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。     

汉中市儿童、孕妇铁缺乏症流行病学调查研究分析

目的调查了解儿童、妇女铁减少(ID)、缺铁性贫血(IDA)及铁缺乏症(IDD)患病率。方法随机抽取汉中市城区7月～7岁儿童532名,30岁以下妊娠38周以内孕妇203名,30岁以下未孕育龄妇女200名为调查对象。检测了血红蛋白(Hb)、锌原卟啉(ZPP)、血清铁蛋白(SF)等指标。结果7个月～7岁儿童ID平均43.80%,IDA平均9.96%。其中7个月～12个月婴儿ID71.67%,IDA22.50%;3个月～36个月幼儿ID33.13%,IDA8.13%;37个月～7岁儿童ID37.30%,IDA5.16%。孕妇ID平均82.17%,IDA平均37.93%。其中早孕组ID75.91%,IDA14.46%,中孕组ID77.14%,IDA51.43%;晚孕组ID100.00%,IDA58.00%。未孕育龄妇女ID49.50%,IDA25.00%。儿童ID、IDA不同年龄组有显著差异(P<0.01),即年龄越小、患病率越高。孕妇孕龄组之间有显著性差异(P<0.01)。即孕龄越大,患病率越高。孕妇ID、IDA患病率与育龄妇女有显著性差异(P<0.01)。孕妇患病率明显高于育龄妇女。不同年龄组儿童、不同孕期孕妇及育龄妇女ID患病率均大于IDA患病率。结论本市儿童、孕妇、育龄妇女铁缺乏症比较普遍,ID、IDA患病率均高于国外和全国平均水平。隐性缺铁十分严重,已成为营养性铁缺乏症的主要问题。婴幼儿和晚期孕妇是铁缺乏症高发人群。     

汉中市儿童、孕妇铁缺乏症流行病学调查研究分析

目的 调查了解儿童、妇女铁减少（ID）、缺铁性贫血（IDA）及铁缺乏症（1DD）患病率。方法 随机抽取汉中市城区7月～7岁儿童532名，30岁以下妊娠38周以内孕妇203名，30岁以下未孕育龄妇女200名为调查对象。检测了血红蛋白（Hb）、锌原卟啉（ZPP）、血清铁蛋白（SF）等指标。结果7个月～7岁儿童ID平均43．80％，IDA平均9．96％。其中7个月～12个月婴儿ID71．67％．IDA22．50％：3个月～36个月幼儿ID33．13％，IDA8．13％；37个月～7岁儿童ID37．30％，IDA5．16％。孕妇ID平均82．17％，IDA平均37．93％。其中早孕组ID75．91％，IDA14．46％，中孕组ID77．14％，IDA51．43％；晚孕组ID100．00％，IDA58．00％。未孕育龄妇女ID49．50％．IDA25．00％。儿童ID、IDA不同年龄组有显著差异（P〈0．01），即年龄越小、患病率越高。孕妇孕龄组之间有显著性差异（P〈0．01）。即孕龄越大，患病率越高。孕妇ID、IDA患病率与育龄妇女有显著性差异（P〈0．01）。孕妇患病率明显高于育龄妇女。不同年龄组儿童、不同孕期孕妇及育龄妇女ID患病率均大于IDA患病率。结论本市儿童、孕妇、育龄妇女铁缺乏症比较普遍，ID、IDA患病率均高于国外和全国平均水平。隐性缺铁十分严重，已成为营养性铁缺乏症的主要问题。婴幼儿和晚期孕妇是铁缺乏症高发人群。     

防治儿童营养性铁缺乏症参照方案

营养性铁缺乏症是单一微量营养素缺乏引起的世界性疾患，据世界卫生组织（WHO）推算，全球约有21．5亿居民存在不同程度的铁缺乏，其中约半数呈现出贫血；妇女和儿童是铁缺乏症的主要罹患者，而孕妇和婴幼儿则是深重的受害群体。据2000年流行学调查资料，在全国15个省，26个市县对9118名7月～7岁儿童所进行的分层随机抽样调查结果，铁缺乏症的检出率平均为40．3％，其中铁耗减（ID）平均为32．5％，缺铁性贫血（IDA）平均为7．8％、其中以后半岁婴儿最为严重达20．5％。     

北方四市城区2～7岁儿童铁缺乏症流行病学调查及分析

目的调查我国北方4市城区2～7岁儿童末梢全血锌原卟啉(ZPP)水平和铁缺乏症患病率.方法流行病学调查采用是整群随机抽样方法.血红蛋白(Hb)用氰化高铁法,末梢全血ZPP用荧光法,血清铁蛋白(SF)用微粒子酶免法.结果北方4市城区(北京、沈阳、丹东和邢台)5333例2～7岁儿童末梢全血ZPP含量中位数分别为2.4,2.2,2.6和2.8μg/(g     

铁缺乏症患儿血清甲状腺素、生长激素

本文没测定了57名铁缺乏症患儿。铁剂治疗前后血清T3、T4、TSH、GH和INS含量、并与健展对照组进行比较。结果表明，铁缺乏患儿血清T3、T4、GH含量明显低于对照组者，血清TSH、INS水平则显著升高。铁剂治疗后随着铁营养状况的改善，上述各指标均恢复正常。表明铁缺乏可影响体内某些激素的代谢，其原因可能与参与激素代谢的含铁酶活性在铁缺乏时减低有关。     

儿童铁缺乏和缺铁性贫血防治专家共识

铁缺乏症（iron deficiency,ID）、缺铁性贫血（iron deficiency anemia,IDA）影响儿童生长发育及大脑认知功能发展。我国儿童ID和IDA患病率较早年已明显下降,但由于国土辽阔、各区域的发展程度不均以及各民族生活习惯差异等原因,部分区域儿童的患病率仍然较高。儿童ID和IDA的规范化防治对改善儿童生长发育,提高我国人口素质意义重大。为此,中华预防医学会儿童保健分会、中国妇幼保健协会儿童早期发展专业委员会、福棠儿童医学发展研究中心儿童保健专业委员会和《中国实用儿科杂志》编辑委员会组织专家参考国家相关部门文件及国内外临床指南共识,查阅循证文献,通过反复研讨形成符合我国临床需求的《儿童铁缺乏和缺铁性贫血防治专家共识》。     

学龄前儿童铁营养状况及铁缺乏危险因素调查

目的 探讨本地区学龄前儿童铁缺乏症的发病率及危险因素。方法 以整群抽样的方法对475名2～7岁儿童进行膳食调查、社会经济状况及饮食习惯调查，同时进行外周血血细胞分析、血清铁蛋白水平测定及幽门螺杆菌(H．pylori)抗体检测。结果 本地区小儿铁缺乏率为22．1％；非条件logistic多元回归分析筛选出铁缺乏症的5个危险因素，即：儿童膳食中动物性食品来源的铁在总铁摄入量中所占比例低(OR：3．13)、高膳食钙摄入(OR：3．43)、对小儿日常饮食进行特别安排(OR：1．89)、不经常吃肉食品(OR：2．05)、血清H．pylori抗体阳性(OR：8．13)和一个保护因素即儿童年龄(OR：0．59)：结论 本地区小儿铁缺乏症的发病率仍然较高，其与小儿不良饮食习惯、血红素铁摄入不足及H．pylori感染等密切相关。     

儿童缺铁性贫血诊疗进展

缺铁性贫血(iron deficiency anemia,IDA)是因体内铁缺乏致使血红蛋白合成减少而引起的贫血。喂养不当、消化系统疾病、微量元素及维生素缺乏等仍然是导致儿童 IDA 的高危因素,高热惊厥与儿童 IDA 的关系尚有争议。研究表明,婴幼儿时期铁缺乏能够导致认知抑制控制功能不可逆减退,延迟结扎脐带等措施则可以有效预防儿童 IDA。间断补充铁剂等方法在治疗儿童 IDA 过程中亦能达到良好效果。     

儿童缺铁性贫血的流行病学研究进展

越来越多的研究表明缺铁性贫血严重危害儿童健康,对儿童认知和精神运动的发育造成不可逆转的损害.虽然我国人民经济生活水平有了极大改善,但儿童缺铁性贫血状况仍不容乐观.该文主要就我国儿童缺铁性贫血的状况、缺铁的危险因素、相应的预防治疗措施等进行综述.     

88例热性惊厥患儿缺铁性贫血相关指标分析

目的了解热性惊厥与缺铁性贫血的关系。方法检测88例热性惊厥患儿的红细胞计数、血红蛋白、红细胞平均容积、红细胞平均血红蛋白、红细胞平均血红蛋白浓度、血清铁、血清铁蛋白,并以同期住院的76例呼吸道、肠道感染而无惊厥患儿为对照组,将两组数据进行统计分析。结果热性惊厥组缺铁性贫血的发生率为61.36%,对照组为43.42%,血红蛋白、血清铁含量与对照组有显著性差异(P<0.05);而且复杂型热性惊厥的缺铁性贫血的发生率占85%,与单纯型比较亦有显著性差异(P<0.05)。结论血清铁与小儿热性惊厥密切相关,缺铁性贫血可能是引起热性惊厥的原因之一。     

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.     

Parameters of iron deficiency in children with cyanotic congenital heart disease

A group of 67 children with cyanotic congenital heart disease (CCHD) were studied, and 35 were given iron treatment according to a regimen that gives iron to patients with a hematocrit (Hct) below 60%. The patients were categorized as iron-deficient and iron-sufficient according to their transferrin saturation and ferritin values. The pretreatment hemoglobin (Hb) and Hct values of the groups were similar. The mean Hct was nearly three times as much as the mean Hb in the iron-sufficient group and more than three times as much as the Hb in the iron-deficient group. Excessive erythrocytosis in the iron-deficient group was impressive. Mean corpuscular volume (MCV) values were below 72.7 fl in all of the iron-deficient patients. After treatment the Hb, Hct, transferrin saturation, and ferritin increased significantly in both groups, with the increments greater in the iron-deficient group. Increments in the erythrocyte (RBC) count were significant in the iron-sufficient group but insignificant in the iron-deficient one. Increments of MCV in the iron-deficient group were significant but insignificant in the iron-sufficient group. Our study demonstrated that prediction of Hb, RBC count, and MCV, measurements of which are easy and inexpensive and require little blood, can suffice for the diagnosis of iron deficiency in patients with CCHD without altering systemic perfusion.     

生理性铁缺乏的假说及其潜在意义

目的 本文提出了少儿生长期存在生理性铁缺乏的新假说,并以实验学方法予以验证。方法 在阐述概念和理论依据基础上,以大鼠进行了实验验证并对营养性铁缺乏和生理性贫血作出了界定。结果 实验结果支持大鼠生长期存在生理性铁缺乏状态;此时给予富铁干预,对成年期铁代谢将产生不利的影响;贫铁干预则可产生回忆性激活效果。结论 作者认为,尽管大鼠铁代谢与人类毕竟不竟相同,但人类生长期是否存在生理性铁缺乏时段以及临床应如何对待,均值得进一步研究。     

Serum iron,serum transferrin and transferrin saturation in healthy children without iron deficiency

Serum iron, serum transferrin and transferrin saturation were studied in 253 healthy, non-anaemic children 4, 8 and 13 years old, and in 60 healthy, non-anaemic adults having serum ferritin values 15 g/l. One hundred and ninety-six children had serum ferritin values 15 g/l (i.e. replete iron stores), 35 had intermediate ferritin values from 10–14 g/l and 22 had ferritin values <10 g/l (i.e. depleted iron stores). Iron replete children showed a gradual rise in serum iron and transferrin saturation values with age. Serum iron and transferrin saturation values were lower (P<0.001, P<0.0001) and transferrin values high (P<0.0001) in iron replete children compared to adults. Iron replete children had a 2.5 centile transferrin saturation value of 5%; 19.9% of these children had saturation values <15% and 8.2% had values <10%. In iron depleted children a transferrin saturation value <7% yielded the highest diagnostic efficiency as regards exhausted iron stores, although with a low predictive value of a positive test. The transferrin saturation is unsuitable as a single diagnostic criterion in the evaluation of iron deficiency in children and should always be combined with other indicators of iron status.