西宁市3—12岁儿童Hb—SFEP测定值的相关分析

本文通过要市４２６名３￣１２岁儿童Ｈｂ及ＦＥＰ二项值的测定，发现用全国建议的西它折算标准来判断本组儿童的贫血患病率为５１．７０％，其中非缺铁性贫血竞高达４４．４％。因此，建议为解决我国不同海拔高度地区血红蛋白低限值的标准制定，必须对所测样本作出严格的统一要求。     

泉州市6月～7岁儿童贫血与佝偻病关系分析

目的 了解泉州市儿童贫血和佝偻病之间的关系。方法 采用分层承机抽样方法，对被调查儿童进行体格检查，检测血红蛋白、血清钙、磷、碱性磷酸酶，拍摄左腕关节、双膝关节X线片。结果 2939名儿童无贫血组及贫血组佝偻病患病率分别为8．71％及18．80％，无佝偻病组及佝偻组儿童贫血患病率分别为15．93％及31．49％。结论 儿童贫血和佝偻病之间存在着密切关系。     

1226名小儿缺铁性贫血调查

调查对象为城镇1月～7岁小儿，非集体饮食，均为正常足月分娩，无水脱、腹泻及其他重要病史，采用沙利氏血红蛋白计比色法进行血红蛋白测定，诊断标准根据中华儿科杂志1983年第2期小儿缺铁性贫血诊断标准和防治建议．1226人中，贫血者488例。患病率39．80％，其中男995人，患病239例，占40．17％，女631人，患病244例，占39．46％。贫血者中，Hb大于90g／L者451例（92．42％），Hb少于90g／L者37例（7．58％），Hb最低为80g／L，无重度贫血。本组患病率～1岁86．98％，～3岁42．12％，～7岁26．66％。本组有下列特点1．患病率比较低为39…     

福建省儿童铁缺乏症流行病学调查报告

目的 了解我省儿童铁营养的现状，为使儿童缺铁性贫血的患病率在2000年的基础上下降1/3掌握基数。方法 在全省范围分三个层次九个流调点对2584名儿童作Hb(血红蛋白)、ZPP(锌原卟啉)及SF(血清铁蛋白)的测定。结果 我省儿童总的铁缺乏症发生率37．23％；铁减少发生率22．87％；缺铁性贫血发生率14．36％。结论 铁缺乏、铁减少及缺铁性贫血的发生率，与饮食的合理性有密切关系。     

河南省汉、黎族7月—7岁儿童铁缺乏症调查及分析

为了解海南省儿童铁缺乏状况及相关因素，采用分层整群抽样方法，问卷、体检和检测外周血血红蛋白、锌原卟啉和血清铁蛋白。结果显示：海南省海口、通什2市汉、黎族7月－7岁945名儿童中缺铁性贫血患病率18．41％，铁减少患病率30．15％，总铁缺乏症患病率48．57％。缺铁性贫血、铁减少和总铁缺乏症患病率汉族分别为9．16％、34．16％和43．32％，黎族分别为38．21％、21．59％和59．80％。缺铁性贫血单因素分析显示所在地、民族、6个月前是否添加奶类、9个月前是否添加鱼、肉类是7月－3岁组儿童相关因素。所在地、民族、家庭抚养和营养不良是4－7岁组儿童相关因素。结论：海南省儿童铁缺乏症仍较普遍存在，黎族患病率高于汉族。     

每周一次补铁方案对学前儿童铁营养与体格发育作用的研究

２５５名３￣５岁学龄前儿童随机会为每周或每日补铁组，补铁剂量为每周一次或每日４ｍｇ／ｋｇ。经两个月补铁试验，观察比较正常与贫血儿童对两种不同补铁方案，在改善儿童铁营养状况和促进体格发育方面的作用。结果显示，每周一次补铁方案使贫血患病率由２４．４％下降到５．７％，血红蛋白含量增加１２．８ｇ／Ｌ。每周一次补铁儿童补铁后身高、体重、上臂围净增长值分别为１．３￣１．５ｃｍ，０．５￣０．７ｋｇ、０．１５￣０     

造血器官及血液疾病

890517 河北中小学生血红蛋白调查/谢华丽…∥中华预防医学杂志.-1988,22(2).-120～121 调查2509名.年龄为7～14岁。贫血者839人,贫血率为33.4％。血红蛋白均数男生高于女生,尤以12岁以后显著(男:128.1±12.1,女124.7±11.6,P<0.01)。作者建议对男女儿童采用不同(?)b标准,年龄可从14岁提前到12岁。7～8岁儿童另制标准。城市学生贫血率     

肥胖儿童营养,血象及T淋巴细胞亚群

研究目的了解肥胖儿童营养及健康状况。研究方法对确诊为单纯肥胖学龄儿童１０４名作血象检测及Ｔ淋巴细胞亚群分析，并对其中３１例作膳食回顾性分析。研究结果Ⅰ°肥胖９名，Ⅱ°肥胖４８名，Ⅲ°胖４７名。膳食调查显示维生素Ｃ、蛋白质及铁摄食量低于ＲＤＡ者分别为７７．４％、４８．４％及２９．０％。１０４名肥胖儿童贫血患病率为２１．２％，男童为１８．４％，女童为２３．６％。肥胖儿童ＣＤ３＋、ＣＤ８＋、ＣＤ４＋／ＣＤ８＋与正常儿童无差异，而ＣＤ４＋细胞百分率则高于正常儿童（Ｐ＜０．０１）。肥胖男童ＣＤ３＋及ＣＤ８＋细胞百分率高于女童（Ｐ＜０．０１，ｐ＜０．０５）。结论肥胖儿童存在某些营养素的缺乏。营养性贫血患病率达２１．２％。肥胖儿童ＣＤ４＋细胞高于正常儿。肥胖男童ＣＤ３＋及ＣＤ８＋细胞病于肥胖女童。     

富阳市托幼机构儿童营养状况调查

目的了解富阳市托幼机构儿童的营养状况。方法对我市3所日托制公立幼儿园的儿童采用称重、记帐法随机抽取1周(5天)的膳食进行调查，同时进行体格检查和血生化测定。结果托幼机构儿童的生长发育低于WHO标准。每日膳食营养素摄人中，热量、钙、视素醇、维生素C存在着不足，贫血患病率为5．47％。结论托幼机构儿童的发生长发育低于WHO标准。每日膳食营养还有待于改善，家长与托幼机构要重视学龄前儿童的合理营养，采取有效措施，提高儿童的营养状况。     

每周一次补铁方案对学前儿童铁营养与体格发育作用的研究

２５５名３～５岁学龄前儿童随机会为每周或每日补铁组，补铁剂量为每周一次或每日４ｍｇ／ｋｇ。经两个月补铁试验，观察比较正常与贫血儿童对两种不同补铁方案，在改善儿童铁营养状况和促进体格发育方面的作用。结果显示，每周一次补铁方案使贫血患病率由２４．４％下降到５．７％，血红蛋白含量增加１２．８ｇ／Ｌ。每周一次补铁儿童补铁后身高、体重、上臂围净增长值分别为１．３～１．５ｃｍ，０．５～０．７ｋｇ、０．１５～０．１３ｃｍ，显著高于正常对照儿童。每周一次补铁方案在改善儿童铁营养，促进体格发育方面的作用与每日补铁方案无显著性差异（Ｐ＞０．０５）。     

THE ANEMIA OF FAMILIAL MEDITERRANEAN FEVER DISEASE

The aim of this study was to evaluate the incidence of anemia detected in familial Mediterranean fever (FMF) and the effect of disease activity and colchicine therapy along with inteleukins to laboratory tests, including serum transferrin receptor (TfR), in the diagnosis of anemia seen in FMF in children. After detecting anemia in 63.4% of 172 FMF patients followed up by our rhematology outpatient polyclinics, it was decided to study 3 groups of patients: group 1, 17 newly diagnosed FMF patients; group 2, 36 FMF patients on colchicine therapy; and group 3, 17 healthy children as control for the symptom of anemia. All 3 groups of patients were investigated for their hematological parameters, iron status, including soluble transferrin receptor (sTFR) concentrations and sTFR index, and IL-6 levels. Anemia ratio was 9/17, 53%; 11/36, 31%; and 1/17, 5% in the groups 1, 2 and 3, respectively. There was a significant difference between hemoglobin (Hb) values in the first group and the second (patients who were on colchicine therapy). Furthermore, in the second group there was a significant difference between the Hb concentrations at the time of diagnosis and after colchicine therapy (p =. 003). There was a positive correlation between Hb and plasma iron and transferrin saturation in group 1 and disease beginning age, iron, transferrin saturation, and erythrocyte sedimentation rate (ESR) in the second group. In the first group the anemic patients' iron and transferrin saturation were significantly lower than normal, while ferritin levels were higher. In the second group, a good correlation was found with ESR and Hb levels; the higher ESR values were detected in patients with lower Hb values. Of the anemic and nonanemic patients of the first and second groups, values for interleukin 6 and iron parameters, including sTFR, were found similar. Anemia detected in FMF patients was found related to iron status more than interleukins. Colchicine therapy had a positive effect on anemia as well as on disease activity. Resolution of symptoms of FMF occurred with correction of the anemia, if the patient ESR values also decreased on colchicine therapy.     

Hemoglobin status associated with performance IQ but not verbal IQ in Chinese preschool children

Background: Despite the body of literature that links anemia with poorer cognition in children and the evidence that the severity of the effects of anemia on children's cognition vary in different populations, few studies have investigated the effects of anemia on the cognitive development of Chinese children. Methods: This longitudinal cohort included 171 children from a developing region of China. Hemoglobin (Hb) and iron levels were taken when the children were 4 years old. At age 6, the children's cognition was tested with the Chinese Wechsler Preschool and Primary Scale of Intelligence. Psychosocial information was also used in analyses. Results: Results showed that the children who had low Hb levels had significantly lower scores in performance IQ (PIQ), but not verbal IQ. Although blood Fe levels were not shown to moderate the link between Hb levels and IQ, we found children who performed the best on IQ tests exhibited low iron levels concurrent with high Hb levels, whereas the group who performed the worst exhibited high iron but low Hb levels. We also found that psychosocial adversity did not differ significantly between children who had normal or low Hb levels, although the effect of Hb on PIQ became only suggestive after controlling for psychosocial adversity, therefore the correlation is not causal but only a suggestive association. Conclusion: Our findings are in agreement with literature on the negative effects of anemia on children's cognition and point to the possibility that the portions of the brain associated with PIQ components are particularly affected by low Hb during crucial periods of development.     

Iron status of children aged 9-36 months in an urban slum Integrated Child Development Services project in Delhi

OBJECTIVE: To assess the magnitude/severity and possible etiology of anemia and iron deficiency among children 9-36 months of age. METHODS: A population-based study on the prevalence, etiology of anemia and iron status in 545 children, 9-36 months of age, was conducted in an urban slum ICDS (Integrated Child Development Services) project in North-East Delhi. Hemoglobin and serum ferritin was estimated and information on socio-economic, demographic, parasitic infection/infestation and dietary intake was collected. RESULTS: Prevalence of anemia (using WHO cut-off values of Hb >11.0 g/dl) among children, 9-36 months of age, was 64%, of these 7.8% had severe anemia (Hb >7.0 g/dl). Using 10.0 g/dl as the Hb cut-off point 44% children less than 18 months of age in the present study population were anemic. On a sub-sample study, 88% children were estimated to be iron deficient, with serum ferritin concentration less than 12 microg/L. The peripheral smear red cell morphology showed 33.9% as microcytic-hypochromic and 37.1% as dimorphic. Dimorphic anemia was 55% in moderate anemia group. The energy and iron intakes were 56% and 45%, respectively of the Recommended Dietary Allowances (RDA). The parasitic infestation/infection was not related to the prevalence or severity of anemia. CONCLUSION: In Delhi, high prevalence of moderate to severe anemia and iron deficiency with vitamins folate and/or B12 among children under 3 years of age in an ICDS block in operation for 20 years is of concern. Dietary origin was the main cause of anemia in this age group.     

Interventions for anemia in pediatric cancer patients

BACKGROUND: Children with cancer frequently develop anemia both from the disease and from chemo- and radiotherapy. Considered a manageable complication, anemia is often not treated until it becomes severe, i.e., hemoglobin (Hb) level 相似文献   

缺铁性贫血患儿血清胃泌素水平测定及间断补铁疗效观察

研究缺铁性贫血 (IDA)儿童胃泌素水平的变化 ;观察间断补铁治疗儿童IDA的疗效。方法 :49例 IDA患儿每周口服一次铁制剂 (元素铁 2 mg/kg) ,共 1 2周。在治疗前后测查 Hb、ZPP、SF及血清胃泌素。结果 :经补铁治疗 ,Hb、SF均极显著性升高 (P<0 .0 1 ) ,ZPP则明显下降 (P<0 .0 1 ) ;IDA患儿血清胃泌素水平明显升高 ,与对照组比较差异显著 ,治疗后恢复正常。结论 :1每周一次间断补铁治疗儿童 IDA效果显著。 2 IDA患儿胃泌素的异常分泌可能与缺铁所致的胃粘膜萎缩有关     

Measurement of reticulocyte hemoglobin content to diagnose iron deficiency in Saudi children

Iron deficiency and iron deficiency anemia are common conditions in children, especially in developing countries. It is often difficult for the pediatrician to know which indices should be used in the diagnosis of these conditions in children. Reticulocyte hemoglobin (Hb) content (CHr) has been shown to be an accurate indicator of anemia, however whether its use suits the situation in developing countries or not is unclear. The aim of this study was to evaluate the value and effectiveness of using CHr as a method to diagnose iron deficiency and iron deficiency anemia in Saudi children. The samples for the study were collected from 305 children suspected to have anemia. Complete blood count, transferrin saturation (Tfsat), ferritin, circulating transferrin receptor (TfR) and CHr were measured. Three groups were defined, iron deficiency (Tfsat <20%, Hb >11 g/dL; n=120), iron deficiency anemia (Tfsat <20%, Hb <11 g/dL; (n=73) and controls (Tfsat >20%; n=112). The anemic group had significantly lower macrocytic anemia (MCV), mean corpuscular hemoglobin (MCH) and CHr. All of the variables in the anemia group were significantly lower than those of the control group except for the ferritin level. Compared to the control group, the iron deficiency group also showed significantly lower values except for transferrin receptor and the ferritin levels. CHr levels of <26 pg correlated well with anemic states. CHr together with a complete blood count may provide an alternative to the traditional hematologic or biochemical panel for the diagnosis of iron deficiency and iron deficiency anemia in young children and is cost-effective in developing countries. A CHr cut-off level of 26 pg is considered to be a reasonable indicator of anemic states.     

The prevalence and etiology of anemia among HIV-infected children in India

In this report, the prevalence and multifactorial etiology of anemia among Indian human immunodeficiency virus (HIV)-infected children are described. HIV-infected children aged 2–12 years were prospectively enrolled in 2007–2008. Measured parameters included serum ferritin, vitamin B₁₂, red-cell folate, soluble transferrin receptor, and C-reactive protein. Children received antiretroviral therapy (ART), iron and, folate supplements as per standard of care. Among 80 enrolled HIV-infected children (mean age 6.8 years), the prevalence of anemia was 52.5%. Etiology of anemia was found to be iron deficiency alone in 38.1%, anemia of inflammation alone in 38.1%, combined iron deficiency and anemia of inflammation alone in 7.1%, vitamin B₁₂ deficiency in 7.1%, and others in 9.5%. Median iron intake was 5.7 mg/day (recommended dietary allowance 18–26 mg/day). Compared to nonanemic children, anemic children were more likely to be underweight (weight Z-score −2.5 vs. -1.9), stunted (height Z-score −2.6 vs. -1.9), with lower CD4 counts (18% vs. 24%, p < 0.01), and higher log viral load (11.1 vs. 7.1, p < 0.01). Hemoglobin (Hb) improved significantly among those who started ART (baseline Hb 11.6 g/dl, 6-month Hb 12.2 g/dl, p = 0.03). Children taking ART combined with iron supplements experienced a larger increase in Hb compared to those receiving neither ART nor iron supplements (mean Hb change 1.5 g/dl, p < 0.01). Conclusion Anemia, particularly iron deficiency anemia and anemia of inflammation, is highly prevalent among children with HIV infection. Micronutrient supplements combined with ART improved anemia in HIV-infected children.     

Anemia and transfusion requirements among Ugandan children with severe malaria treated with intravenous artesunate

Abstract

Parenteral artesunate for the treatment of severe malaria in non-immune travelers is associated with late-onset hemolysis. In children in sub-Saharan Africa, the hematologic effects of malaria and artesunate are less well documented. Here we report a prospective case series of 91 children with severe malaria treated with parenteral artesunate, managed at a resource-poor hospital in Africa, with longitudinal data on hemoglobin (Hb), lactate dehydrogenase (LDH), haptoglobin, and erythrocyte morphology. The median (range) age was 2 (1–8) years and 43 (47%) were female. The median (IQR) admission Hb level was 69 (55–78) g/L and 20 patients (22%) had severe malarial anemia (Hb?<?50?g/L). During hospitalization, 69 patients (76%) received one or more blood transfusions. Fatal outcome in 8 patients was associated with severe anemia in 6/8 cases. Follow-up Hb measurement was performed on 35 patients (38%) at day 14 after initial hospital admission; the remaining patients had no clinical evidence of anemia at the follow-up visit. The convalescent Hb was median (range) 90 (60–138) g/L, which was significantly higher than the paired admission levels (median increase +28?g/L, p?<?.001). Evidence of hemolysis (elevated LDH and low haptoglobin) was common at admission and improved by day 14. No patient met the standardized definition of post-artemisinin delayed hemolysis (PADH). In this cohort of young children with severe malaria treated with artesunate, anemia was common at admission, required one or more transfusions in a majority of patients, and markers of hemolysis had normalized by day 14.     

Thalassemia and iron deficiency in a group of northeast Thai school children: relationship to the occurrence of anemia

The cross-sectional study assessed anemia, thalassemia, and hemoglobinopathies, as well as iron deficiency, among 190 northeastern Thai school children aged 10 to 11 years. The aim was to analyze the reasons for anemia among the group. Hemoglobin concentration and other hematological parameters were determined using an automated blood cell counter. Beta-thalassemia and other hemoglobinopathies were identified by high performance liquid chromatography (HPLC) analysis of hemoglobin. Alpha-thalassemia was identified by polymerase chain reaction (PCR) and related techniques. Iron deficiency was assessed using serum ferritin (SF) <20 ng/ml as indicator. Based on the WHO criteria, anemia was defined by hemoglobin (Hb) level <11.5 g/dl. Twenty five out of 190 children (13.2%; 95% CI = 8.7–18.8%) were anemic. Iron deficiency was found in only two out of 190 children (1.0%; 95% CI = 0.1–3.8%), but the two iron deficient children were not anemic. The proportion of thalassemia and hemoglobinopathies among the group was 61.1% (95% CI = 53.7–68.0%). As underlying reasons for anemia, thalassemia and hemoglobinopathies were found in 22 out of 25 (88.0%) anemic children. Beta-thalassemia and homozygous Hb E seem to be important, while this was less obvious for heterozygous α-thalassemia and heterozygous Hb E. Conclusion: The results suggest that thalassemia and hemoglobinopathies may be major contributing factors to the occurrence of anemia in this area among the children’s population.