铁缺乏对学龄青少年注意力和学习成绩的影响

铁不仅是人体正常生长发育的必需营养元素,而且对正常的智能、行为发育和认知功能非常重要,而注意是认知功能的重要组成部分,会影响认知、操作效率、活动水平等,并对学生学习成绩产生一定影响。有报道表明,铁缺乏会影响缺铁性贫血(iron deficient anemia,IDA)儿童的注意稳定性,铁剂治疗后IDA儿童的注意持久性显著改善。由于儿童青少     

不同剂量富马酸亚铁治疗儿童缺铁性贫血疗效评价

目的探讨不同剂量铁剂治疗儿童缺铁性贫血的疗效评价。方法对78例营养性缺铁性贫血患儿分2组(常规量铁剂组、小剂量铁剂组),用富马酸亚铁治疗,分析2种不同剂量铁剂网织红细胞(Ret)、血红蛋白(Hb)水平变化及临床疗效。结果2组不同剂量铁剂治疗后,Ret、Hb水平以及治愈率和总有效率比较,差异无统计学意义(P>0.05),小剂量组副作用明显减少(P<0.01)。结论小剂量铁剂治疗缺铁性贫血副作用小,服药次数少,易被患儿接受,有利于贫血的康复。     

铁剂补血应注意

贫血是一种常见的疾病,尤其以缺铁性贫血最为多见。含铁的制剂是治疗缺铁性贫血的主要药物。常用的铁剂有硫酸亚铁,主要成分为二价铁,其吸收率较高,副作用小,价格便宜,广泛应用于缺铁性贫血的患者;１０％枸橼酸铁胺,为三价铁盐,吸收率较低,但它易溶于水,适用于儿童口服。在服用铁剂治疗贫血时应注意以下几个问题： 从小剂量开始。为减少胃肠道反应,补铁药应饭后服用。胃酸缺乏的贫血病人,在服铁剂的同时,可服用浓度小于１％的稀盐酸以及维生素Ｃ,维生素Ｃ本身也能促进造血功能。 不能盲目服用铁剂。没有患缺铁性贫血的患者,…     

小儿缺铁性贫血的治疗

营养性缺铁性贫血是儿童常见病,在发展中国家患病率为30％-90％,我国7岁以下儿童患病率25％-65％。本病可引起机体代谢紊乱,影响儿童智力、免疫功能及生长发育,应及时给予有效的治疗。小儿缺铁性贫血的治疗原则主要为去除病因和给予铁剂。     

贫血为何久治不愈

贫血是由多种疾病引起的一种综合症状。儿童更为常见。因缺铁造成贫血称缺铁性贫血,比较常见。 但是,有的贫血病人较长时间服用铁剂后疗效甚微;还有的人服用铁剂后非但没有取得明显疗效,反而出现了一些并发症,增加了病痛。那么,贫血病人久治不愈究竟原因何在? 没有对症下药 缺铁性贫血主要服用铁剂进行治疗。但服用铁剂要根据不同病情对症下药。例如,轻症的贫血病人可服用硫酸亚铁,但有些孕妇和腹泻病人服用后见效缓慢,原因是硫酸亚铁对胃肠道的刺激性大,病     

铁剂治疗对轻度缺铁性贫血儿童的血液生化指标的影响

93名轻度缺铁性贫血儿童分成Ⅰ组(铁剂治疗)和Ⅱ组(安慰剂),37名正常儿童为Ⅲ组(正常对照)。在服药前、服药30天和60天时分别对各组儿童的血红蛋白(Hb)、游离红细胞原卟啉(FEP)、FEP/Hb和血清铁蛋白(SF)进行分析。Ⅰ组治疗60天后,Hb、FEP、FEP/Hb和SF水平分别从服药前的10.5g/dl、41.8μg/dl、4.0μg/g、13.2ng/ml明显变为12.5g/dl、24.1μg/dl、2.0μg/g和75.7ng/ml(P<0.01),而Ⅱ、Ⅲ组变化小且不规则,其服药前后各血液生化指标的净增值明显低于Ⅰ组。本文结果说明,轻度缺铁性贫血儿童的Hb、FEP、EFP/Hb在铁剂治疗后可迅速恢复到正常水平,而SF只有足够铁剂治疗才能恢复到正常水平。     

儿童营养性缺铁性贫血铁剂治疗效果观察

营养性缺铁性贫血(IDA)是常见的全球性营养缺乏病,常见于7岁以下儿童。我国7岁以下儿童缺铁性贫血患病率为20％～70％,严重影响儿童智力及生长发育。用铁剂治疗缺铁怀贫血患者的疗效,已为大量临床实践民证实。但在药物种类、剂量及疗程方面,尚水有特定标准。我们采用氯化血红素治疗儿童缺铁性贫血199例,用硫酸亚铁治疗198例作对照,现将结果报告如下。     

儿童缺铁性贫血500例治疗与分析

目的：探讨儿童缺铁性贫血发生的相关因素以及治疗对策。方法：在我社区选取500名缺铁贫血性儿童作为研究对象,随机分为两组,其中观察组250名儿童采取小剂量铁剂联合饮食治疗;对照组250名儿童采取常规铁剂剂量治疗,分析两组的治疗效果。结果：根据两组儿童的治疗效果数据比较,观察组儿童在进行治疗后,无论治愈数据、好转数据皆明显高于对照组儿童,无效数据明显低于对照组儿童（P〈0．05）。结论：在儿童缺铁性贫血的治疗中,除了坚持防治结合的策略,还应该从饮食营养方面着手,保证患儿的早日康复和健康成长。     

铁剂合用维生素A治疗小儿缺铁性贫血的临床研究

缺铁性贫血是儿童的常见病,用铁剂治疗往往能在较短时间内纠正贫血状态.临床上见到有的缺铁性贫血患儿平日膳食中的铁含量充足,抑或正在应用铁剂治疗,但其血色素迟迟不升,研究认为,此与体内维生素A缺乏而导致铁代谢障碍有关.为从临床角度证实这一研究结论,我们于1994年9~12月间分别在湖州市和江山市农村的8个行政村,对缺铁性贫血患儿开展了药物治疗的对照研究.现将结果报告如下.     

铁剂临床应用的若干问题

缺铁性贫血为临床上最常见的贫血症,尤以农村为多见,好发于妇女、儿童,治疗缺铁性贫血的方法除了消除引起本病的病因外,口服铁剂是最常见和最有效的方法。由于口服铁剂在胃肠道吸收受多种因素的影响,应用或配伍不当,均难以达到治疗的目的。本文就口服铁刺的若干问题叙述如下,供同道参考。     

幽门螺旋杆菌感染和学龄儿童缺铁性贫血相关性研究

目的探讨幽门螺旋杆菌(Helicdbacter pylori,H.Pylori)感染与学龄儿童缺铁性贫血(iron deficiency anemia,IDA)之间的关系。方法将2003年2月～2008年6月在我院就诊的门诊学龄儿童以因慢性腹痛而行胃镜检查及H.Pylori检测的120例患儿为观察对象,根据检查结果分为H.Pylori阳性慢性胃炎组、H.Pylori阴性慢性胃炎组及H.Pylori阳性胃部镜下无损害组三组。所有病例均检测血红蛋白(Hb)、平均红细胞体积(MCV)、血清铁(SI)、血清铁蛋白(SF)、总铁结合力(TBC)等IDA指标。比较三组之间的IDA指标和IDA伴发率。结果三组病例IDA指标两两比较显示,Hp阴性慢性胃炎组分别和Hp阳性慢性胃炎组、Hp阳性胃部镜下无损害组的IDA指标比较差异均有统计学意义(P<0.01,P<0.05),而Hp阳性慢性胃炎组与Hp阳性胃部镜下无损害组之间的比较差异则无统计学意义(P>0.05)。Hp阴性慢性胃炎的IDA伴发率均明显低于Hp阳性慢性胃炎组和阳性胃部镜下无损害组(P<0.05),Hp阳性慢性胃炎组与Hp阳性胃部镜下无损害组之间的IDA伴发率差异无统计学意义(P>0.05)。结论H.Py-lori感染与学龄儿童IDA之间具有显著的相关性,H.Pylori感染与IDA的相关性较慢性胃炎更为密切。     

幽门螺旋杆菌感染和学龄儿童缺铁性贫血相关性研究

目的探讨幽门螺旋杆菌（Helicdbacter pylori, H.P ylori）感染与学龄儿童缺铁性贫血（iron deficiency anemia, IDA）之间的关系。方法将2003年2月-2008年6月在我院就诊的门诊学龄儿童以因慢性腹痛而行胃镜检查及H．Pylori检测的120例患儿为观察对象,根据检查结果分为H.Pylofi阳性慢性胃炎组、H．Pylori阴性慢性胃炎组及H．Pylori阳性胃部镜下无损害组三组。所有病例均检测血红蛋白（Hb）、平均红细胞体积（MCV）、血清铁（sI）、血清铁蛋白（SF）、总铁结合力（TBC）等IDA指标。比较三组之间的IDA指标和IDA伴发率。结果三组病例IDA指标两两比较显示,Hp阴性慢性胃炎组分别和Hp阳性慢性胃炎组、Hp阳性胃部镜下无损害组的IDA指标比较差异均有统计学意义（P〈0．01,P〈0．05）,而Hp阳性慢性胃炎组与Hp阳性胃部镜下无损害组之间的比较差异则无统计学意义（P〉0．05）。Hp阴性慢性胃炎的IDA伴发率均明显低于Hp阳性慢性胃炎组和阳性胃部镜下无损害组（P〈0．05）,Hp阳性慢性胃炎组与Hp阳性胃部镜下无损害组之间的IDA伴发率差异无统计学意义（P〉0．05）。结论H．Pvloft感染与学龄儿童IDA之间具有显著的相关性,H．Pylori感染与IDA的相关性较慢性胃炎更为密切。     

云南少数民族贫困地区农村6～23月龄儿童缺铁性贫血患病水平及影响因素

目的 了解云南省少数民族贫困地区6～23月龄儿童缺铁性贫血现状,为制定儿童贫血干预措施提供参考依据。方法 采用多阶段分层整群抽样的方法抽取云南省不同程度贫困地区1 226名6～23月龄儿童进行血常规、血清铁蛋白测定及体格检查,同时对其看护人进行问卷调查。结果 研究对象中,儿童贫血患病率为47.15%,其中,缺铁性贫血患病率为32.87%;不同程度贫困地区儿童缺铁性贫血率差异有统计学意义(P均<0.05)。缺铁性贫血的多因素Logistic回归分析显示男童比女童患缺铁性贫血的危险性增加;随着儿童年龄增大,患缺铁性贫血的危险性降低;母亲职业为农民、家庭年收入越低、未给儿童补充营养包是6～23月龄儿童贫血的危险因素。结论 云南省少数民族贫困地区6～23月龄儿童缺铁性贫血患病率较高,贫困、健康服务可及性差、未补充营养包是缺铁性贫血患病危险因素。应开展多种形式的健康教育,加强儿童家长的喂养指导,合理添加辅食,同时建议扩大贫困地区6～23月龄儿童营养包补充范围及多种防治方法。     

Serum iron status in Orang Asli children living in endemic areas of soil-transmitted helminths

We conducted a cross sectional study to examine the association of intestinal parasitic infections and protein energy malnutrition (PEM) with iron-status indicators and anaemia among Orang Asli children in Selangor, Malaysia. A total of 281 children aged 2 - 15 years were studied. The data were collected using structured questionnaires, anthropometric measurements and laboratory analysis for blood and faecal samples. All children were infected either by A. lumbricoides, T. trichiura or hookworm and almost 19%, 26% and 3% of the children had severe infection of ascariasis, trichuriasis and hookworm infection respectively. The prevalence of giardiasis among them was 24.9%. Overall, 41.5% of the children were anaemic (haemoglobin < 11.0 g/dL). Of these 61.0% of the children had iron deficiency and 36.5% had iron deficiency anaemia (IDA), which accounted for 88.0% of anaemia in this population. Severe trichuriasis had the most significant correlation with anaemia and iron deficiency in this population. It contributed to low concentrations of haemoglobin, serum iron and serum ferritin and high total iron binding capacity (TIBC). Significant underweight and stunting were associated with low concentrations of haemoglobin and serum iron while significant wasting was significantly associated with low concentration of serum ferritin. Logistic regression analysis confirmed that severe trichuriasis was a strong predictor of IDA. It also confirmed that children who were significantly underweight and whose mother was working were independent predictors of IDA in this population.     

Preschool-aged children with iron deficiency anemia show altered affect and behavior

This study compared social looking and response to novelty in preschool-aged children (47-68 mo) with or without iron deficiency anemia (IDA). Iron status of the participants from a low-income community in New Delhi, India, was based on venous hemoglobin, mean corpuscular volume, and red cell distribution width. Children's social looking toward adults, affect, and wary or hesitant behavior in response to novelty were assessed in a semistructured paradigm during an in-home play observation. Affect and behavior were compared as a function of iron status: IDA (n = 74) vs. nonanemic (n = 164). Compared with nonanemic preschoolers, preschoolers with IDA displayed less social looking toward their mothers, moved close to their mothers more quickly, and were slower to display positive affect and touch novel toys for the first time. These results indicate that IDA in the preschool period has affective and behavioral effects similar to those reported for IDA in infancy.     

Iron deficiency anaemia in childhood and thyroid function

Studies in animals and adults have indicated iron deficiency anaemia to be associated with altered thyroid hormone metabolism. The aim of the present study was to determine the effect of iron deficiency anaemia on the thyroid function of young children. Concentrations of thyroxine (T4) and triiodothyronine (T3), free thyroid hormones (fT4 and fT3), thyroxine binding globulin (TBG), and thyroid stimulating hormone (TSH) were measured in the basal state and in response to an intravenous bolus of thyrotropin releasing hormone (TRH) in nine children one to three years of age with iron deficiency anaemia (IDA) before and after treatment with oral iron. The results of the anaemic children were also compared to basal and stimulated concentrations of thyroid hormones, TBG, and TSH of eight iron sufficient, age-matched children. Seven of the IDA and 6 of the control children were male. The mean haemoglobin (Hb) and serum ferritin (SF) in the IDA children at baseline were 93g/L (range 81-102) and 6g/L (range 1-12) which increased to 121g/L (range 114-129) and 54g/L (range 19-175), respectively, after a mean of 2.3 months (SD 0.5) of iron therapy. In the control group, mean Hb and SF were 125g/L (range 114-130) and 51 g/L (range 24-144), respectively. The basal values of TBG and thyroid hormones of the IDA children before and after iron treatment were not different from the control children. Similarly, there was no statistical difference in the thyroid hormones in the IDA children before compared to after resolution of the anaemia. Compared to the control children, the TSH response over time to TRH, TSH area under the curve (TSHAUC), and the peak TSH value after stimulation were all lower in the IDA children both before and after resolution of anaemia, but the differences were not significant. Iron therapy and resolution of anaemia had no effect among the IDA children. The time to reach the peak TSH concentration was longer in the IDA children (P=0.08) than the control children before iron therapy. While the time to peak TSH decreased upon resolution of the anaemia, the difference was not significant. There was no effect of Hb concentration, age, or anthropometry with TSH, TSHAUC, or time to peak TSH after TRH stimulation in the IDA children before treatment. Normal thyroid function was preserved in these children with iron deficiency anaemia, however three of nine children had minor abnormalities of hypothalamic-pituitary function. These results indicate that hypothyroidism is unlikely to be a major cause of impaired psychomotor development or growth in young children with iron deficiency anaemia.     

兰州市和东乡县汉族与东乡族学龄期儿童缺铁性贫血对智力发育的影响

目的 探讨兰州市和东乡县汉族与东乡族学龄期儿童缺铁性贫血(IDA)的发病情况及其对智力发育的影响。方法 于兰州市及东乡县的两所学校随机分层抽样包括汉族及东乡族6～12岁儿童396名。进行体格发育指标测量、静脉血采集以及问卷调查,分析血常规及血清铁等指标,其中符合IDA诊断标准的为贫血组,选取背景资料相似的健康儿童为对照组,使用中国-韦氏儿童智力量表(C-WISC)评估两组儿童的智力水平,并行相关分析研究。 结果 IDA患病率为8.6%。贫血组儿童语言智商及总智商均低于对照组,主要体现在C因子方面;农村地区(东乡县)儿童操作智商较城市地区(兰州市)儿童低;贫血组中东乡县儿童拼图及背数分测试分值低于兰州市儿童,差异具有统计学意义。结论 抽查学校的儿童IDA患病率仍高,形势严峻;IDA对儿童智力发育存在一定影响;城乡两地儿童智力发育存在一定差异。     

兰州市及东乡县汉族与东乡族学龄期儿童铁缺乏对照研究及相关因素分析

目的 了解兰州市与东乡县学龄期儿童铁缺乏、铁减少、缺铁性贫血患病率及影响因素,为预防和治疗铁缺乏提供参考依据。方法 2015年10月分别于兰州市及东乡县的两所学校抽取6~12岁儿童396名。进行体格发育指标测量、静脉血采集和调查问卷。分析血红蛋白、血清铁、血清铁蛋白等指标,对调查问卷进行多因素Logistic回归分析。结果 396例儿童中铁减少、缺铁性贫血、铁缺乏的患病率分别为12.6%、8.6%、21.2%;东乡县儿童铁减少、缺铁性贫血、铁缺乏的患病率均较兰州市高,差异有统计学意义(P<0.05);东乡族儿童铁减少、缺铁性贫血、铁缺乏的患病率均较汉族高,差异均具有统计学意义(P<0.05);不同性别儿童铁减少、缺铁性贫血、铁缺乏患病率差异无统计学意义(P>0.05);不同年龄组儿童缺铁性贫血患病率差异有统计学意义(P<0.05),但铁减少的患病率差异无统计学意义(P>0.05)。在13个相关因素中,婴儿期(6月龄后)喂养、零食食入及偏食(OR>1,P<0.05)对缺铁性贫血患病率有显著影响,经济水平、带养人学历、家中有亲属贫血、注意饮食搭配、用铁锅烹饪及肉食食入为缺铁性贫血保护因素。结论 兰州市及东乡县学龄期儿童铁缺乏患病率较前降低,隐性缺铁仍是目前重要问题。     

铁缺乏及补充对7～12岁儿童智力及脑功能影响的研究

从Ｈｂ＜１２０ｇ／Ｌ，ＦＥＰ＞５００μｇ／Ｌ，ＳＦ＜１６μｇ／Ｌ及补铁后Ｈｂ升高１０ｇ／Ｌ四项指标任选三项为ＩＤＡ诊断指标，以武汉市市郊７～１２岁儿童１１６０人为研究对象，共筛查出ＩＤＡ患者２６９人，并以配对的方法随机抽取７０名分为缺铁补铁组（另补铁１０ｍｇ、ＶＣ５０ｍｇ）和缺铁组（即安慰剂组，不含铁及ＶＣ），另设正常对照组３０人，连续３个月。观察补铁前后各组Ｈｂ、ＦＥＰ、ＳＦ、智商（ＩＱ）、脑事件相关电位（ＥＲＰｓ）中Ｎ１、Ｐ２、Ｎ２、Ｐ３四成分的变化情况。结果表明，经３个月补铁，缺铁补铁组各项指标均恢复正常，与正常对照组比较无显著性差异（Ｐ＞０．０５）。缺铁补铁组智商的变化主要表现在视觉记忆（Ｐ＜０．０１）、有意义记忆、语言推理及数量推理（Ｐ＜０．０５）等四方面有明显改善；脑事件相关电位的变化主要是Ｎ１和Ｐ３两成分的潜伏期明显缩短（Ｐ＜０．０５和Ｐ＜０．０１）。结果表明，铁缺乏对儿童智力及脑功能存在明显影响，但经３个月补铁后能恢复正常。     

几种红细胞和铁参数在儿童缺铁性贫血和溶血性贫血中的比较

目的:研究多种红细胞和铁参数在缺铁性贫血和溶血性贫血中的不同变化,了解它们在二者中有无鉴别意义。方法:采用全自动血细胞分析仪做血常规及红细胞分析,血液荧光测定仪测定锌原卟啉,EIA法测定血清转铁蛋白受体,检测了40例缺铁性贫血患儿(Hb 62.6±20.8 g/L)和33例溶血性贫血患儿(Hb 58.5±21.6 g/L),包括15例β-地中海贫血(仅1例为轻型)。结果:缺铁性贫血和各种溶血性贫血的红细胞分布宽度(RDW)、锌原卟啉(ZPP)、血清转铁蛋白受体(sTfR)均增高。RDW-SD在各种溶血性贫血均显著高于缺铁性贫血,P均<0.01;RDW-CV只在β-地中海贫血明显高于缺铁性贫血,P<0.01,而其他溶血性贫血的RDW-CV值却和缺铁性贫血非常相似(P=0.998)。缺铁性贫血的ZPP明显高于溶血性贫血,P<0.01。sTfR在β-地中海贫血高于缺铁性贫血和其他类型溶血性贫血,P均<0.05;不同的溶血性贫血sTfR升高的程度不同。结论:虽然缺铁性贫血和溶血性贫血的红细胞分布宽度、ZPP、sTfR均增高,但程度并不一致,可根据以上变化将二者区别开来。在评价溶血性贫血的sTfR水平时,应首先考虑溶血性贫血的类型。