晚期孕妇铁缺乏症

目的：研究晚期孕妇铁缺乏症的发病率与影响因素。方法：测定２２５例晚期妊娠妇女血红蛋白、血清铁蛋白、骨髓可染铁等项目。结果：城市患者１２０例，山区患者１０５例，其中缺铁性贫血７３例，占３２．４％，隐性缺铁１３７例，占６０．９％。城市和农村铁缺乏症的患病率无明显差异。结论：多胎妊娠、多产、哺乳是产生缺铁性贫血的危险因素。     

单中心孕妇铁缺乏现状纵向研究及干预效果分析*

目的：纵向分析本中心孕妇铁缺乏现状及干预效果。方法：选取2017年7月—2019年2月在我院产前检查的孕早、中、晚期孕妇,筛选检测铁蛋白3次以上,检测血清铁蛋白(serum ferritin, SF)及血红蛋白(hemoglobin, Hb),按照首次检查是否缺铁、贫血分为4组：铁缺乏贫血和不贫血组及非铁缺乏贫血和不贫血组,铁缺乏组予补充铁剂,研究孕妇缺铁情况及补铁疗效,分析补铁效果不佳原因。结果：符合中心研究要求的孕妇共994例,各期SF和Hb差异均有统计学意义(均P<0.001),妊娠早、中、晚期铁缺乏(iron deficiency, ID)患病率分别为66.90%、78.41%、64.88%,缺铁性贫血(iron deficiency anemia, IDA)患病率分别为16.95%、14.13%、3.94%。经正规补铁治疗后,妊娠晚期ID及IDA均明显改善(P<0.001)。结论：铁缺乏现象严峻,但可防可治。孕妇进行SF检测,指导孕妇科学补铁,关注孕妇补铁的依从性,可明显减少妊娠期缺铁及相关并发症的发生。     

铁调素在妊娠期缺铁性贫血中的表达及其与铁代谢参数的相关性

［摘要］ 目的观察铁调素在不同程度缺铁性贫血孕妇中的表达水平,探讨铁调素与红细胞参数、铁代谢参数、促红细胞生成素(erythropoietin,EPO)及炎性指标C反应蛋白（C-reactive protein,CRP）之间的关系,进一步阐明铁调素在妊娠期妇女缺铁性贫血中的调节机制。 方法选取定期产检的孕妇和体检的健康未孕妇女共80例,分为健康对照组、孕妇正常组、孕妇轻度贫血组和孕妇中度贫血组。空腹采集血样,应用血细胞分析仪LH750检测血常规,采用酶联免疫吸附测定法检测血清中铁调素、EPO、血清铁蛋白（serum ferritin,SF）、血清转铁蛋白（serum transferrin,TRF）,采用分光光度法检测血清铁（serum iron,SI）、总铁结合力（total iron binding force,TIBC）,采用免疫比浊法检测CRP。 结果与健康对照组比较,孕妇正常组、孕妇轻度贫血组和孕妇中度贫血组外周血红蛋白（hemoglobin,Hb）、红细胞压积（hematocrit,Hct）、SI和铁调素均降低,CRP均升高（P＜0.05）;与健康对照组比较,孕妇轻度贫血组和孕妇中度贫血组红细胞平均体积（mean corpuscular volume,MCV)、红细胞平均血红蛋白含量 （mean corpuscular hemogolobin,MCH）和红细胞平均血红蛋白浓度（mean corpuscular hemogolobin concentration,MCHC）均降低,TIBC均升高（P＜0.05）;与健康对照组比较,孕妇中度贫血组EPO升高（P＜0.05）。与孕妇正常组比较,孕妇轻度贫血组和孕妇中度贫血组Hb、Hct、MCV、MCH、MCHC、SI和铁调素均降低,TIBC均升高（P＜0.05）;与孕妇正常组比较,孕妇中度贫血组EPO和CRP均升高（P＜0.05）。与孕妇轻度贫血组比较,孕妇中度贫血组Hb、Hct、MCV、MCH、SI均降低,TIBC和EPO均升高（P＜0.05）。铁调素与Hb、Hct、MCV、MCH、MCHC、SI均呈正相关,与TIBC、EPO均呈负相关（P＜0.05）。 结论妊娠期缺铁性贫血与铁调素表达水平的下调有关,可能是通过EPO抑制发挥作用。     

Iron stores in low-income pregnant Mexican women at term

BACKGROUND: Iron stores can be depleted during pregnancy. Serum ferritin is the most useful non-invasive test to assess iron stores in women of reproductive age. Iron status of pregnant Mexican women at term from a low-income group was investigated through serum ferritin determinations. METHODS: Hemoglobin and serum ferritin were measured in 201 low-income urban women with at-term pregnancy receiving attention at a public university hospital. Hemoglobin cut-off value was 110.0 g/L. Depending on their serum ferritin concentration, women were divided into three groups: group I, iron deficiency, serum ferritin <12 microg/L; group II, borderline iron stores, serum ferritin >or=12 microg/L and <30 microg/L, and group III, normal iron stores, serum ferritin >or=30 microg/L. RESULTS: Mean SF value in the entire group was 7.0 +/- 6.4 microg/L, with a mean Hb of 110.1 +/- 15.8 g/L. One hundred seventy-two women (85.6%) had empty iron stores. Ninety-two women (46%) in the entire group had iron deficiency anemia, as did 79 (46%) of the 172 iron-deficient women. During their pregnancy, 165 women (82%) did not ingest any supplemental iron and 131 (65%) did not receive any prenatal care. CONCLUSIONS: We documented a high prevalence of iron deficiency and iron deficiency anemia, together with practically no prenatal care utilization and no supplemental iron ingestion in this low-income group. A serum ferritin concentration >or=12 microg/L was always accompanied by a normal hemoglobin concentration. These data suggest that prenatal care and iron supplementation may be considered as major determinants of maternal iron stores to prevent iron deficiency anemia.     

婴幼儿缺铁性贫血对智能发育的影响

缺铁性贫血是婴幼儿期常见疾病,本文综述了铁缺乏症引起人类或动物行为改变的生理生化基础,近年来国内外对缺铁性贫血儿童智能发育的研究情况。缺铁影响大脑的发育,缺铁时单胺氧化酶、多巴胺、能量代谢紊乱,可能是缺铁性贫血儿童智能改变的理化基础。缺铁性贫血可影响儿童的运动、认知、学习能力、视听觉的发育,并可能对智能发育存在长期影响。     

铁叶绿酸钠片治疗缺铁性贫血临床研究

目的观察铁叶绿酸钠治疗成人和儿童缺铁性贫血的有效性和安全性。方法采用随机、对照、多中心的临床研究方法,以琥珀酸亚铁薄膜衣片为对照,对2776例受试者进行试验。结果试验组总有效率79．84％,显效率58．52％;能提高红细胞计数、血红蛋白、血细胞比容、红细胞平均体积、红细胞平均血红蛋白量、红细胞平均血红蛋白浓度、缩小红细胞体积分布宽度,而且对白细胞系及血小板系也有一定作用;它能改善铁代谢,提高血清铁（Fe）、转铁蛋白饱和度（TS）、铁蛋白（SF）,降低总铁结合力（TIBC）、转铁蛋白（Tf）、血清可溶性转铁蛋白受体（sTfR）。结论铁叶绿酸钠片治疗缺铁性贫血是安全有效的药物。     

A study of micronutrient status in pregnancy

The present study was performed, to analyse the inter-relationship among trace elements: Iron, copper and zinc in pregnancy. Eighty-four pregnant women were compared with 30 age matched nonpregnant healthy controls. Fasting blood samples were analysed for heamoglobin, iron, copper and zinc. On the basis of Hb concentration (<10g/dl) and iron levels(<50microg/dl), the pregnant women were sub-grouped as anaemic, non-anaemic, Iron deficient anaemic and non-iron deficient anaemic. The level of copper was found to be significantly higher in iron deficiency anaemia, when compared to non-iron deficiency anaemia (p<0.05), and in non-anaemic pregnant women, compared to non-anaemic non-pregnant women (controls).The level of zinc is also significantly lower in Iron deficiency anaemic pregnancy, when compared to the other groups. There is evidence of influence of pregnancy, on the level of trace elements in blood. This could be a result of competitive inhibition in the absorption of trace elements in the intestine, or an effect of hormonal changes (insulin, oestrogen), during pregnancy. A judicious supplementation of micronutrients, during pregnancy, especially in iron deficiency anaemia, is essential.     

NaFeEDTA fortified soy sauce showed higher iron absorption rate in Chinese females

Objective NaFeEDTA was considered as a promising iron fortificant for controlling iron deficiency anemia. Soy sauce is a suitable food carrier for iron fortification and is a popular condiment in China. Iron absorption rates of NaFeEDTA and FeSO4 were observed and compared in adult female subjects. Methods The stable isotope tracer method was used in Chinese females consuming a typical Chinese diet. Ten healthy young Chinese women were selected as subjects in the 15-day study. A plant-based diet was used based on the dietary pattern of adult women in the 1992 National Nutrition Survey. Six milligram of 54Fe in 54FeSO4 soy sauce and 3 mg 58Fe in Na58FeEDTA soy sauce were given to the same subjects in two days. Food samples and fecal samples were collected and analyzed. Results Iron absorption rates of NaFeEDTA and FeSO4 were 10.51%±2.83 and 4.73%±2.15 respectively. The 58Fe(NaFeEDTA) absorption was significantly higher than that of 54Fe(FeSO4)(P<0.01). The iron absorption rate from NaFeEDTA was 1.2 times higher than that from FeSO4 in Chinese adult women consuming a typical Chinese diet. Conclusion The higher absorption rate of NaFeEDTA suggested that NaFeEDTA would be a better iron fortificant used in soy sauce for the controlling of iron deficiency anemia in China.     

小儿缺铁性贫血与全血微量元素关系的研究

目的：探讨小儿缺铁性贫血与全血微量元素关系。方法：120例缺铁性贫血患儿，抽血检测全血微量元素含量；并以80例健康小儿为对照。结果：120例缺铁性贫血患儿全血标本显示铜、锌、钙等微量元素均降低，而铅、镉等元素含量显著升高。结论：小儿缺铁性贫血与全血微量元素关系密切。     

柳州市444名婴幼儿铁缺乏调查结果分析

目的：了解柳州市婴幼儿铁缺乏状况，为防治婴幼儿铁缺乏症提供依据。方法：采用外周血检测血红蛋白、锌原卟啉、血清铁蛋白。结果：本次调查的444名婴幼儿中铁蛋白低3名（0．68％），锌原卟啉值增加65名（14．64％），缺铁性贫血49名（11．04％），均系轻度贫血。男、女比较无明显差异（P＞0．05）。少数民族儿童贫血发生率高于汉族儿童（P＜0．05）。结论：铁缺乏普遍存在，其原因并非是营养素缺乏，而是没有合理的添加辅食、重视平衡膳食和有效防治佝偻病。     

Artificial Intelligence Models for Predicting Iron Deficiency Anemia and Iron Serum Level Based on Accessible Laboratory Data

Iron deficiency anemia (IDA) is the most common nutritional deficiency worldwide. Measuring serum iron is time consuming, expensive and not available in most hospitals. In this study, based on four accessible laboratory data (MCV, MCH, MCHC, Hb/RBC), we developed an artificial neural network (ANN) and an adaptive neuro-fuzzy inference system (ANFIS) to diagnose the IDA and to predict serum iron level. Our results represent that the neural network analysis is superior to ANFIS and logistic regression models in diagnosing IDA. Moreover, the results show that the ANN is likely to provide an accurate test for predicting serum iron levels with high accuracy and acceptable precision.     

广西毛南族农村妇女铁营养状况调查

对450名广西环江县毛南族农村育龄妇女进行血清铁蛋白(SF)、红细胞游离原卟啉(FEP)及血红蛋白(Hb)3项铁指标测定.结果发现:铁缺乏症患病率为27.8%(其中ID4.2%,IDE 7.8%,IDA 15.8%).随着孕次或产次的增加,血红蛋白水平逐渐下降,铁缺乏症患病率逐渐增高.有妊娠或分娩史的妇女与未孕或未生育的妇女血红蛋白水平与铁缺乏症患病率比较均有显著性差异(P<0.05).     

昌吉市育龄妇女贫血状况调查分析

目的了解昌吉市育龄妇女贫血患病状况及有关影响因素,提出预防、干预措施。方法采用整群抽样方法,分别对2011年及2012年同期内的昌吉市城区工厂、机关、学校及周边农牧区的15～49周岁育龄妇女共计8709人进行血红蛋白(Hb)检测。选取2011年及2012年在我院住院的316例育龄贫血女患者,给予叶酸、维生素B12、铁蛋白测定,必要时行骨髓穿刺、活检等检查以明确病因。同时进行有关影响因素的问卷调查,进行统计分析。结果在所调查的8 709名育龄妇女中,2011年贫血患病率为18.15%,2012年为19.36%,患病率无明显差异;2011年及2012年的昌吉市城区与周边农牧区贫血患病率均无明显差异;但妊娠期妇女贫血患病率均明显高于育龄期妇女。贫血患者中主要为缺铁性贫血。本调查分析与贫血发生有关的影响因素有年龄、民族、职业、饮奶茶习惯、月经情况、家庭收入情况、既往有无慢性病史、有无伴随消化道症状、工作压力等。结论昌吉市育龄期妇女贫血患病率略低于全国平均患病率,但整体人数仍巨大,尤在妊娠期患病率较高,需对贫血发生的影响因素进行干预,提高育龄期妇女的健康状况。     

Iron deficiency occurs frequently in patients with pernicious anemia

We assessed iron status in patients with pernicious anemia. Iron deficiency coexisted as a presenting finding in 25 (20.7%) of 121 patients for whom data could be evaluated. Another 27 patients (22.3%) developed iron deficiency one month to 14 years later (median, two years). It was impossible to predict such a development in these 27 patients from any of their initial findings. The cause of the iron deficiency was identified in 17 of the 52 iron-deficient patients and suspected in another four. These findings show that patients with pernicious anemia are at high risk for iron deficiency, both at initial presentation and subsequently. Although the cause of the iron deficiency is often not identifiable, clinically important entities are detected often enough to warrant routine investigation for iron deficiency in such patients.     

The impact of maternal iron deficiency and iron deficiency anemia on child’s health

Iron deficiency anemia is extremely common, particularly in the developing world, reaching a state of global epidemic. Iron deficiency during pregnancy is one of the leading causes of anemia in infants and young children. Many women go through the entire pregnancy without attaining the minimum required intake of iron. This review aims to determine the impact of maternal iron deficiency and iron deficiency anemia on infants and young children. Extensive literature review revealed that iron deficiency is a global nutritional problem affecting up to 52% of pregnant women. Many of these women are symptomatic. Lack of proper weight gain during pregnancy is an important predictor of iron deficiency.Anemia is generally defined according to hemoglobin levels, which may vary according to many factors most importantly age, gender, and ethnicity. Any level below 13 g/dL for males, and below 12 g/dL for females is considered abnormal.1 Hemoglobin levels of less than 11 g/dL at any time during pregnancy are considered abnormal. Once anemia is recognized, the possibility of iron deficiency should be considered.2 Abnormalities in red blood cell indices on complete blood count typically precede the development of lowered hemoglobin levels.3 Iron deficiency usually develops slowly over time, and may not be symptomatic, or clinically obvious. Once iron stores are completely depleted, iron accessibility to the tissues decline leading to symptomatic anemia. The objective of this review is to outline the impact of maternal iron deficiency, and iron deficiency anemia on infants and young children.

Iron metabolism

Iron is a crucial component in the metabolic processes involved in tissue oxygenation. An average individual contains a total of 3-5 grams of iron. A standard diet could supply up to 15 mg of iron per day. The acidic environment aids iron absorption, which takes place in the first, and second parts of the small intestine. Iron absorption is therefore enhanced by the co-administration of acidic compounds, such as ascorbic acid. Iron absorption is also normally enhanced in response to heightened needs. After absorption, protein-bound iron is transported into the bone marrow for incorporation in the production of red blood cells.4 Excess iron is stored as ferritin, a labile, and easily available provider of iron.

Epidemiology

Iron deficiency is the most globally prevalent nutritional problem reaching an epidemic level in many developing countries.5 In addition, it is the most common nutritional deficiency encountered in the developed world;6 up to 50% of cases are the result of insufficient iron intake.7 Pregnancy is associated with increased iron demand, and therefore, increase the risk of iron deficiency anemia. Up to 52% of pregnant women in the developing world are affected.8 Lowered iron stores in their newborn baby will increase the risk of subsequent iron deficiency anemia. Prematurity and early weaning off breastfeeding increases the risk further, because of reduced iron stores. Other causes and risk factors for developing iron deficiency anemia are summarized in 9

Table 1

Common causes of iron deficiency anemia.9Open in a separate window

Iron deficiency anemia

Typical features of iron deficiency anemia are caused by lowered oxygen delivery to the tissues, and include pallor, fatigue, apathy, fainting, and breathlessness.2,9 Additional features include headaches, palpitation, hair loss, and tinnitus. Chronic iron deficiency anemia lowers work tolerance, productivity, and the quality of life. This leads to further socio-economic difficulties. Dysfunction in the immune system results in increased risks for infections.9With more severe degrees of anemia, cardiac failure may develop. During pregnancy, iron deficiency anemia correlates with negative perinatal outcomes including premature labor, intrauterine growth retardation, low birth weight, birth asphyxia, and neonatal anemia.2,6

Nutritional factors

Pregnancy and lactation result in increased iron demands. The nutritional status is the key in preventing iron deficiency. A healthy varied diet can be routinely supplemented by prophylactic doses of iron to prevent depletion of iron stores. The total iron intake during pregnancy should not be less than 1000 mg.10A recent study9 found that most pregnant women were not receiving adequate amounts of iron, despite taking fortified food and supplementation. Even in developed countries, such as the United Kingdom (UK), up to 50% of women during their reproductive age have poor iron residual supplies, and are at risk of developing anemia if they conceive.9 Another UK study11 found that 40% of women aged between 19-34 years had iron levels below the recommended doses.Normal weight gain is an indicator of proper maternal nourishment. Healthy weight prior to conception and an average weight gain of 12 kg (10-14 kg) is linked to favorable perinatal outcomes.12 This results in the delivery of a baby with a healthy birth weight of 3.1-3.6 kg.12,13 Ideal maternal weight gain may be difficult to achieve in practice. Therefore, enhanced physical activity should be combined with nutritious food that does not promote excessive weight gain, which is also a risk factor for iron deficiency. Vegetarians and vegans may require additional iron fortified food and supplementation to prevent the possible shortages of dietary intake.12Teenage mothers are another group of women at increased risk. They have a greater nutritional requirement due to their own growth spurts.14,15 Teenage pregnancies are usually unplanned, and therefore these mothers may already experience suboptimal nutritional status prior to conception making them at an even higher risk for developing iron deficiency anemia.14

Impact of iron deficiency anemia

Throughout pregnancy, iron deficiency anemia adversely affects the maternal and fetal well-being, and is linked to increased morbidity and fetal death. Affected mothers frequently experience breathing difficulties, fainting, tiredness, palpitations, and sleep difficulties.16 They also have an increased risk of developing perinatal infection, pre-eclampsia, and bleeding. Post-partum cognitive impairment and behavioral difficulties were also reported.17-19 Adverse perinatal outcomes include intrauterine growth retardation, prematurity, and low birth weight, all with significant mortality risks, particularly in the developing world.20-22 Iron deficiency during the first trimester, has a more negative impact on fetal growth than anemia developing later in pregnancy.23,24 This is also true for risk of premature labor.25 Poor socio-economic status contributes significantly to all aspects of these inter-linked problems that are more commonly encountered in the developing world. Any successful public prevention or treatment program should put into consideration all these contributing and correlating factors.Lowered iron stores of the newborn child may persist for up to one year and result in iron deficiency anemia.26 Such a state should be identified and treated promptly because of the possible long term consequences. Iron is essential for neural metabolism and functioning. Iron deficiency anemia results in changes in energy metabolism within the brain with defects in neurotransmitter function and myelination.27 Therefore, infants and young children with iron deficiency anemia are at risk of developmental difficulties involving cognitive, social-emotional, and adaptive functions.28,29 Other studies have documented delays in both language and motor development. Breastfeeding is usually protective, but not if the mother is iron deficient. It has been noted that iron levels in breast milk fall as lactation progresses over time.30 Careful monitoring and adequate supplementation is therefore needed for infants at risk.

Iron supplementation

Routine maternal iron supplementation is a vital mean in correcting the global problem of iron deficiency and preventing its negative effects.31 Whilst oral supplementation is most prevalent, it is also possible to provide iron parentally (intramuscular or intravenous). Prophylactic oral iron supplementation can be associated with some side effects, such as nausea and constipation, which are normally more common during pregnancy. It is ideal to start iron supplementation before conception, or as soon as possible, in order to reduce the risks of prematurity and low birth weight.32 It is also important to note the importance of other micronutrients, such as zinc, copper, vitamin A and E, on fetal growth and development.33 Further research is required to clarify the need for such supplementation and the recommended doses.Iron treatment should be started once iron deficiency anemia is recognized in infants and young children. However, several randomized control trials found no benefits on future psychomotor development.34Another review of several randomized controlled trials of children found that iron treatment did not result in an enhanced cognitive function in children less than 5 years of age.35 This suggests that early prophylaxis is better than delayed treatment. However, recent studies indicated some cognitive and motor benefits from treating children less than 5 years of age.36 In addition, iron supplementation improved the attention and concentration of adolescents and adult women with symptomatic iron deficiency anemia, suggesting more positive effects of treating severe degrees of anemia.37-39In conclusion, adequate iron intake is crucial for healthy pregnancy. However, adequate nutrition may not be possible in many developing countries. Iron supplementation should be considered early in these cases. There is an increasing need for public health strategies to educate the population as to the need for a healthy diet and iron supplementation before conception, or at least at the beginning of the pregnancy. Integrating this information into educational curricula, pre-marital counselling, and prenatal care is needed. Mothers should receive appropriate nutritional advice and supplementation at their first point of contact with healthcare professionals.     

Clinical presentations,radiological characteristics,and biological risk factors of cerebral venous thrombosis at a University Hospital in Saudi Arabia

Objectives:To describe the clinical features and possible etiologies of cerebral vein thrombosis (CVT) in a Saudi Arabian cohort.Methods:A retrospective, observational design was implemented. Data pertaining to 36 patients (19 female and 17 male) with confirmed CVT diagnosis admitted to a hospital in Saudi Arabia between 2008 and 2019 were obtained and analyzed.Results:The age of patients ranged between 19 to 82 years, and the mean/median age was 33/29 years. Most commonly reported symptoms were headache ( 72%), unilateral lower limb weakness (39%), and seizures (17%). Papilledema was found in 8% of patients. Thrombotic disorders were identified in 14% and infections were identified in 8% of the patients. Two patients had ulcerative colitis, 2 were diagnosed with Behcet’s disease, and 2 women were using oral contraceptive pills. Single sinus thrombosis was detected in only 22% of patients. One patient with diabetic ketoacidosis died. Thrombotic disorder was the most common risk factor, followed by that iron deficiency anemia.Conclusion:The transverse sinus was the most frequently thrombosed sinus. Iron deficiency anemia emerged as a predisposing preventable condition for CVT, while genetic factors were found to be less important in this cohort.     

贫血患者血清铁铁蛋白细胞内外铁检测结果分析

目的探讨各类贫血患者血清铁、铁蛋白和骨髓细胞内外铁含量多或寡与贫血症的相互关系.方法应用比色法、放射免疫法和普鲁士兰反应法检测186例各种贫血患者血清铁、铁蛋白浓度和细胞内外铁粒、铁小珠的含量.结果急、慢性白血病贫血、再生障碍性贫血、铁粒幼红细胞性贫血、溶血性贫血、巨幼红细胞性贫血患者血清铁浓度升高;肾性贫血、肝性贫血、缺铁性贫血、肿瘤性贫血、骨髓增生异常综合症(MDS-RA)患者血清铁下降;铁蛋白增高主要见于急、慢性白血病贫血和铁粒幼红细胞性贫血、肿瘤性贫血及骨髓增生异常综合症等;细胞内外铁颗粒减少和外铁消失主要见于缺铁性贫血和肾性贫血.结论检测血清铁、铁蛋白和细胞内外铁能灵敏地反映机体铁的贮存和利用水平;恶性肿瘤或其它细胞快速增殖时,细胞合成铁蛋白的能力较强.     

136例缺铁性贫血病因分析

目的 分析总结缺铁性贫血的主要病因.方法 回顾分析台山市第二人民医院2003年1月至2008年12月门诊及住院的136例缺铁性贫血患者的临床资料.结果 男性病例中,胃肠道疾病是引起缺铁性贫血的主要病因,其中最为常见的是消化性溃疡、慢性胃炎,占46%,痔疮占10%;其次是钩虫病,占10%.女性病例中,月经过多是最主要的病因,占39%;其次是消化性溃疡、慢性胃炎,占21%;再次是妊娠、哺乳,占8%.结论 除月经过多、妊娠、哺乳等女性特殊生理时期外,从总体上看,消化性溃疡、慢性胃炎等胃肠道疾病是引起15岁以上人群缺铁性贫血的主要原因占31%应引起重视.     

探讨孕前孕期补铁现状及其对孕产妇贫血影响的研究

目的探讨孕产妇在孕前孕期铁剂补充现状以及其对孕产妇贫血影响的研究。方法采用分层随机抽样方法,随机抽取2011年1月～2012年1月妊娠满37周的孕妇或者在助产机构住院分娩的处于产褥期的产妇,且孕期或者分娩后3~7 d内做过至少1次及以上的血常规检查者作为研究对象,运用问卷调查和血液检测方法,了解其铁剂补充现状和贫血情况。结果本次共调查2 019名孕产妇,其中有32.19%孕产妇在孕前孕期补充过铁剂。孕产妇补充铁剂时期、频率以孕期、"每天1次"为主,91.54%铁剂的补充是在医生指导下进行的。补充过铁剂的孕产妇贫血患病率低于未补充者。孕前/孕期都补充铁剂、补充频率为"每天1次"、经医生指导补铁的孕产妇的贫血患病率较低。结论补充铁剂能有效预防孕产妇贫血,建议从孕前至整个孕期都应科学合理的补充铁剂,降低贫血的发生。     

6月-36月婴幼儿缺铁性贫血相关因素分析

目的分析导致婴幼儿缺铁性贫血（iron deficiency anemia,IDA）的相关危险因素。方法 2010年10月-2011年10月在山西省儿童医院血液科住院治疗的缺铁性贫血患儿和同期在儿保科门诊体检的健康婴幼儿各65例,进行回顾性病例对照研究。收集其性别、年龄、胎龄、出生体重等信息,建立Logistic回归模型,进行单因素及多因素分析。结果单因素分析结果其中患儿居住地、家庭经济状况、母亲文化程度、父亲文化程度、是否接受育儿指导、母乳喂养、添加辅食时间、添加富含铁的食物、出生体重、是否早产、母亲晚期贫血等11个因素有统计学意义（P〈0.05）,提示这些因素可能和婴幼儿缺铁性贫血的发生有关。然后把这11项结果进行Logistic多因素分析,其中喂养方式、经济状况、母亲文化程度、添加辅食时间、辅食种类、出生体重、母晚期贫血情况7项指标在多因素条件Logistic回归分析中有统计学意义（P〈0.05）。结论结果提示喂养方式、经济状况、母亲文化程度、添加辅食时间、辅食种类、出生体重、母晚期贫血情况7项指标与婴幼儿缺铁性贫血的发病密切相关,可能为引起婴幼儿缺铁性贫血较显著的危险因素。