中国九市四至七岁儿童乳恒牙替换及其与体格生长的相关性分析

目的探讨中国9个城市(简称九市)4~7岁儿童乳恒牙替换及其与体格生长的关系,分析恒牙发育长期变化趋势。方法采用分层整群抽样的方法,以4~7岁儿童为调查对象,于2015年6—10月在北京、哈尔滨、西安(北片),上海、南京、武汉(中片),广州、福州、昆明(南片)九市进行横断面调查,共37973名儿童,其中男19035名,女18938名。6岁以下每6个月为1组,6~<7岁1岁为1组。现场检查乳牙脱落、恒牙萌出情况,测量身高、体重等,并依据2009年中国儿童生长标准计算体格指标Z分值。采用Probit概率单位回归方法计算换牙年龄。不同性别、地区、年龄分组组间比较采用χ2检验或t检验。并利用1995年中国九市儿童体格发育调查中乳恒牙替换相关数据,分析恒牙发育的长期变化趋势。结果九市37973名儿童随着年龄增长换牙率逐渐增加,从4.0~<4.5岁的0.6%(42/7568)增长至5.5~<6.0岁的30.3%(2295/7583),6.0~<7.0岁达到74.5%(5680/7627)。除4.0~4.5岁组外,无论城郊男童换牙率均低于女童(P均<0.05);城区换牙率(男5.5~<6.0岁、女4.5~<5.0岁组之后)略高于郊区,如6.0~<7.0岁组男童城郊分别为74.2%(1427/1924)、69.2%(1305/1885)(χ2=11.446,P<0.01)。九市儿童换牙年龄为6.00(95%CI:5.98~6.01)岁。换牙年龄的第3~97百分位变化范围为4.88~7.11岁。女童中位换牙年龄(5.94岁)早于男童(6.06岁);城区(5.94岁)早于郊区(6.05岁);北片(5.97岁)、中片地区(5.97岁)略早于南片地区(6.05岁)。已换牙儿童体重、身高、体质指数Z分值均高于未换牙儿童(0.35±1.17比0.03±1.13、0.32±1.00比0.03±1.02、0.23±1.16比0.04±1.13,t=20.81、21.67、12.09,P均<0.05)。与1995年相比,2015年5.0岁以后儿童换牙率明显提高,如城区男童6.0~<7.0岁组1995年为63.8%(1146/1796),2015年提高至74.2%(1427/1924)(χ2=46.748,P<0.01);中位换牙年龄2015年较1995年提前0.24岁。结论九市4~7岁儿童换牙年龄女童早于男童,城区早于郊区,北、中片早于南片地区。换牙早晚与体格生长水平有关。近20年换牙年龄存在小幅提前趋势。     

山东省淄博地区身材矮小儿童发病率调查及病因分析

目的　调查淄博地区身材矮小儿童发病率和病因构成。方法　采用随机整群抽样法 ,对淄博市城区和郊区的 18所小学共 15479例 7～ 13岁小学生普查身高 ,对身高不足同年龄同性别儿童平均身高 -2s者详细询问病史、全面体检并行有关实验室检查。结果　共检出身材矮小儿童 99例 ,总检出率为 0 .64% ,其中城区为 0 .8% ,郊区为 0 .41% ,经统计学处理有显著性差异 (χ2 =10 .68　P <0 .0 1)。性别和各年龄组身材矮小儿童的检出率无统计学差异 (χ2 =2 .55,4.18　P均 <0 .0 5)。结论　身材矮小儿童的总检出率较 80年代明显下降 ,城区检出率高于郊区。病因构成以生长激素缺乏症 (GHD)占首位 (2 4/78,3 0 .8% ) ,锌缺乏症也占一定比例(14 /90 ,15.6% )。     

2005年中国九市七岁以下儿童体格发育调查

目的了解和掌握我国儿童的体格发育现状及变化趋势,并提供0—7岁儿童的体格发育参考数据。方法采取随机整群抽样方法,调查北京、哈尔滨、西安、上海、南京、武汉、福州、广州、昆明九市及其郊区农村7岁以下儿童体格发育状况,包括体重、身高（长）、坐高（顶臀长）、头围、胸围5项指标;分男、女22个年龄组,各年龄组100—150人,共138775人。结果2005年九市儿童的体重、身高和坐高值与1995年相比有明显的增长,并且随年龄增长,增幅逐渐增大;头围、胸围也有不同程度增长。城区、郊区之间仍存在明显差别,但郊区儿童的身高增长速度快于城区,城市与郊区儿童的身高差别逐渐缩小。九市1975至2005年的4次调查数据比较显示：30年间我国儿童的体重、身高值呈现快速增长趋势,表现为第2个10年的增长速度快于第1个10年,第3个10年的增长速度又快于第2个10年。结论我国九市城区与郊区7岁以下儿童的体格发育生长水平及营养状况较10年前有明显改善,我国儿童体格生长发育仍处于长期趋势中的快速增长阶段。九市儿童的平均生长水平已达到2006年世界卫生组织颁布的儿童生长标准。     

营养性疾病

980096江门市。一6岁儿童营养不良流行病学调查研究/彭晓珊…//中华儿童保健杂志一1996,4(2)一76一78 用分层随机整群抽样的方法对江门市区6 988名0一6岁儿童进行营养不良流行病学调查,采用年龄别体重、年龄别身高和身高别体重作为评价指标,用标准差记分评价法与1985年我国九市男女身高、体重测量值为参照人群进行比较,以分析江门市区儿童营养不良的患病中国医学文摘·儿科学1998年第17卷第1期情况。结果示中、重度低体重、发育迟缓、消瘦3种表现类型的营养不良患病率分别为3.22%、5.31%和0.77%。郊区儿童患病率高于城区;1一2岁年龄组患病率…     

郑州地区7~12岁儿童血压分布特征

目的：了解郑州地区7~12岁儿童的血压现况。方法按分层整群随机抽样法抽取郑州市3个城区和2个郊区县的5所学校6~13岁在校儿童,测量身高、体质量、腰围、臀围、收缩压(SBP)和舒张压(DBP),对相关数据进行分析。结果调查的7~12岁儿童有效人数为6460人,其中城区3206人(49.63%),郊区县3254人(50.37%);男童3525人(54.57%),女童2935人(45.43%)。男童的SBP(117.86±18.18)mmHg明显高于女童(113.82±13.11) mmHg,差异有统计学意义(t=3.16,P=0.002)。高血压发生率7.52%;其中男童高血压发生率明显高于女童,差异有统计学意义(χ2=9.66, P=0.002);无论男、女童,城区儿童高血压发生率均高于郊区县,差异有统计学意义(χ2=24.15、14.39,P均=0.000)。男童的SBP和DBP,女童SBP均与年龄、身高、体质量、BMI、腰围呈显著正相关(P均<0.01)。结论郑州地区儿童青少年血压的分布特征为男性高于女性,城区高于郊区县,儿童血压与年龄、身高、体质量、BMI、腰围密切相关。     

上海市城郊两区整群抽样6～18岁儿童青少年身高分布特点及矮小症患病率调查

目的 研究上海市6~18岁儿童青少年身高及矮小症患病率分布特点。方法 采用整群抽样抽取上海市1个城区和1个郊区,普查2个区内所有6~18岁共70 431名中小学生的身高。分析身高的年龄别分布特点,并与1975、1995年全国和上海市学生体质测试标准进行比较;并以1995年上海市身高评价标准进行评价,分析矮小症患病率分布特点。结果 ①研究人群中身高特点为男性显著高于女性（P<0.000 1）。②男性身高增长以6~15岁较为明显,11岁后身高增长加快,15岁后增幅减小;女性身高增长在6~14岁较为明显,10岁以后增长加快,14岁后增幅减小。③与全国身高标准相比,上海城区和郊区儿童青少年的各年龄组身高均高于全国标准。与1975年上海儿童青少年身高参考标准相比,身高增长分别为城区男性(6.4±2.1) cm,郊区男性(10.5±2.5) cm,城区女性(4.8±0.9) cm,郊区女性(8.6±1.9) cm,其中以郊区儿童青少年特别是11岁以上儿童青少年身高增长更为显著;而城区儿童青少年身高在1995至2003年的增幅较小,在1975至1995年增幅较大。④上海市儿童青少年各年龄组总体矮小症的患病率为0.5%~6.03%,平均患病率为3.77%;城区矮小症的粗患病率为2.78%,标准化患病率为2.57%;郊区矮小症的粗患病率为4.52%,标准化患病率为3.75%。矮小症患病率在13岁以前较高;城区矮小症患病率低于郊区,男、女矮小症患病率在城区相近,在郊区则男性高于女性。结论 上海市儿童青少年身高生长曲线存在性别的三相性差异,6~9岁和12~18岁均呈现男高女低,10~11岁呈现女高男低的特点。1975至2003年上海儿童青少年身高均呈现显著增长现象,但城区儿童身高在1995年后增幅明显减小。上海儿童青少年平均矮小症患病率为3.77%,患病率在13岁以前较高;郊区儿童青少年矮小症患病率高于城区。     

不同参考标准下重庆城区儿童超重／肥胖检出率比较

目的比较3种筛查标准下重庆城区儿童超重/肥胖现况,寻求适宜的儿童肥胖筛查标准。方法按照整群抽样原则抽取本市3个城区的12534名2～18岁儿童作为调查对象,测量其身高及体质量。并分别采用WHO的身高标准体质量法标准(标准1)、国际肥胖工作组(IOTF)的超重/肥胖体质量指数(BMI)标准(标准2)和国立卫生统计中心/疾病预防控制中心(NCHS/CDC)的BMI标准(标准3)评价儿童的超重/肥胖。结果按照标准1、2和3的规定,重庆城区儿童的超重检出率分别为13.0%、9.8%、9.8%;肥胖检出率分别为9.8%、2.9%、6.0%,均有显著性差异(Pa<0.001),且男童超重/肥胖检出率均高于女童。3种标准间,健康儿童、超重儿童或肥胖儿童的BMI均值均有显著性差异(Pa<0.001)。采用标准1和2得到的超重检出率,或采用标准1和3得到的超重检出率均在6岁前和14岁后2个年龄段存在统计学差异(Pa<0.01)。在2～6岁各年龄组,采用标准1和3得到的儿童肥胖检出率比较无显著性差异;在6～18岁各年龄组,采用标准1得到的肥胖检出率均显著高于采用标准2和3得到的肥胖检出率(Pa<0.01);在3～6岁、8～10岁、13岁组采用标准2和3得到的儿童肥胖检出率比较有显著性差异。结论儿童肥胖已经成为重庆城区重要的健康问题之一。采用3种标准筛查的儿童超重/肥胖检出率在2～18岁各年龄组均有所不同,应谨慎使用。     

儿科基础

960001四川农村0一3岁儿童体格发育现状/刘震…//四川医学一1995,16(2)一91一93 对6694名儿童随机抽样调查。结果:四川农村O一3岁儿童的平均体重、身高均明显低于九市城区同龄儿童,但与郊区同龄儿童相同。绵竹、蒲江,剑阁分别代表平原、丘陵、山区三县儿童,各年龄组平均体重很近似。36个月平均分别为12     

宁夏吴忠市7岁以下儿童生长状况及影响因素分析

目的：了解宁夏吴忠市7岁以下儿童生长状况及影响因素,为制定相关干预措施提供参考依据。方法：采用分层整群的抽样方法,对宁夏吴忠市两县区7岁以下儿童进行了调查,生长状况采用Z评分法评价。结果：7岁以下儿童生长迟缓、低体重、消瘦的发生率分别为12.58%、5.71%、5.55%。儿童年龄的身高Z评分(HAZ)、年龄的体重Z评分(WAZ)以及身高的体重Z评分(WHZ)均值分别为-0.26±2.50、0.29±4.54和0.65±3.02。不同民族儿童消瘦发生率差异有统计学意义（P＜0.05）,不同地区和不同年龄段儿童生长迟缓发生率、低体重的发生率差异有统计学意义（P＜0.05）。儿童生长迟缓的主要影响因素为地区（OR=0.369,P＜0.001）、民族（OR=1.694,P=0.027）、儿童年龄（OR=1.143,P=0.002）。低体重的主要影响因素为地区（OR=0.453,P=0.001）、儿童年龄（OR=1.204,P=0.002）。消瘦的主要影响因素为民族（OR=1.735,P=0.024）。结论：吴忠市7岁儿童生长水平欠佳,其生长水平与民族、地区、年龄等因素有关。     

中国7岁以下儿童重量指数的生长规律及参照标准建立

目的 分析中国7岁以下正常儿童重量指数（PI）随年龄增长的变化规律,制定0~2岁儿童PI的参照标准及生长曲线。方法 体重和身高测量值来自2005年“中国九市7岁以下儿童体格发育调查”,根据体重和身高测量值计算PI值［体重(kg)·身长-3(m-3)］,并建立7岁以下正常儿童PI数据库。分析PI在各主要百分位（P3、P50及P97）上的变化规律,比较PI在性别和城郊群体水平上的差异。以3岁以下儿童为参照人群,采用LMS方法建立PI参照值及标准化曲线,模型构建使用LMS Pro软件。选择“转换年龄”模式,具体参数：男性自由度L-M-S=3-11-6,POWER=0.05及OFSET=0.10;女性自由度L-M-S=3-11-4,POWER=0.05及OFSET=0.15。结果 0~7岁儿童总样本量为138 775名,其中城区69 760名（男34 901名,女34 859名）,郊区69 015名（男34 650名,女34 365名）,男女及城郊样本量各半,各年龄组1 496~1 666名。0~2岁儿童曲线拟合的数据：男23 703名,女23 625名,每年龄组1 512~1 622名。①PI随年龄增长先攀升,2~3月龄达峰值,然后急速下降,2岁以后趋缓,并随年龄增长持续缓慢下降。男女间、城郊间差异均不明显;但在1月龄至3岁,男性略高于女性,1~6月龄及2~3岁时郊区略高于城区。②采用百分位和标准差单位两种表达形式给出0~2岁儿童数值及标准化生长曲线图。结论 本研究分析了中国7岁以下正常儿童PI的生长规律,建立了0~2岁儿童PI的参照标准及生长曲线,为进一步研究和应用PI奠定基础。     

Prevalence and correlates of stunting among primary school children in rural areas of southern Pakistan

Protein-energy malnutrition is one of the leading causes of childhood morbidity and mortality in developing countries. The purpose of the present study was to measure the prevalence of stunting and its correlates among school children aged 6-12 years in the rural areas of southern Pakistan. We selected 1915 children aged 6-12 years enrolled in 32 primary schools in rural Sindh, Pakistan. Trained community health workers conducted child height and weight measurements and collected information from the parents. The Z-scores for the distribution of height-for-age, weight-for-age, and weight-for-height relative to those of National Center for Health Statistics/Center of Disease Control and prevention (NCHS/CDC) reference population were calculated. Out of 1915 children, 300 (16.5 per cent) were stunted. Female children compared to males were more likely to be stunted (prevalence ratio (PR) = 1.26; 95 per cent confidence interval (CI): 1.02-1.53). Children older than 7 years were more likely to be stunted (PR, 1.40; CI, 1.14-1.72). Fathers who were working as government employees (PR, 1.71; CI, 1.05-2.79), shopkeepers (PR, 2.00; CI, 1.22-3.26) and farmers (PR, 1.43; CI, 0.93-2.22) were more likely to have children who were stunted when compared to landlords. In rural areas of southern Pakistan, sex of child, age of the child, and father's occupation may be considered as important risk factors for stunting among school children aged 6-12 years.     

Height and weight of urban preschool children in relation to their mothers' educational levels and employment status in Rasht City, northern Iran

This study determined the relationship between anthropometric status of 3-5-year-old urban children and theirs mothers' educational levels and employment status in Rasht City, northern Iran. A total of 1319 children (638 girls and 681 boys) at the ages of 3 and 6 years in all day-care centres in Rasht City were studied, using a cross-sectional design. Height and weight of the children were measured, and data on mothers' educational levels, employment status and duration of any breastfeeding were collected. Height for age, weight for age and weight for height of the children were compared with the National Center for Health Statistics (NCHS) reference population of the United States, and z-values 12 years of schooling, OR = 1.87; 95% CI: 1.08-2.4) had higher relative risk for underweight than children of mothers with an intermediate level of education (5-12 years of schooling). Children of mothers with college education were also more at risk for development of stunting (OR = 1.41; 95% CI: 1.14-4.22). In addition, children of employed mothers were more likely to be underweight (OR = 1.52; 95% CI: 1.05-2.31), stunted (OR = 2.42; 95% CI: 1.21-6.35) and wasted (OR = 3.35; 95% CI: 1.21-5.58) than children of non-employed mothers. The relative risk for undernutrition was higher in the children of both less and highly educated mothers compared with children of mothers with an intermediate level of education. Mothers' employment was also negatively related to nutritional status of these children in day-care centres in Rasht City.     

成都地区0~14岁城乡儿童哮喘流行病学调查对比分析

目的：探讨成都地区不同生活环境、不同经济水平和不同卫生条件下0~14岁城乡儿童哮喘的患病率、发病规律及影响因素。方法：首先确定调查对象为中心城区、城镇及农村3个层面的0~14岁儿童,采取随机、整群和不等比抽样方法抽出所需调查的学校、幼儿园及社区的全部0~14岁儿童为调查对象,向家长发放问卷初筛表,然后筛选出相关疾病的可疑患者,再经呼吸专科医师问诊和体查以明确诊断。所有数据经SPSS统计软件分析。结果：中心城区、城镇及农村3个层面实际调查人数分别12082例、5677例及5590例,确诊哮喘、咳嗽变异性哮喘患儿分别为551例、150例及142例,累计患病率分别为4.56%、2.64%及2.54%,中心城区累计患病率明显高于城镇和农村。至调查时中心城区准确诊断率最高,城镇其次,农村诊断率最低。在哮喘的治疗中,从中心城区到城镇到农村,抗生素的使用率逐级增加、吸入激素及白三烯调节剂的使用率呈逐级减少的趋势。3层面显示患儿的性别、年龄、首次发作年龄、呼吸道感染和遗传因素等均与哮喘发病有关。结论：人口密度和生活环境的差异、医疗卫生资源和经济收入的不同可影响哮喘的患病率和治疗。     

Stunting, underweight and wasting among Integrated Child Development Services (ICDS) scheme children aged 3-5 years of Chapra, Nadia District, West Bengal, India

This study investigated age and sex variations in height and weight, levels of stunting, underweight and wasting among 533 (254 boys; 279 girls) 3- to 5-year-old rural children of Bengalee ethnicity at 11 Integrated Child Development Services centres of Nadia District, West Bengal, India. Height-for-age, weight-for-age and weight-for-height < -2 z-scores were used to evaluate stunting, underweight and wasting, respectively, following the National Center for Health Statistics (NCHS) Guidelines. Results revealed that boys were significantly heavier than girls at age 3 years. Significant age differences existed in mean height and weight in both sexes. Mean z-scores of height-for-age, weight-for-age and weight-for-height were lower than those of NCHS for both sexes at all ages. The overall (age and sex combined) rates of stunting, underweight and wasting were 23.9%, 31.0% and 9.4%, respectively. The rate of underweight and wasting was higher among girls (underweight = 35.1%, wasting = 12.2%) compared with boys (underweight = 26.5%, wasting = 6.3%). In general, the frequency of stunting increased with increasing age in both sexes. Based on the World Health Organization classification of severity of malnutrition, the overall prevalence of underweight was very high (>or=30%). The prevalence rates of stunting (20-29%) and wasting (5-9%) were medium. In conclusion, the nutritional status of the subjects is unsatisfactory. There is scope for improvement in the form of enhanced supplementary nutrition.     

A health and nutritional profile of rural school children in KwaZulu-Natal, South Africa

A community-based cross-sectional study was undertaken to measure anthropometric indices, micronutrient status and prevalence of parasite infections in 579 rural South African primary school children. Eleven schools were selected randomly from a Magisterial District in southern KwaZulu-Natal (KZN). In each school, all pupils aged between 8 and 10 years were selected. The following outcome measures were obtained: anthropometric--height for age, weight for age and body mass index; micronutrient status--anaemia, serum ferritin and vitamin A; and prevalence of parasite infections--Ascaris lumbricoides, Trichuris trichiura and Schistosoma haematobium. The observed prevalences were: stunting 7.3%, underweight for age 0.7%, and obesity 3.1%; anaemia 16.5% (Hb < 12 g/dl), vitamin A deficiency 34.7% (serum retinol < 20 micrograms/dl) and 28.1% with reduced serum ferritin (< 12 ng/ml); Trichuris trichiura 53.9%, Ascaris lumbricoides 27.3% and Schistosoma haematobium 24.5%. We conclude that micronutrient deficiency, parasitic infestations and stunting remain significant problems among school-aged children in South Africa. Micronutrient supplementation and de-worming provide opportunities for school-based health promotion and primary health care interventions, and might produce significant health and educational benefits.     

全国31个城市儿童食物过敏自我报告率调查

目的 了解全国主要城市儿童食物过敏患病现状.方法 采用问卷方式对全国31个城市0~14岁儿童进行调查,获得食物过敏家长报告率.采用EpiInfo软件对数据进行双录入比对校正,SPSS20.0软件包进行统计分析.结果 全国31城市共337560名0~14岁儿童参加了调查,共有19676人自我报告过敏(5.83%).以华东及东北地区食物过敏家长报告率最高,过敏人数分别为5259(7.38%)和2916(7.03%),西北地区最低,有2419(4.35%)人报告食物过敏;在不同地区之间,食物过敏报告率的差异存在统计学意义(χ2=657.01,P<0.001).在不同城市之间,青岛食物过敏患病率最高,为9.11%(917/10066),拉萨最低,为2.33%(116/4984).不同性别儿童食物过敏报告率分别为5.87%(男)和5.79%(女),差异无统计学意义(χ2=1.08,P=0.299).学龄前儿童(3~5岁)食物过敏报告率(6.65%)最高,与其他年龄段比较差异存在统计学意义(χ2=46.47,P<0.001).在家长自报有食物过敏的儿童中,38.5%有湿疹病史,23.0%有过敏性鼻炎病史,37.7%有家族过敏史.结论 全国31个城市0~14岁儿童食物过敏的家长报告率为5.83%,在不同地区、不同城市及不同年龄段儿童,食物过敏患病率存在显著差异,在不同性别之间未发现食物过敏报告率存在显著差异.     

Patterns in child stunting by age: A cross-sectional study of 94 low- and middle-income countries

Child stunting prevalence is primarily used as an indicator of impeded physical growth due to undernutrition and infections, which also increases the risk of mortality, morbidity and cognitive problems, particularly when occurring during the 1000 days from conception to age 2 years. This paper estimated the relationship between stunting prevalence and age for children 0–59 months old in 94 low- and middle-income countries. The overall stunting prevalence was 32%. We found higher stunting prevalence among older children until around 28 months of age—presumably from longer exposure times and accumulation of adverse exposures to undernutrition and infections. In most countries, the stunting prevalence was lower for older children after around 28 months—presumably mostly due to further adverse exposures being less detrimental for older children, and catch-up growth. The age for which stunting prevalence was the highest was fairly consistent across countries. Stunting prevalence and gradient of the rise in stunting prevalence by age varied across world regions, countries, living standards and sex. Poorer countries and households had a higher prevalence at all ages and a sharper positive age gradient before age 2. Boys had higher stunting prevalence but had peak stunting prevalence at lower ages than girls. Stunting prevalence was similar for boys and girls after around age 45 months. These results suggest that programmes to prevent undernutrition and infections should focus on younger children to optimise impact in reducing stunting prevalence. Importantly, however, since some catch-up growth may be achieved after age 2, screening around this time can be beneficial.     

Prevalence of undernutrition in Santal children of Puruliya district, West Bengal

This study was carried out to determine the prevalence of undernutrition among the Santal children of Puruliya district of West Bengal. 442 Santal children (216 boys and 226 girls) aged 5-12 years were taken from randomly selected schools of Balarampur and Baghmundi areas of Puruliya. Nutritional status was analyzed by Z-score values according to the height for age, weight for age and weight for height reference data of National Center for Health Statistics (NCHS). The prevalence of undernutrition among Santal children was as follows: stunting (17.9%), underweight (33.7%) and wasting (29.4%). Severe (below -3 Z-score) stunting, underweight and wasting were found in 4.98%, 7.92% and 9.51% of Santal children, respectively. In girls, prevalence of stunting (21.7%) and wasting (35.8%) was higher in comparison to boys (13.8% stunting and 22.7% wasting).