儿童营养性缺铁性贫血的危险因素分析

雷庆龄; 戴碧涛; 宪莹; 于洁

doi:10.7499/j.issn.1008-8830.2014.01.004

PDF(1242 KB)

中国当代儿科杂志 ›› 2014, Vol. 16 ›› Issue (1) : 16-19. DOI: 10.7499/j.issn.1008-8830.2014.01.004

论著·临床研究

儿童营养性缺铁性贫血的危险因素分析

雷庆龄, 戴碧涛, 宪莹, 于洁

作者信息 +

Risk factors for nutritional iron deficiency anemia in children

LEI Qing-Ling, DAI Bi-Tao, XIAN Ying, YU Jie

Author information +

文章历史 +

摘要

目的探讨营养性缺铁性贫血（IDA）的临床特点，分析影响贫血及其程度的危险因素，为预防和临床诊治提供参考依据。方法回顾性分析372例IDA患儿临床资料，调查其发病及贫血程度的影响因素。结果 372例患儿中，男女比例为2.72：1；6月龄至2岁患儿占79.9%；早产儿占30.7%；出生体重< 2.5 kg者占22.9%，≥2.5 kg者占77.1%；自然分娩者占36.0%，剖宫产64.0%；未适时添加辅食者占79.3%；既往患过下呼吸道或反复上呼吸道感染、腹泻、有外伤、手术史者占46.2%。单因素分析显示年龄、出生体重、孕周、是否适时添加辅食、既往有上述病史与贫血严重程度有关。多因素分析显示，出生体重、既往有上述病史者是贫血严重程度的主要危险因素。结论 IDA高发于6月龄至2岁儿童；喂养不当仍是导致缺铁性贫血的主要原因之一；贫血严重程度主要与出生体重、既往有下呼吸道或反复上呼吸道感染、腹泻、外伤、手术史密切相关。

Abstract

Objective To investigate the clinical features of nutritional iron deficiency anemia (IDA) and analyze the risk factors for the severity of anemia, and to provide a basis for the prevention and clinical diagnosis and treatment of this disease. Methods A retrospective analysis was performed on the clinical data of 372 children with IDA to investigate the risk factors for the severity of IDA. Results Of 372 cases, the male-to-female ratio of these patients was 2.72:1. Of all cases, 79.9% were aged 6 months to 2 years, and 30.7% were premature infants; 22.9% had a birth weight of < 2.5 kg, and 77.1% had a birth weight of ≥2.5 kg; 36.0% were delivered by natural birth, and 64.0% were delivered by caesarean section; 79.3% were not given solid foods in time; 46.2% had a history of lower respiratory tract infection/recurrent upper respiratory tract infection, diarrhea, trauma, or surgery. The univariate analysis showed that age, birth weight, gestational age, timely introduction of solid foods, and a history of lower respiratory tract infection/recurrent upper respiratory tract infection, diarrhea, trauma, or surgery were associated with the severity of anemia. The multivariate analysis showed that birth weight and the mentioned medical history were associated with the severity of anemia. Conclusions Nutritional IDA is common in children aged 6 months to 2 years. Nowadays, improper feeding pattern is still one of the main causes of IDA. Birth weight and a history of lower respiratory tract infection/recurrent upper respiratory tract infection, diarrhea, trauma, or surgery are closely associated with the severity of anemia.

导出引用

雷庆龄, 戴碧涛, 宪莹, 于洁. 儿童营养性缺铁性贫血的危险因素分析[J]. 中国当代儿科杂志. 2014, 16(1): 16-19 https://doi.org/10.7499/j.issn.1008-8830.2014.01.004

LEI Qing-Ling, DAI Bi-Tao, XIAN Ying, YU Jie. Risk factors for nutritional iron deficiency anemia in children[J]. Chinese Journal of Contemporary Pediatrics. 2014, 16(1): 16-19 https://doi.org/10.7499/j.issn.1008-8830.2014.01.004

参考文献

[1] 中国儿童铁缺乏症流行病学调查协作组. 中国7个月至7岁儿童铁缺乏症流行病学的调查研究[J]. 中华儿科杂志, 2004, 42(12): 886-891.
[2] 胡瑞梅, 魏美文, 张岩, 等. 铁缺乏对大鼠学习记忆能力的影响[J]. 中国当代儿科杂志, 2001, 3(6): 643-645.
[3] 胡亚美, 江载芳. 实用儿科学[M]. 第7版. 北京:人民卫生出版社, 2002: 1714-1717.
[4] 卫生部. 中国0-6岁儿童营养发展报告(2012)[R]. 北京:中华人民共和国卫生部, 2012.
[5] 巴蕾. 北京市朝阳区5岁以下流动儿童贫血及相关因素调查[J]. 中国儿童保健杂志, 2011, 19(4): 357-359.
[6] 李红星, 洪美花. 1个月~5岁儿童贫血调查分析[J]. 中国妇幼保健, 2010, 25(26): 3783-3785.
[7] WHO/UNICEF/UNU. Iron deficiency aneamia: assessment, prevention, and control. A guide for programme managers[S]. Geneva: World Health Organization, 2001.
[8] Meinzen-Derr JK, Grerrero ML, Altaye M, et al. Risk of infant anemia is associated with exclusive breast-feeding and maternal anemia in a mexican cohort[J]. J Nutr, 2006, 136(2): 452-458.
[9] Monterrosa EC, Frongillo EA, Vasquez-Garibay EM, et al. Predominant breast-feeding from birth to six months is associated with fewer gastrointestinal infections and increased risk for Iron deficiency among Infants[J]. J Nutr, 2008, 138(8): 1499-1504.
[10] 张义琼, 朱易萍, 周晨燕, 等. 儿童缺铁性贫血发病和贫血程度的危险因素分析[J].四川大学学报(医学版), 2010, 41(1): 174.
[11] 孙静, 霍军生, 王波, 等. 应用铁强化酱油控制贫血效果观察[J]. 卫生研究, 2008, 37(3): 333-334.
[12] 王丽娟, 霍军生, 孙静, 等. 营养包对汶川地震后四川省理县6~23月龄婴幼儿干预效果研究[J]. 卫生研究, 2011, 40(1): 61-64.
[13] Ekiz C, Agaoglu L, Karakas Z, et al. The effect of iron deficiency anemia on the function of the immune system[J]. Hematol J, 2005, 5(7): 579-583.
[14] Bhaskaram P. Micronutrient malnutrition, infection, and immunity: an overview [J]. Nutr Rev, 2002, 60(5): S40-S45.
[15] Han O. Molecular mechanism of intestinal iron absorption[J]. Metallomics, 2011, 3(2): 103-109.
[16] Foot NJ, Dalton HE, Shearwin-Whyatt LM, et al. Regulation of the divalent metal ion transporter DMT1 and iron homeostasis by a ubiquitin-dependent mechanism involving Ndfips and WWP2[J]. Blood, 2008, 112(10): 4268-4275.
[17] 唐京京, 张翠梅, 付四毛, 等. 中山市城区幼儿缺铁性贫血现况调查及相关因素研究[J].中国儿童保健杂志, 2013, 20(5): 449-451.
[18] 常素英, 何武, 贾凤梅, 等.中国儿童营养状况15年变化分析—5岁以下儿童贫血状况[J] . 卫生研究, 2007, 36(2): 210-212.
[19] 郑建梅, 杨道科. 婴、幼儿营养性缺铁性贫血249例相关因素分析[J]. 中华妇幼临床医学杂志, 2009, 5(3): 60-63.