¿å À√◊Õ·∑âß À√◊Õ§≈Õ¥ º‘¥ª°µ‘·µà°”‡π‘¥ æ‘°“√ √Ÿª√à“ß·§√–·°√𠵑 ªí≠≠“‡ ◊ËÕ¡ ∑’ˇ√’¬°«à“‚√§‡ÕãÕ À√◊Õ¿“«–§√‘µ‘π‘ ´÷¡(Cretinism) ‡¥Á°‡À≈à“π’ș૬µ—«‡Õ߉¡à‰¥â ®÷ß ‡ªì π ¿“√–∑“߇»√…∞°‘ ® ·≈– — ß §¡¢Õߪ√–‡∑» Õ¬à“ß¡“° º≈°√–∑∫¢Õß‚√§¢“¥ “√‰Õ‚Õ¥’π¡‘‰¥â ¡’µàÕ‡¥Á°‡æ’¬ß°≈ÿࡇ¥’¬« ·µà¬—ß¡’º≈µàÕª√–™“°√ °≈ÿà¡«—¬Õ◊ËπÊ ¥â«¬ ºŸâ„À≠à∑’ˉ¡à‰¥â√—∫ “√‰Õ‚Õ¥’π Õ¬à“ßæՇ撬߮–Õ‘¥‚√¬ÕàÕπ‡æ≈’¬ßà“¬ ·≈–‡°‘¥ ‚√§§ÕæÕ° ´÷Ëß∑”„À⧫“¡ “¡“√∂„π°“√∑”ß“π ≈¥≈ßµ“¡‰ª¥â«¬ ´÷Ëß®–¡’º≈°√–∑∫µàÕ°“√æ—≤π“ ∑“߇»√…∞°‘®·≈– —ߧ¡¢Õߪ√–‡∑»‚¥¬√«¡‰ª ¥â«¬µ“¡≈”¥—∫ „π°“√·°â ªí ≠ À“°“√¢“¥ “√‰Õ‚Õ¥’ π °√–∑√«ß “∏“√≥ ÿ ¢ °√¡Õπ“¡— ¬ °√–∑√«ß 120 ‡¡…“¬π - ¡‘∂ÿπ“¬π 2555 °√¡Õπ“¡—¬

à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒

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2532 ‰¥â ®— ¥ µ—È ß ‚§√ß°“√§«∫§ÿ ¡ ‚√§¢“¥ “√ ‰Õ‚Õ¥’π·Ààß™“µ‘¢π÷È ‡πâπæ◊πÈ ∑’¿Ë “§‡Àπ◊Õ 14 ®—ßÀ«—¥ µàÕ¡“ ªï æ.». 2539 ®÷ߢ¬“¬°“√¥”‡π‘πß“π®π ‡µÁ¡æ◊Èπ∑’Ë„π 75 ®—ßÀ«—¥(13-14) ‚¥¬°“√ à߇ √‘¡°“√ ∫√‘‚¿§‡°≈◊Õ‡ √‘¡‰Õ‚Õ¥’πÀ√◊Õ‡°≈◊ÕÕπ“¡—¬ °“√ ∫√‘‚¿§πÈ”¥◊Ë¡‡ √‘¡‰Õ‚Õ¥’π„π§√—«‡√◊Õπ ·≈–„π ‚√߇√’¬π °“√∫√‘‚¿§πÈ”ª≈“‡ √‘¡‰Õ‚Õ¥’π ∂÷ß °√–π—Èπªí≠À“°“√¢“¥ “√‰Õ‚Õ¥’π°Á¬—߉¡à≈¥≈ß ‡∑à“∑’˧«√¥—ß®–‡ÀÁπ‰¥â®“°°“√ ”√«®‚√§¢“¥ “√ ‰Õ‚Õ¥’π„π°≈ÿà¡À≠‘ßµ—Èߧ√√¿å „π‡¢µ√—∫º‘¥™Õ∫ ¢Õß»Ÿπ¬åÕπ“¡—¬∑’Ë 1 ∑’˧√Õ∫§≈ÿ¡„π 4 ®—ßÀ«—¥ Õ—π ‰¥â · °à ππ∑∫ÿ √’ ª∑ÿ ¡ ∏“π’ æ√–π§√»√’ Õ ¬ÿ ∏ ¬“ Õà“ß∑Õß ‡¡◊ËÕæ.». 2543-2547 æ∫§«“¡™ÿ°¢Õß °“√¢“¥ “√‰Õ‚Õ¥’π √âÕ¬≈– 52, 30.7, 40.9 ·≈– 29.2 µ“¡≈”¥—∫ ®“°¢âÕ¡Ÿ≈∑’Ë°≈à“«¡“¢â“ßµâπ ª√–°Õ∫°—∫ °√–∑√«ß “∏“√≥ ÿ ¢ ¡’ 𠂬∫“¬„π‡√◊Ë Õ ß°“√ ªÑ Õ ß°— π ‚√§¢“¥ “√‰Õ‚Õ¥’ π ‚¥¬¡’ ¡ “µ√°“√ π—∫ πÿπ°“√„™â‡°≈◊Õ‡ √‘¡‰Õ‚Õ¥’π„π§√—«‡√◊Õπ ·≈– ¡“µ√°“√„ÀâÀ≠‘ßµ—Èߧ√√¿å∑ÿ°§π∑’ËΩ“°§√√¿å„π ∂“π欓∫“≈ “∏“√≥ ÿ¢ ‰¥â√—∫¬“´÷Ëߺ≈‘µ‚¥Õß§å ° “√‡¿ — ™ °√√¡ ‰¥â · °à ¬“‡ √‘ ¡ ‰Õ‚Õ¥’ π (Triferdine) ‚¥¬„Àâ√∫— ª√–∑“π«—π≈– 1 ‡¡Á¥ µ≈Õ¥ °“√µ—Èߧ√√¿å·≈–¢≥–‡≈’Ȭß≈Ÿ°¥â«¬πÈ”π¡¡“√¥“ ¥—ßπ—Èπ ºŸâ«‘®—¬®÷ß π„®∑’Ë®–»÷°…“º≈¢Õß°“√„À⬓ ‡¡Á¥‡ √‘¡‰Õ‚Õ¥’π (Triferdine) „πÀ≠‘ßµ—Èߧ√√¿å ∑’¡Ë “Ω“°§√√¿å ∑’‚Ë √ß欓∫“≈ à߇ √‘¡ ÿ¢¿“æ »Ÿπ¬å Õπ“¡—¬∑’Ë 1 ‡æ◊ËÕ∑’Ë®–‡ªìπ¢âÕ¡Ÿ≈„π°“√ à߇ √‘¡ ÿ¢ ¿“æ·≈–ªÑÕß°—π¿“«–¢“¥ “√‰Õ‚Õ¥’πµàÕ‰ª

º≈¢Õß°“√„À⬓‡¡Á¥‡ √‘¡‰Õ‚Õ¥’π (Triferdine) µàÕ√–¥—∫‰Õ‚Õ¥’π„πªí “«–·≈–§«“¡√à«¡¡◊Õ„π°“√√—∫ª√–∑“π¬“œ

«—µ∂ÿª√– ߧ尓√»÷°…“ 1. ‡æ◊ËÕ»÷°…“√–¥—∫‰Õ‚Õ¥’π„πªí “«–„π À≠‘ßµ—Èߧ√√¿å∑’Ë¡“Ω“°§√√¿å∑’˧≈‘π‘°Ω“°§√√¿å‚√ß æ¬“∫“≈ à߇ √‘¡ ÿ¢¿“æ °àÕπ·≈–À≈—ß√—∫ª√–∑“𠬓«‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π (Triferdine ) 2. ‡æ◊ËÕ»÷°…“§«“¡√à«¡¡◊Õ„π°“√√—∫ª√– ∑“𬓫‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π (Triferdine )

«‘∏’°“√»÷°…“ °“√»÷°…“π’ȇªìπ°“√»÷°…“«‘®—¬·∫∫ cross sectional study °≈ÿ¡à ª√–™“°√∑’®Ë –»÷°…“ ‡ªìπÀ≠‘ßµ—ßÈ §√√¿å Õ“¬ÿ 18- 35 ªï ∑’Ë¡“Ω“°§√√¿å∑’˧≈‘π‘°Ω“°§√√¿å ‚√ß欓∫“≈ à߇ √‘¡ ÿ¢¿“æ »Ÿπ¬åÕπ“¡—¬∑’Ë 1 °√ÿ߇∑æœ ®”π«πª√–¡“≥ 300 §π °“√§”π«≥¢π“¥µ—«Õ¬à“ß Ÿµ√ Sample size (n)=(α1 - α/2)2 (p q) d2 p = ∂“π°“√≥å‚√§¢“¥ “√‰Õ‚Õ¥’πªï 2553 ®“°Õ— µ √“§«“¡™ÿ ° √«¡¢Õß°“√¢“¥ “√ ‰Õ‚Õ¥’π (√–¥—∫‰Õ‚Õ¥’π„πªí “«–πâÕ¬°«à“ 150 ‰¡‚§√°√—¡ / ≈‘µ√) „πÀ≠‘ßµ—Èߧ√√¿å¢Õß 4 ®—ßÀ«—¥ (æ√–π§√»√’Õ¬ÿ∏¬“ Õà“ß∑Õß ππ∑∫ÿ√’ ª∑ÿ¡∏“π’) = 41% À√◊Õ 0.41 q = 1 - p = 0.59 α1 - α/2 = §à“ α score∑’Ë√–¥—∫ 1-α/2 À√◊Õ 95 √–¥—∫§«“¡‡™◊ËÕ¡—Ëπ‡∑à“°—∫ 1.96 d = §à“§«“¡‡§≈◊ËÕπ∑’ˬա√—∫‰¥â 15% ¢Õß p ‡∑à“°—∫ 0.06 ·∑π§à“ = 1.96 x 1.96 x 0.41 x 0.59 0.06 x 0.06 = 258 ‡°Á∫‡æ‘¡Ë ‡µ‘¡ 15% ‡æ◊ÕË ªÑÕß°—π¢âÕ¡Ÿ≈ Ÿ≠À“ª√–¡“≥ 300 √“¬

«‘∏’°“√ ÿࡵ—«Õ¬à“ß °“√‡°Á∫¢âÕ¡Ÿ≈ ·≈–°“√«‘‡§√“–Àå »÷ ° …“À≠‘ ß µ—È ß §√√¿å ∑ÿ ° §π∑’Ë ºà “ π‡°≥±å °“√§—¥‡¢â“ ·≈– ¡—§√„®∑’®Ë –‡¢â“√à«¡‚§√ß°“√ Õ“ “ ¡—§√∑ÿ°√“¬ ®–‰¥â√—∫°“√Õ∏‘∫“¬∂÷ß §«“¡‡ªìπ¡“ ¢Õß‚§√ß°“√ °“√√—∫ª√–∑“𬓠º≈¢â“߇§’¬ß·≈– §«“¡ª≈Õ¥¿— ¬ ·≈–∑ÿ ° √“¬®–‰¥â √— ∫ °“√¢Õ„Àâ ≈ß™◊ËÕ ¡—§√„®¬‘π¬Õ¡‡¢â“√à«¡‚§√ß°“√ §≥–ºŸâ«‘®—®–¢Õ„ÀâÕ“ “ ¡—§√∑ÿ°√“¬™à«¬µÕ∫·∫∫ Õ∫∂“¡ ‡æ◊ËÕÀ“§«“¡ —¡æ—π∏å√–À«à“ßªí®®—¬‡ ’ˬߵà“ßÊ ∑’Ë Õ“®∑”„À⇰‘¥¿“«–¢“¥‰Õ‚Õ¥’π À≈—ß®“°π—Èπ‡¢â“ ¡“√—∫°“√µ√«®√à“ß°“¬ µ√«®ªí “«–‡æ◊ËÕÀ“§à“ ‰Õ‚Õ¥’ π À≈— ß ®“°π—È π ®–‰¥â √— ∫ ¬“«‘ µ “¡‘ π ‡ √‘ ¡ ‰Õ‚Õ¥’π ·≈–®–¡’°“√µ‘¥µ“¡Õ“ “ ¡—§√ µ“¡ √–¬–‡«≈“∑’Ë Ÿµ‘π√’·æ∑¬å𗥉«â ®”π«π 2 §√—Èß §√—Èß ∑’Ë 1 ®–µ‘¥µ“¡„π°“√𗥧√—Èß∂—¥‰ª ‚¥¬ —¡¿“…≥å Õ“ “ ¡—§√ ‡°’ˬ«°—∫°“√√—∫ª√–∑“π¬“ Õ“°“√ ¢â“߇§’¬ß¢Õ߬“ ·≈–§√—Èß∑’Ë 2 ®–µ‘¥µ“¡‡¡◊ËÕÕ“¬ÿ §√√¿åª√–¡“≥ 28-32 —ª¥“Àå ‚¥¬ —¡¿“…≥å Õ“ “ ¡—§√ ·≈–‡°Á∫ªí “«–‡æ◊ËÕµ√«®§à“√–¥—∫ ‰Õ‚Õ¥’π Õ“ “ ¡—§√∑ÿ°√“¬‰¡à‡ ’¬§à“„™â®à“¬„¥Ê ∑—ßÈ ‘πÈ ·≈–¢âÕ¡Ÿ≈∑’‰Ë ¥â®–π”¡“«‘‡§√“–Àå∑“ß ∂‘µ‘ ‚¥‚ª√·°√¡∑“ߧա摫‡µÕ√å Inclusion Criteria ºŸâ∑’Ë®–‡¢â“√à«¡‚§√ß°“√«‘®—¬π’È ®–µâÕß¡’ §ÿ≥ ¡∫—µ‘µàÕ‰ªπ’ȧ√∫∂â«π∑ÿ°¢âÕ - Õ“¬ÿ 18 - 35 ªï ∑’˵—Èߧ√√¿å - ª√– ߧ宖‡¢â“√à«¡‚§√ß°“√ - ≈ß™◊ÕË „π„∫¬‘π¬Õ¡‡¢â“√à«¡‚§√ß°“√«‘®¬— Exclusion Criteria À“°Õ“ “ ¡—§√√“¬„¥¡’§ÿ≥ ¡∫—µ‘µàÕ‰ªπ’È (·¡â·µà‡æ’¬ß¢âÕ‡¥’¬«) „À⧗¥ÕÕ°®“°°“√»÷°…“ ‰¥â∑—π∑’ - ¡’ª√–«—µ„‘ ™â¬“µà“ßÊ ¥—ßµàÕ‰ªπ’È À√◊Õ ‡§¬

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

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∫ ∑ «‘ ∑ ¬ “ ° “ √ „™â¬“™π‘¥µà“ßÊ ¿“¬„π 90 «—π ❍ ¬“√—°…“‚√§‰∑√Õ¬¥å ❍ ¬“ ‡µ’¬√Õ¬¥å - Õ“ “ ¡— § √∑’Ë ‰ ¥â √— ∫ ¬“«‘ µ “¡‘ π ‡ √‘ ¡ ‰Õ‚Õ¥’π ™π‘¥Õ◊ËπÊ ‡™àπ obimin AZ - ¡’ª√–«—µ‘ºà“µ—¥µàÕ¡‰∑√Õ¬¥å - ¡’™’æ®√¡“°°«à“ 110 §√—Èß / π“∑’ - ¡’ ª √–«— µ‘ · ≈– À√◊ Õ º≈‡≈◊ Õ ¥‡ªì π ‚√§ ∏“≈— ´’‡¡’- ‰¡à √à « ¡¡◊ Õ À√◊ Õ ¢“¥°“√µ‘ ¥ µ“¡µ≈Õ¥ ‚§√ß°“√ Discontinuation Criteria - Õ“ “ ¡—§√µâÕß°“√‡≈‘° À√◊ÕÕÕ°®“° °“√»÷°…“ - Õ“ “ ¡—§√ ¡’Õ“°“√„® —Ëπ ¡’™’æ®√ ¡“° °«à“ 110 §√—Èß / π“∑’

º≈°“√»÷°…“ ¢âÕ¡Ÿ≈∑—Ë«‰ª ®”π«πÕ“ “ ¡—§√∑’ˇªìπÀ≠‘ßµ—Èߧ√√¿å„π ß“π«‘®—¬π’È ¡’∑—Èß ‘Èπ 299 §π ‚¥¬¡’Õ“¬ÿ ·≈–√–¥—∫ °“√»÷°…“ ¥—ß· ¥ß„πµ“√“ß∑’Ë 1-2 Õ“¬ÿ§√√¿å‡©≈’¬Ë 9.37 —ª¥“Àå °“√µ√«®§«“¡ ¡∫Ÿ√≥å¢Õß√à“ß°“À≠‘ßµ—ßÈ §√√¿å „™â‡°≥±å«¥— ¥â«¬¥—™π’¡«≈°“¬ (Body Mass Index : BMI) æ∫«à“ à«π„À≠à√Õâ ¬≈– 57.0 Õ¬Ÿ„à π‡°≥±åª°µ‘ ‚¥¬¡’§“à ‡©≈’¬Ë BMI ‡∑à“°—∫ 20.99 ¥—ß· ¥ß„πµ“√“ß∑’Ë 3 ¢â Õ ¡Ÿ ≈ „π‡√◊Ë Õ ß¢Õß°“√√— ∫ ª√–∑“π Õ“À“√∑–‡≈ ·≈–°“√„™â‡°≈◊Õ„π°“√ª√–°Õ∫ Õ“À“√ æ∫«à“ à«π„À≠àÀ≠‘ßµ—Èߧ√√¿å ¡’°“√√—∫ ª√–∑“πÕ“À“√∑–‡≈ ¡’°“√„™â‡°≈◊Õ·≈–‡°≈◊Õ‡ √‘¡ ‰Õ‚Õ¥’π „π°“√ª√–°Õ∫Õ“À“√ §‘¥‡ªìπ√âÕ¬≈– 99.3, 97.0 ·≈– 89.6 ¥—ß· ¥ß„πµ“√“ß∑’Ë 4 -5 122 ‡¡…“¬π - ¡‘∂ÿπ“¬π 2555 °√¡Õπ“¡—¬

à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒

À≠‘ ß µ—È ß §√√¿å à « π„À≠à ‰ ¡à ‡ §¬√— ∫ ª√–∑“𬓠«‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π√âÕ¬≈– 97.0 ®“°¢âÕ¡Ÿ≈√–¥—∫ ‰Õ‚Õ¥’π„πªí “«–¢ÕßÀ≠‘ßµ—Èߧ√√¿å„π§√—Èß·√° ¢Õß°“√Ω“°§√√¿å æ∫«à“ à«π„À≠à√âÕ¬≈– 83.3 ¡’ √–¥—∫‰Õ‚Õ¥’π„πªí “«–Õ¬Ÿà„π‡°≥±å∑’ˉ¡à¢“¥ “√ ‰Õ‚Õ¥’π(≥ 150 ‰¡‚§√°√—¡/≈‘µ√)‚¥¬¡’§à“¡—∏∞“π‡∑à“°—∫ 261.9 ‰¡‚§√°√—¡/≈‘µ√ ‡¡◊ËÕÀ“§«“¡ —¡æ—π∏å¢Õß√–¥—∫‰Õ‚Õ¥’π„πªí “«–°—∫ªí®®—¬µà“ßÊ ∑’Ë¡’º≈°—∫√–¥—∫‰Õ‚Õ¥’𠇙àπ °“√√—∫ª√–∑“π Õ“À“√∑–‡≈ °“√„™â‡°≈◊Õ„π°“√ª√–°Õ∫Õ“À“√ °“√ √—∫ª√–∑“π‡°≈◊ÕÀ√◊Õº≈‘µ¿—≥±å‡ √‘¡‰Õ‚Õ¥’π ‰¡à æ∫«à“¡’§«“¡ —¡æ—π∏å°—πÕ¬à“ß¡’π—¬∑“ß ∂‘µ‘ ¢â Õ ¡Ÿ ≈ „π‡√◊Ë Õ ß°“√√— ∫ ª√–∑“𬓠«‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π „π°“√µ√«®µ‘¥µ“¡Õ“°“√¢ÕßÀ≠‘ßµ—ßÈ §√√¿å §√—Èß∑’Ë 1 (À≈—ß®“°µ√«®§√—Èß·√° 4 —ª¥“Àå) æ∫ «à“ ¡’À≠‘ßµ—ßÈ §√√¿å¡“µ‘¥µ“¡Õ“°“√∑—ßÈ À¡¥ 299 §π ¢âÕ¡Ÿ≈„π‡√◊ËÕߢÕß°“√√—∫ª√–∑“𬓫‘µ“¡‘π‡ √‘¡ ‰Õ‚Õ¥’π æ∫«à“ à«π„À≠àÀ≠‘ßµ—Èߧ√√¿å‰¡à¡’º≈ ¢â“߇§’¬ß®“°°“√√—∫ª√–∑“𬓠§‘¥‡ªìπ√âÕ¬≈– 87.3 ·≈–¡’º≈¢â“߇§’¬ß§‘¥‡ªìπ√âÕ¬≈– 12.7 ‚¥¬„π À≠‘ßµ—Èߧ√√¿å∫“ß√“¬∑’Ë¡’Õ“°“√®–¡’º≈¢â“߇§’¬ß À≈“¬Õ¬à“ß √“¬≈–‡Õ’¬¥¡’¥ß— π’È Õ“°“√√–§“¬‡§◊Õß ®ÿ°‡ ’¬¥∑âÕß ∑âÕßÕ◊¥ Õ“À“√‰¡à¬àÕ¬ √âÕ¬≈– 8.7 Õ“°“√Õ“‡®’¬π √âÕ¬≈– 7.4 ·≈–Õ◊ËπÊ ´÷Ë߉¥â·°à Õ“°“√∑âÕߺŸ° ∂à“¬Õÿ®®“√– ’¥” „® —Ëπ √âÕ¬≈– 5.0 ‚¥¬„π®”π«ππ’È ¡’À≠‘ßµ—ßÈ §√√¿åÀ¬ÿ¥√—∫ª√–∑“𬓠10 §π §‘¥‡ªìπ√âÕ¬≈– 3.3 ¥—ß· ¥ß„πµ“√“ß∑’Ë 9 „π°“√µ√«®µ‘ ¥ µ“¡Õ“°“√¢ÕßÀ≠‘ ß µ—È ß §√√¿å§√—Èß∑’Ë 2 (‡¡◊ËÕÀ≠‘ßµ—Èߧ√√¿å¡’Õ“¬ÿ§√√¿å ª√–¡“≥ 28-32 —ª¥“Àå) æ∫«à“¡’À≠‘ßµ—Èߧ√√¿å ¢“¥°“√µ‘¥µàÕ 135 §π §‘¥‡ªìπ√âÕ¬≈– 45.2 ·≈– ¡’À≠‘ßµ—Èߧ√√¿å¡“µ√«®µ‘¥µ“¡Õ“°“√‡æ’¬ß 164 §π‚¥¬„π®”π«ππ’È ¡’ ° “√À¬ÿ ¥ √— ∫ ª√–∑“π¬“

º≈¢Õß°“√„À⬓‡¡Á¥‡ √‘¡‰Õ‚Õ¥’π (Triferdine) µàÕ√–¥—∫‰Õ‚Õ¥’π„πªí “«–·≈–§«“¡√à«¡¡◊Õ„π°“√√—∫ª√–∑“π¬“œ

«‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π 13 §π§‘¥‡ªìπ√âÕ¬≈– 7.9 À≠‘ß µ—Èߧ√√¿å∑’Ë¡“µ‘¥µ“¡Õ“°“√‡¡◊ËÕÕ“¬ÿ§√√¿å 28-32 —ª¥“Àå æ∫«à“ à«π„À≠ଗߧ߉¡à¡’Õ“°“√¢â“ß ‡§’¬ß®“°°“√√—∫ª√–∑“𬓠§‘¥‡ªìπ√âÕ¬≈– 88.4 ·≈–¡’ º ≈¢â “ ߇§’ ¬ ß√â Õ ¬≈– 11.6 ‚¥¬¡’ Õ “°“√ √–§“¬‡§◊Õß ®ÿ°‡ ’¬¥∑âÕß ∑âÕßÕ◊¥ Õ“À“√‰¡à¬àÕ√âÕ¬≈– 7.9 Õ“°“√Õ“‡®’¬π√âÕ¬≈–2.4 ·≈–Õ◊ËπÊ ´÷Ëß ‰¥â·°àÕ“°“√∑âÕߺŸ° ∂à“¬Õÿ®®“√– ’¥” √âÕ¬≈– 1.8 ¥—ß· ¥ß„πµ“√“ß∑’Ë 9 ·≈–‡¡◊ËÕ‡°Á∫ªí “«–‡æ◊ËÕ µ√«®À“√–¥—∫‰Õ‚Õ¥’π¢ÕßÀ≠‘ßµ—ßÈ §√√¿å„π§√—ßÈ ∑’Ë 2 æ∫«à“ à«π„À≠à √âÕ¬≈– 61.6 ¡’√–¥—∫‰Õ‚Õ¥’π„π

ªí “«–Õ¬Ÿà„π‡°≥±å∑’ˉ¡à¢“¥ “√‰Õ‚Õ¥’π ·µàæ∫ «à“ —¥ à«π·≈–®”π«π¢Õß√–¥—∫‰Õ‚Õ¥’π ∑’Ë¡’§à“µË” °«à“‡°≥±åª°µ‘ ¡’®”π«π∑’Ë Ÿß¢÷Èπ ‚¥¬¡’§à“¡—∏∞“π‡∑à“°—∫ 173.4 ‰¡‚§√°√—¡/≈‘µ√ ‡¡◊ËÕÀ“§«“¡ — ¡ æ— π ∏å √ –À«à “ ß°“√√— ∫ ª√–∑“π ·≈–À¬ÿ ¥ √— ∫ ª√–∑“𬓫‘ µ “¡‘ π ‡ √‘ ¡ ‰Õ‚Õ¥’ π °— ∫ √–¥— ∫ ‰Õ‚Õ¥’ π „πªí “«–§√—È ß ∑’Ë 2 ‰¡à æ ∫«à “ ¡’ § «“¡ —¡æ—π∏å°—πÕ¬à“ß¡’π—¬∑“ß ∂‘µ‘

«‘®“√≥å °“√»÷°…“º≈¢Õß°“√„À⬓‡¡Á¥‡ √‘¡‰Õ‚Õ¥’π (Triferdine) µàÕ√–¥—∫‰Õ‚Õ¥’π„πªí “«–·≈– §«“¡√à«¡¡◊Õ„π°“√√—∫ª√–∑“π¬“¢ÕßÀ≠‘ßµ—ßÈ §√√¿å ¡’°“√«‘‡§√“–Àå¢Õâ ¡Ÿ≈µà“ßÊ ‰¥â·°à ¢âÕ¡Ÿ≈∑—«Ë ‰ª ¢âÕ¡Ÿ≈ „π‡√◊ËÕߢÕß°“√√—∫ª√–∑“πÕ“À“√∑–‡≈ ·≈–°“√ „™â‡°≈◊Õ„π°“√ª√–°Õ∫Õ“À“√ ¢âÕ¡Ÿ≈„π‡√◊ËÕß°“√ √—∫ª√–∑“𬓫‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π ¢âÕ¡Ÿ≈√–¥—∫ ‰Õ‚Õ¥’ π „πªí “«– °à Õ π·≈–À≈— ß °“√„Àâ ¬ “

µ“√“ß∑’Ë 1 · ¥ß ™à«ßÕ“¬ÿ¢Õß°≈ÿࡵ—«Õ¬à“ß ™à«ßÕ“¬ÿ

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√âÕ¬≈–

16-20 21-25 26-30 31-35 º≈√«¡

30 89 102 78 299

10.0 29.8 34.1 26.1 100.0

µ“√“ß∑’Ë 2 · ¥ß √–¥—∫°“√»÷°…“¢Õß°≈ÿࡵ—«Õ¬à“ß √–¥—∫°“√»÷°…“

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µË”°«à“À√◊Õ‡∑à“°—∫ª√–∂¡»÷°…“ µË”°«à“À√◊Õ‡∑à“°—∫¡—∏¬¡»÷°…“ ª«™.ª« . Õπÿª√‘≠≠“µ√’ ª√‘≠≠“µ√’ ª√‘≠≠“‚∑ ‰¡à‰¥â‡√’¬π º≈√«¡

16 151 33 81 1 4 286 *

5.6 52.8 11.5 28.3 .3 1.4 100.0

* À¡“¬‡Àµÿ: ¢âÕ¡Ÿ≈‰¡à§√∫®“°·∫∫ —¡¿“…≥å

«‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’𠧫“¡ —¡æ—π∏å√–À«à“ß√–¥—∫ ‰Õ‚Õ¥’π„πªí “«– ·≈–ªí®®—¬∑’ˇ°’ˬ«¢âÕß °≈ÿࡵ—«Õ¬à“߇ªìπÀ≠‘ßµ—Èߧ√√¿å ¡’Õ“¬ÿÕ¬Ÿà „π™à«ß 18-35 ªï ‚¥¬ à«π„À≠à¢Õß°≈ÿࡵ—«Õ¬à“ß ®–¡’Õ“¬ÿ„π™à«ß 21-30 ªï ´÷Ëß™à«ßÕ“¬ÿ¥—ß°≈à“«

‡ªìπ™à«ßÕ“¬ÿ∑’ËÕ¬Ÿà„π«—¬‡®√‘≠æ—π∏ÿå °≈ÿࡵ—«Õ¬à“ß à«π„À≠à ¡’§“à ¥—™π’¡«≈°“¬ Õ¬Ÿ„à π™à«ß 18.5 - 22.9 °‘‚≈°√—¡/‡¡µ√2 ´÷Ë߇ªìπ§à“∑’ËÕ¬Ÿà„π™à«ßπÈ”Àπ—°µ—« ª°µ‘ §ß‡ªìπ‡æ√“–Õ“¬ÿ§√√¿å¬—߉¡à¡“° ª√–°Õ∫ °—∫„π™à«ß 2-3 ‡¥◊Õπ·√°¬—ß√—∫ª√–∑“πÕ“À“√‰¡à

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∫ ∑ «‘ ∑ ¬ “ ° “ √ µ“√“ß∑’Ë 3 · ¥ß ¥—™π’¡«≈°“¬ ¢Õß°≈ÿࡵ—«Õ¬à“ß ¥—™π’¡«≈°“¬

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<18.5 18.5 - 22.9 23.0 - 24.9 25.0 - 29.9 ≥ 30.0 º≈√«¡ §à“‡©≈’ˬ

64 170 28 32 4 298 * 20.99

21.5 57.0 9.4 10.7 1.3 100.0

9.97 9.10 9.40 9.39 9 9.37

* À¡“¬‡Àµÿ: ¢âÕ¡Ÿ≈‰¡à§√∫®“°·∫∫ —¡¿“…≥å

µ“√“ß∑’Ë 4 · ¥ß√âÕ¬≈–¢ÕßÀ≠‘ßµ—Èߧ√√¿å ∑’Ë√—∫ª√–∑“πÕ“À“√∑–‡≈ ·≈–„™â‡°≈◊Õª√–°Õ∫Õ“À“√ √—∫ª√–∑“πÕ“À“√∑–‡≈

®”π«π

√âÕ¬≈–

‰¡à√∫— ª√–∑“π √—∫ª√–∑“π º≈√«¡ „™â‡°≈◊Õª√–°Õ∫Õ“À“√ ‰¡à‰¥â√—∫ª√–∑“𠉥â√—∫ª√–∑“π º≈√«¡

2 297 299

0.7 99.3 100.0

9 290 299

3.0 97.0 100.0

µ“√“ß∑’Ë 5 · ¥ß√âÕ¬≈–¢ÕßÀ≠‘ßµ—Èߧ√√¿å ∑’Ë√Ÿâ®—°‡°≈◊Õ‡ √‘¡‰Õ‚Õ¥’π·≈–√—∫ª√–∑“π‡°≈◊Õ‡ √‘¡ ‰Õ‚Õ¥’π À√◊Õº≈‘µ¿—≥±å∑’ˇ √‘¡‰Õ‚Õ¥’π √Ÿâ®—°‡°≈◊Õ‡ √‘¡‰Õ‚Õ¥’π

®”π«π

√âÕ¬≈–

‰¡à√Ÿâ®—° √Ÿ®â °— º≈√«¡ √—∫ª√–∑“π‡°≈◊Õ‡ √‘¡‰Õ‚Õ¥’πÀ√◊Õ º≈‘µ¿—≥±å∑‡’Ë √‘¡‰Õ‚Õ¥’π ‰¡à√∫— ª√–∑“π √—∫ª√–∑“π º≈√«¡

31 268 299

10.4 89.6 100.0

31 268 299

10.4 89.6 100.0

§àÕ¬‰¥â‡π◊ËÕß®“°¡’Õ“°“√·æâ∑âÕß ‡«’¬π»’√…– ®“° ¢âÕ¡Ÿ≈„π‡√◊ËÕ߇°≈◊Õ‡ √‘¡‰Õ‚Õ¥’π °“√√—∫ª√–∑“π ‡°≈◊Õ‡ √‘¡‰Õ‚Õ¥’π À√◊Õ º≈‘µ¿—≥±å∑’ˇ √‘¡‰Õ‚Õ¥’π æ∫«à“ À≠‘ßµ—Èߧ√√¿å à«π„À≠à¡’°“√„™â‡°≈◊Õ·≈– º≈‘µ¿—≥±å¥—ß°≈à“« Õ“®‡ªìπ‡æ√“–„πªí®®ÿ∫—π¡’ 124 ‡¡…“¬π - ¡‘∂ÿπ“¬π 2555 °√¡Õπ“¡—¬

à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒

°“√√≥√ß§å ® “°∑“ß¿“§√— ∞ ·≈–°√–∑√«ß “∏“√≥ ÿ¢¡“°¢÷Èπ ¡’°“√ÕÕ°ª√–°“»°√–∑√«ß „π‡√◊ËÕß°“√∫—ߧ—∫„Àâ¡’°“√‡ √‘¡‰Õ‚Õ¥’π„π πÈ”ª≈“ ‡°≈◊Õ·≈–º≈‘µ¿—≥±å∑’Ë„™â„π°“√∫√‘‚¿§ „π à«π ¢âÕ¡Ÿ≈√–¥—∫‰Õ‚Õ¥’π„π°≈ÿࡵ—«Õ¬à“ß æ∫«à“ √–¥—∫

º≈¢Õß°“√„À⬓‡¡Á¥‡ √‘¡‰Õ‚Õ¥’π (Triferdine) µàÕ√–¥—∫‰Õ‚Õ¥’π„πªí “«–·≈–§«“¡√à«¡¡◊Õ„π°“√√—∫ª√–∑“π¬“œ

µ“√“ß∑’Ë 6 · ¥ ß √â Õ ¬ ≈ – ¢ Õ ß ° “ √ √— ∫ ª√–∑“𬓠«‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π ®”π«π

√âÕ¬≈–

290 9 299

97.0 3.0 100.0

‰¡à√∫— ª√–∑“π √—∫ª√–∑“π º≈√«¡

µ“√“ß∑’Ë 7 · ¥ß√–¥—∫‰Õ‚Õ¥’π„πªí “«– ¢ÕßÀ≠‘ßµ—Èߧ√√¿å „π§√—Èß·√° ¢Õß°“√Ω“°§√√¿å <50 50 - 99 100 - 149 ≥150 º≈√«¡ §à“¡—∏¬∞“π 261.9 §à“µË” ÿ¥ 14.90 §à“ Ÿß ÿ¥ 1221.60

®”π«π

√âÕ¬≈–

3 19 28 249 299

1.0 6.4 9.4 83.3 100.0

‰Õ‚Õ¥’π„πªí “«–∑’ˇ°Á∫°àÕπ°“√√—∫ª√–∑“𬓠‡¡Á¥‡ √‘¡‰Õ‚Õ¥’π ¢Õß°≈ÿ¡à µ—«Õ¬à“ß à«π„À≠à (√âÕ≈– 83.3) ¡’§“à ¡“°°«à“À√◊Õ‡∑à“°—∫ 150 ‰¡‚§√°√—¡/ ≈‘µ√ ‚¥¬¡’§à“¡—∏¬∞“π ‡∑à“°—∫ 261.9 ‰¡‚§√°√—¡/ ≈‘µ√ ·µà‡¡◊ËÕÀ“§«“¡ —¡æ—π∏å¢Õß√–¥—∫‰Õ‚Õ¥’π„π ªí “«–°—∫ª√–«—µ°‘ “√√—∫ª√–∑“πÕ“À“√∑–‡≈ °“√ „™â‡°≈◊Õ·≈–º≈‘µ¿—≥±å‡ √‘¡‰Õ‚Õ¥’π °≈—∫‰¡àæ∫ «à“¡’§«“¡ —¡æ—π∏å°—πÕ¬à“ß¡’π—¬∑“ß ∂‘µ‘ Õ“® ‡π◊ËÕß¡“®“°‡°≈◊Õ·≈–º≈‘µ¿—≥±å‡ √‘¡‰Õ‚Õ¥’π‰¡à¡’ §ÿ ≥ ¿“æ ‡ ◊Ë Õ ¡§ÿ ≥ ¿“æ À√◊ Õ Õ“®¡’ ª √‘ ¡ “≥ ‰Õ‚Õ¥’π‰¡à‡æ’¬ßæÕ14-15 √«¡∑—Èß„πß“π«‘®—¬π’ȺŸâ «‘ ®— ¬ ‰¡à ‰ ¥â ¡’ ° “√‡°Á ∫ ¢â Õ ¡Ÿ ≈ „π‡√◊Ë Õ ß§«“¡∂’Ë · ≈– ª√‘¡“≥¢Õß°“√√—∫ª√–∑“πÕ“À“√¥—ß°≈à“« ´÷Ëß Õ“®‡ªìπª√–‡¥Áπ∑’˵âÕߧ”π÷ß∂÷ß„π°“√∑”«‘®—¬„π §√—ÈßµàÕ‰ª ‡¡◊ËÕ‡°Á∫¢âÕ¡Ÿ≈„π‡√◊ËÕߺ≈¢â“߇§’¬ß¢Õß °“√√—∫ª√–∑“𬓫‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π„π§√—Èß∑’Ë 1 ·≈– 2 æ∫«à“ à«π„À≠à‰¡à¡º’ ≈¢â“߇§’¬ß §‘¥‡ªìπ 87.3

µ“√“ß∑’Ë 8 · ¥ß §«“¡ —¡æ—π∏å¢Õß√–¥—∫‰Õ‚Õ¥’π„πªí “«– °—∫°“√√—∫ª√–∑“πÕ“À“√∑–‡≈ °“√ „™â‡°≈◊Õ„π°“√ª√–°Õ∫Õ“À“√ ·≈–°“√√—∫ª√–∑“π‡°≈◊Õ‡ √‘¡‰Õ‚Õ¥’π À√◊Õ º≈‘µ¿—≥±å ∑’ˇ √‘¡‰Õ‚Õ¥’π ª√–«—µ‘°“√√—∫ª√–∑“πÕ“À“√∑–‡≈ ‰¡à√—∫ª√–∑“π √—∫ª√–∑“π º≈√«¡ P value= 1.00 ª√–«—µ‘°“√√—∫ª√–∑“π‡°≈◊ÕÀ√◊Õ„™â‡°≈◊Õ„π °“√ª√–°Õ∫Õ“À“√À√◊Õ‰¡à ‰¡à√—∫ª√–∑“π √—∫ª√–∑“π º≈√«¡ P value =0.065 ª√–«—µ‘°“√√—∫ª√–∑“π‡°≈◊Õ‡ √‘¡‰Õ‚Õ¥’π À√◊Õ º≈‘µ¿—≥±å∑’ˇ √‘¡‰Õ‚Õ¥’π ‰¡à√—∫ª√–∑“π √—∫ª√–∑“π º≈√«¡ P value = 0.516

º≈°“√µ√«®À“‰Õ‚Õ¥’π„πªí “«– §√—Èß∑’Ë 1 <50 50 - 99 100 - 149 >150 0 0 0 2 3 19 28 247 3 19 28 249

º≈√«¡ 2 297 299

1 2 3

0 19 19

0 28 28

8 241 249

9 290 299

0 3 3

3 16 19

1 27 28

27 222 249

31 268 299

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

April - June 2012

125

∫ ∑ «‘ ∑ ¬ “ ° “ √ µ“√“ß∑’Ë 9 · ¥ß®”π«π·≈–√âÕ¬≈–¢ÕßÀ≠‘ßµ—Èߧ√√¿å∑’Ë¡’º≈¢â“߇§’¬ß®“°°“√√—∫ª√–∑“𬓠«‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π „π°“√µ√«®µ‘¥µ“¡§√—Èß∑’Ë 1 ·≈–§√—Èß∑’Ë 2 §√—Èß∑’Ë 1 º≈¢â“߇§’¬ß ‰¡à¡’‡≈¡’ º≈√«¡ √–§“¬‡§◊Õß ®ÿ°‡ ’¬¥∑âÕß ∑âÕßÕ◊¥∑âÕ߇øÑÕ Õ“À“√‰¡à¬àÕÕ“‡®’¬π Õ◊ËπÊ À¬ÿ¥∑“π¬“

®”π«π

√âÕ¬≈–

®”π«π

√âÕ¬≈–

261 38 299 26

87.3 12.7 100.0 8.7

145 19 164 13

88.4 11.6 100.0 7.9

22 15 10

7.4 5.0 3.3

4 3 13

2.4 1.8 7.9

µ“√“ß∑’Ë 10 · ¥ß√–¥—∫‰Õ‚Õ¥’π¢ÕßÀ≠‘ßµ—Èß §√√¿å§√—Èß∑’Ë 2 <50 50 - 99 100 - 149 ≥150 º≈√«¡ §à“¡—∏¬∞“π 173.4 §à“µË” ÿ¥ 14.60 §à“ Ÿß ÿ¥1021.40

®”π«π

√âÕ¬≈–

12 25 26 101 164

7.3 15.2 15.9 61.6 100.0

·≈– 88.4 µ“¡≈”¥—∫ ·≈–æ∫«à“°≈ÿࡵ—«Õ¬à“ß¡’º≈ ¢â“߇§’¬ß‡ªìπ à«ππâÕ¬ ‡™àπ Õ“°“√√–§“¬‡§◊Õß ®ÿ° ‡ ’¬¥∑âÕß ∑âÕßÕ◊¥ ∑âÕ߇øÑÕ ∑âÕߺŸ° ∂à“¬Õÿ®®“√– ’¥” Õ“À“√‰¡à¬àÕ¬ ´÷ËßÕ“®®–‡ªìπº≈®“°¬“∏“µÿ ‡À≈Á ° ∫”√ÿ ß ‡≈◊ Õ ¥∑’Ë ‡ ªì π à « πª√–°Õ∫„π‡¡Á ¥ ¬“ «‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π‚¥¬æ∫„π°“√µ‘¥µ“¡‡°Á∫ ¢âÕ¡Ÿ≈ §√—Èß∑’Ë 1 §◊ÕÕ“¬ÿ§√√¿å 12-16 —ª¥“Àå ·≈– §√—Èß∑’Ë 2 §◊Õ 28-32 —ª¥“Àå „π —¥ à«π·≈– ®”π«π∑’ËæÕÊ °—π ”À√—∫Õ“°“√Õ“‡®’¬π æ∫«à“ „π°“√µ‘¥µ“¡§√—Èß∑’Ë 1 æ∫«à“ ¡’¡“°°«à“„π§√—Èß∑’Ë 2 πà“®–‡ªìπº≈¡“®“°¡’Õ“°“√·æâ∑âÕß√à«¡¥â«¬„π ™à«ß∑’ËÕ“¬ÿ§√√¿å¬—߉¡à¡“° 126 ‡¡…“¬π - ¡‘∂ÿπ“¬π 2555 °√¡Õπ“¡—¬

§√—Èß∑’Ë 2

à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒

„π°“√µ‘¥µ“¡‡°Á∫¢âÕ¡Ÿ≈§√—Èß∑’Ë 2 §◊Õ‡¡◊ËÕ Õ“¬ÿ§√√¿å 28-32 —ª¥“Àå æ∫«à“°≈ÿࡵ—«Õ¬à“ß¡“ µ‘¥µ“¡Õ“°“√‡æ’¬ß 164 √“¬ ®“°„π§√—ßÈ ·√° 299 √“¬ §‘¥‡ªìπ√âÕ¬≈– 54.85 ®“°°“√µ‘¥µ“¡ Õ∫ ∂“¡∑“ß‚∑√»—æ∑åæ∫«à“ à«π„À≠à°≈—∫‰ªΩ“° §√√¿å·≈–§≈Õ¥∑’Ë¿Ÿ¡‘≈”‡π“‡¥‘¡„πµà“ß®—ßÀ«—¥ ´÷Ëß ∑”„Àâ¢Õâ ¡Ÿ≈∑’‰Ë ¥â®“°°“√‡°Á∫µ—«Õ¬à“ß„π§√—ßÈ ∑’Ë 2 ¥—ß °≈à“«Õ“®‡ªìπµ—«·∑π°≈ÿࡪ√–™“°√∑—ÈßÀ¡¥‰¥â‰¡à ¥’π—°·µà “¡“√∂𔉪‡ªìπ¢âÕ¡Ÿ≈‡æ◊ËÕ°“√æ—≤π“µàÕ ‰ª‰¥â ·≈–®“°°“√‡°Á∫ªí “«–‡æ◊ËÕµ√«®√–¥—∫ ‰Õ‚Õ¥’π§√—ßÈ ∑’Ë 2 „π°≈ÿ¡à µ—«Õ¬à“ß∑’¡Ë “µ‘¥µ“¡Õ“°“√ 164 √“¬ æ∫«à“ à«π„À≠à (√âÕ¬≈– 61.6) ¡’§à“ ¡“°°«à“À√◊Õ‡∑à“°—∫ 150 ‰¡‚§√°√—¡/≈‘µ√ ‚¥¬¡’ §à“¡—∏¬∞“π‡∑à“°—∫ 173.4 ‰¡‚§√°√—¡/≈‘µ√ ·µà ‡¡◊ËÕπ”¢âÕ¡Ÿ≈√–¥—∫‰Õ‚Õ¥’π„πªí “«– °àÕπ·≈– À≈—ß√—∫ª√–∑“𬓫‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π¡“‡ª√’¬∫ ‡∑’¬∫ æ∫«à“ √–¥—∫‰Õ‚Õ¥’π„πªí “«–‡©≈’ˬ°àÕπ √—∫ª√–∑“𬓠¡’§à“ Ÿß°«à“ ·≈–¡’ —¥ à«π¢Õߧà“∑’Ë ª°µ‘ (¡“°°«à“À√◊Õ‡∑à“°—∫ 150 ‰¡‚§√°√—¡/≈‘µ√) ¡“°°«à“√–¥—∫‰Õ‚Õ¥’πÀ≈—ß√—∫ª√–∑“π¬“ Õ“® ‡ªì π ‡æ√“–À≠‘ ß µ—È ß §√√¿å ‡ ¢â “ „®«à “ ‡¡◊Ë Õ ‰¥â √— ∫ ª√– ∑“𬓫‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π·≈â« √à“ß°“¬®–‰¥â√—∫

º≈¢Õß°“√„À⬓‡¡Á¥‡ √‘¡‰Õ‚Õ¥’π (Triferdine) µàÕ√–¥—∫‰Õ‚Õ¥’π„πªí “«–·≈–§«“¡√à«¡¡◊Õ„π°“√√—∫ª√–∑“π¬“œ

µ“√“ß∑’Ë 11 · ¥ß§«“¡ —¡æ—π∏å¢Õß°“√√—∫ª√–∑“π ·≈–À¬ÿ¥√—∫ª√–∑“𬓫‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π °—∫√–¥—∫‰Õ‚Õ¥’π „πªí “«–§√—Èß∑’Ë 2 ¬—ߧß√—∫ª√–∑“𬓇 √‘¡‰Õ‚Õ¥’πÕ¬Ÿà Õ’°À√◊Õ‰¡à ‰¡à√∫— ª√–∑“π √—∫ª√–∑“π º≈√«¡ P value = 0.223

º≈°“√µ√«®À“‰Õ‚Õ¥’π„πªí “«– §√—Èß∑’Ë 1 <50 50 - 99 100 - 149 ≥150 3 2 2 7 9 23 24 94 12 25 26 101

“√‰Õ‚Õ¥’π‡æ’¬ßæÕ ‰¡à®”‡ªìπµâÕß√—∫ª√–∑“π ‡°≈◊Õ‰Õ‚Õ¥’π À√◊ÕÕ“À“√∑–‡≈‡ √‘¡‡¢â“‰ªÕ’°·≈– Õ“®®–‡ªìπ®“°§«“¡°—ß«≈„π‡√◊ËÕߢÕß°“√¡’ “√ ‰Õ‚Õ¥’π‡°‘π„π√à“ß°“¬ ´÷ËßÕ“®‡ªìπª√–‡¥Áπ∑’˵âÕß §”π÷ß∂÷߇¡◊ËÕ„Àâ°“√¥Ÿ·≈ ÿ¢¿“æÀ≠‘ßµ—Èߧ√√¿å ·≈– ‡¡◊ËÕ¡’°“√»÷°…“«‘®—¬µàÕ‰ª

√ÿªº≈°“√»÷°…“ À≠‘ßµ—Èߧ√√¿å à«π„À≠à ¡’√–¥—∫‰Õ‚Õ¥’π„π ªí “«–∑—È ß °à Õ π·≈–À≈— ß √— ∫ ª√–∑“𬓫‘ µ “¡‘ π ‡ √‘¡‰Õ‚Õ¥’π Õ¬Ÿà„π‡°≥±å∑’ˉ¡à¢“¥ “√‰Õ‚Õ¥’π

¢âÕ‡ πÕ·π– 1. §«√¡’°“√„À⧫“¡√Ÿâ‡°’ˬ«°—∫°“√¥Ÿ·≈ ÿ¢¿“æ °“√√—∫ª√–∑“πÕ“À“√∑’Ë¡’ª√–‚¬™πå √«¡ ∂÷ß Õ“À“√·≈–º≈‘µ¿—≥±å∑’Ë¡’·√à∏“µÿ‰Õ‚Õ¥’π Õ¬à“ß ‡æ’¬ßæÕ°—∫À≠‘ßµ—Èߧ√√¿å 2. §«√¡’°“√„À⧫“¡√Ÿâ„π‡√◊ËÕߪ√–‚¬™πå ¢Õß°“√√—∫ª√–∑“𬓇¡Á¥«‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π„π À≠‘ßµ—Èߧ√√¿å 3. §«√¡’°“√√≥√ߧå„π‡√◊ËÕߪ√–‚¬™πå¢Õß °“√„Àâ À ≠‘ ß µ—È ß §√√¿å √— ∫ ª√–∑“𬓇¡Á ¥ «‘ µ “¡‘ π ‡ √‘ ¡ ‰Õ‚Õ¥’ π „π∫ÿ § ≈“°√∑“ß°“√·æ∑¬å · ≈– “∏“√≥ ÿ¢ 4. º≈®“°°“√‡°Á ∫ ¢â Õ ¡Ÿ ≈ „π‡√◊Ë Õ ßº≈¢â “ ß ‡§’ ¬ ߢÕ߬“‡¡Á ¥ ‡ √‘ ¡ ‰Õ‚Õ¥’ π „π‡√◊Ë Õ ßÕ“°“√

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√–§“¬‡§◊Õß ®ÿ°‡ ’¬¥ ∑âÕßÕ◊¥ ∑âÕߺŸ° ´÷ËßÕ“®‡ªìπ º≈®“°¬“∏“µÿ ‡ À≈Á ° ∫”√ÿ ß ‡≈◊ Õ ¥ ´÷Ë ß ‡ªì π à « π ª√–°Õ∫¢Õ߬“‡¡Á¥«‘µ“¡‘π‡ √‘¡‰Õ‚Õ¥’π πà“®–¡’ °“√ª√—∫ Ÿµ√¬“ ‚¥¬·¬°¬“∏“µÿ‡À≈Á°∫”√ÿ߇≈◊Õ¥ ÕÕ°¡“®“°¬“‡¡Á¥‡ √‘¡‰Õ‚Õ¥’π 5. °“√µ√«®‰Õ‚Õ¥’ π „πªí “«–‡æ◊Ë Õ ª√–‡¡‘ π ‡√◊Ë Õ ß¿“«–¢“¥ “√‰Õ‚Õ¥’ π π—È π ∂◊ Õ «à “ ‡ªìπ°“√„™âµ—«™’È«—¥ ”À√—∫°≈ÿࡪ√–™“°√ ‰¡à§«√ π”¡“„™â„π°“√«‘π‘®©—¬√“¬∫ÿ§§≈

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THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

April - June 2012

127

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‡Õ° “√Õâ“ßÕ‘ß 1. World Health Organization. Review of iodine deficiency disorders in the South-East Asia Region : information document for the fifty-seventh session of the Regional Committee for South East Asia.;2004 Available online at http://searo.who.int.

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5. Gabriella Morreale de Escobar, Mar__a Jesu_s Obrego_n, Francisco Escobar del Rey. Iodine deficiency and brain development in the first half of pregnancy . Public Health Nutrition;10(12A):1554-70.

6. Zimmermann M. Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: a review. The American Journal of Clinical Nutrition 2009 ; 89 : 668672.

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