兰州市及东乡县6～12岁儿童铁缺乏症现况及缺铁性贫血相关因素分析
发布时间：2018-10-15 08:07
【摘要】：目的:通过测定相关血清学指标了解兰州市及东乡县6~12岁学龄期儿童铁缺乏症(Iron Deficiency,ID)现况,对诊断为缺铁性贫血(Iron Deficiency Anemia,IDA)的儿童进行家庭及饮食方面相关因素分析,并对居住在兰州市和东乡县的汉族和东乡族儿童进行对照研究,了解不同民族、不同区域贫血状况。方法:2015年10月分别在兰州市及东乡县选取两所学校,采取分层随机抽样法抽取396名6~12岁儿童为研究对象。分别进行体格发育指标测量、静脉血采集和问卷调查。分析血清学相关指标,计算铁缺乏症(ID)检出率,筛选出IDA儿童34例为病例组,同时选取年龄、性别、民族、地区相匹配的非IDA儿童34例为对照组,对两者的家庭因素及饮食行为调查问卷进行单因素分析与多因素Logistic回归分析,并对兰州市及东乡县IDA儿童进行对照研究。结果:1.兰州市及东乡县6~12岁儿童ID现状396例儿童铁减少、IDA、ID的检出率分别为12.63%、8.59%、21.21%。东乡县铁减少、IDA、ID的检出率均高于兰州市儿童,差异存在统计学意义(P㩳0.05)。东乡族较汉族铁减少、IDA、ID的检出率高,差异存在统计学意义(P㩳0.05)。随着年龄增加儿童IDA检出率逐渐降低(P㩳0.05),而铁减少与年龄变化无关系(P㧐0.05)。男、女童之间铁减少、IDA、ID的检出率比较差异无统计学意义(P㧐0.05)。2.IDA组儿童与非IDA儿童单因素分析2.1家庭因素IDA组与非IDA组家庭人均月收入总体分布不同(Z=-3.887,P㩳0.05),看护人学历总体分布不同(Z=-4.790,P㩳0.05),看护人对贫血知识了解情况总体分布不同(Z=-4.077,P㩳0.05)。2.2家庭饮食习惯IDA组与非IDA组家庭饮食结构分布不同(Z=-2.527,P㩳0.05),在是否用铁锅烹饪食物及是否有饮茶习惯方面,差异存在统计学意义(铁锅烹饪c2=2.946,P㩳0.05;饮茶习惯c2=2.435,P㩳0.05)。2.3饮食行为IDA组与非IDA儿童在婴儿期喂养分布不同(Z=-2.873,P㩳0.05),偏食、挑食情况方面分布不同(Z=-2.078,P㩳0.05);肉食食入及零食食入方面分布不同(肉食食入Z=-2.992,P㩳0.05;零食食入Z=-1.970,P㩳0.05)。2.4运动因素在运动时间方面IDA组与非IDA组分布不同(Z=-1.995,P㩳0.05)。3.兰州市及东乡县IDA儿童影响因素比较结果显示两地区儿童在家庭经济水平、看护人学历、饮食结构、婴儿期喂养分布不同(经济水平Z=-2.373,P㩳0.05;看护人学历Z=-2.905,P㩳0.05;饮食结构Z=-2.222,P㩳0.05;婴儿期喂养Z=-2.689,P㩳0.05)。4.IDA相关的家庭及饮食因素Logistic回归分析多因素Logistic回归分析显示婴儿期喂养(OR=8.945,95%CI:1.097~9.485)(P=0.007)、零食食入(OR=2.688,95%CI:1.052~6.866)(P=0.039)、偏食、挑食(OR=2.770,95%CI:1.664~11.553)(P=0.017)对IDA检出率有显著影响。结论:兰州市及东乡县儿童ID检出率较之前全国调查结果好转,尤其是东乡县儿童较全国农村儿童IDA检出率有所降低,但隐性缺铁仍是目前营养性铁缺乏的主要攻克目标。贫困、不注意饮食结构、不良饮食行为是东乡族IDA儿童的危险因素,应在提高国民经济收入的同时,加强相关医疗知识的宣传。定期对家长和儿童举行健康知识宣教,督促家长完善家庭膳食结构,教育儿童改变不良的饮食习惯是预防学龄期儿童IDA的关键。
[Abstract]:Objective: To study the status of iron deficiency (ID) in children aged 6 to 12 years old in Lanzhou and Dongxiang County by measuring relevant serological indicators, and to analyze the factors related to family and diet for children diagnosed with iron deficiency anemia (IDA). A comparative study was conducted on children living in Lanzhou and Dongxiang county, and the status of anemia in different nationalities and regions was studied. Methods: Two schools were selected in Lanzhou and Dongxiang County in October, 2015, and 396 children aged 6 to 12 years were sampled by stratified random sampling. Physical development index measurement, venous blood collection and questionnaire survey were carried out respectively. The detection rate of iron deficiency (ID) was analyzed, 34 cases of IDA children were selected as case group, 34 cases of non-IDA children matched with age, sex, nationality and area were selected as control group. The single factor analysis and multi-factor logistic regression analysis were carried out on the family factors and dietary behavior questionnaire in Lanzhou and Dongxiang County. Result: 1. The prevalence rate of IDA and ID was 12.63%, 8.59% and 21.21%, respectively. The rate of iron reduction, IDA and ID in Dongxiang County was higher than that of Lanzhou children, and the difference was statistically significant (P? 0.05). The prevalence of IDA and ID was higher in Dongxiang nationality than Han nationality in Han nationality (P? 0.05). The incidence of IDA in children increased with age (P? 0.05), and there was no relationship between iron decrease and age (P? 0.05). There was no significant difference in the rates of iron reduction, IDA and ID between boys and girls (P? 0.05). 2. The overall distribution of household factor IDA and non-IDA (Z =-3.887, P? 0.05) was different (Z =-4.790, P? 0.05). The overall distribution of the knowledge of anemia was different (Z =-4.0777, P? 0.05). The distribution of dietary structure between IDA group and non-IDA group (Z =-2.527, P? 0.05) was different (Z =-2.527, P? 0.05). The distribution of dietary behavior IDA and non-IDA children in infancy (Z =-2.73, P? 0.05) was different (Z = -2. 873, P? 0.05). The distribution of food intake and snack food was different (Z =-2.992, P? 0.05; snack food was Z =-1.970, P? 0.05). P? 0.05). 2. 4 Movement factors were different between IDA group and non-IDA group in exercise time (Z =-1.995, P? 0.05). 3. The effect factors of IDA children in Lanzhou and Dongxiang County showed that the distribution of children in the two regions was different in the family's economic level (Z =-2.373, P? 0.05; Z =-2.905, P? 0.05; diet structure Z =-2.222, P? 0.05; feeding Z =-2.689, P? 0.05; infant feeding Z =-2.222, P? 0.05; infant feeding Z =-2.222, P? 0.05). Logistic regression analysis of family and dietary factors related to P? 0.05). IDA showed that infant feeding (OR = 8.945, 95% CI: 1. 097 ~ 9. 485) (P = 0.0007), snack food intake (OR = 2.688, 95% CI: 1. 052 ~ 6.866) (P = 0.039), partial eclipse, food selection (OR = 2.770, 95% CI: 1. 664 ~ 11. 553) (P = 0.017) had a significant effect on the detection rate of IDA. Conclusion: The detection rate of children IDs in Lanzhou and Dongxiang County has improved, especially in Dongxiang County, but the detection rate of IDA in rural children in Dongxiang County has decreased, but the recessive iron deficiency is still the main target to overcome the deficiency of nutritional iron in Dongxiang County. Poverty, not pay attention to the diet structure, poor diet behavior is the risk factor of the Dongxiang IDA children, should strengthen the national economic income, strengthen the publicity of relevant medical knowledge. It is the key to prevent the development of children IDA during the period of childhood development by holding regular health knowledge training to parents and children, urging parents to improve the family's dietary structure, and educating children to change bad eating habits.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.5
[Abstract]:Objective: To study the status of iron deficiency (ID) in children aged 6 to 12 years old in Lanzhou and Dongxiang County by measuring relevant serological indicators, and to analyze the factors related to family and diet for children diagnosed with iron deficiency anemia (IDA). A comparative study was conducted on children living in Lanzhou and Dongxiang county, and the status of anemia in different nationalities and regions was studied. Methods: Two schools were selected in Lanzhou and Dongxiang County in October, 2015, and 396 children aged 6 to 12 years were sampled by stratified random sampling. Physical development index measurement, venous blood collection and questionnaire survey were carried out respectively. The detection rate of iron deficiency (ID) was analyzed, 34 cases of IDA children were selected as case group, 34 cases of non-IDA children matched with age, sex, nationality and area were selected as control group. The single factor analysis and multi-factor logistic regression analysis were carried out on the family factors and dietary behavior questionnaire in Lanzhou and Dongxiang County. Result: 1. The prevalence rate of IDA and ID was 12.63%, 8.59% and 21.21%, respectively. The rate of iron reduction, IDA and ID in Dongxiang County was higher than that of Lanzhou children, and the difference was statistically significant (P? 0.05). The prevalence of IDA and ID was higher in Dongxiang nationality than Han nationality in Han nationality (P? 0.05). The incidence of IDA in children increased with age (P? 0.05), and there was no relationship between iron decrease and age (P? 0.05). There was no significant difference in the rates of iron reduction, IDA and ID between boys and girls (P? 0.05). 2. The overall distribution of household factor IDA and non-IDA (Z =-3.887, P? 0.05) was different (Z =-4.790, P? 0.05). The overall distribution of the knowledge of anemia was different (Z =-4.0777, P? 0.05). The distribution of dietary structure between IDA group and non-IDA group (Z =-2.527, P? 0.05) was different (Z =-2.527, P? 0.05). The distribution of dietary behavior IDA and non-IDA children in infancy (Z =-2.73, P? 0.05) was different (Z = -2. 873, P? 0.05). The distribution of food intake and snack food was different (Z =-2.992, P? 0.05; snack food was Z =-1.970, P? 0.05). P? 0.05). 2. 4 Movement factors were different between IDA group and non-IDA group in exercise time (Z =-1.995, P? 0.05). 3. The effect factors of IDA children in Lanzhou and Dongxiang County showed that the distribution of children in the two regions was different in the family's economic level (Z =-2.373, P? 0.05; Z =-2.905, P? 0.05; diet structure Z =-2.222, P? 0.05; feeding Z =-2.689, P? 0.05; infant feeding Z =-2.222, P? 0.05; infant feeding Z =-2.222, P? 0.05). Logistic regression analysis of family and dietary factors related to P? 0.05). IDA showed that infant feeding (OR = 8.945, 95% CI: 1. 097 ~ 9. 485) (P = 0.0007), snack food intake (OR = 2.688, 95% CI: 1. 052 ~ 6.866) (P = 0.039), partial eclipse, food selection (OR = 2.770, 95% CI: 1. 664 ~ 11. 553) (P = 0.017) had a significant effect on the detection rate of IDA. Conclusion: The detection rate of children IDs in Lanzhou and Dongxiang County has improved, especially in Dongxiang County, but the detection rate of IDA in rural children in Dongxiang County has decreased, but the recessive iron deficiency is still the main target to overcome the deficiency of nutritional iron in Dongxiang County. Poverty, not pay attention to the diet structure, poor diet behavior is the risk factor of the Dongxiang IDA children, should strengthen the national economic income, strengthen the publicity of relevant medical knowledge. It is the key to prevent the development of children IDA during the period of childhood development by holding regular health knowledge training to parents and children, urging parents to improve the family's dietary structure, and educating children to change bad eating habits.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R725.5
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