上海儿童青少年铁缺乏及贫血与有关因素的研究

目的:调查分析上海市儿童青少年贫血患病率现况及影响因素。方法:随机分层抽取市区和郊区6～17岁中小学生948名进行健康问卷调查和贫血筛检;依据WHO标准按病例(贫血)与对照(非贫血)1∶1配对各118例,测定血清铁蛋白(serumferritin,s-FT)、运铁蛋白受体(transferrinreceptor,TfR)、血清铁(seruniron,SI)、总铁结合力(totalironbindingcapacity,TIBC)、运铁蛋白饱和度(transferrinsaturation,TS)、VB12、叶酸、血铜、血铅、肠道寄生虫感染、膳食营养素摄入量、膳食备份铁含量。结果:受试者贫血患病率为19.9%,大多数为轻度贫血。贫血组体内铁营养状况明显低于对照组,而血铅含量高于对照组,差异有显著性(P<0.05);未发现血清VB12、叶酸、铜以及肠道寄生虫感染与贫血的关系。膳食调查显示受试者总铁摄入量超过DRI,但是膳食备份测定铁的实际含量为膳食调查方法的71%～85%,病例组低于对照组。结论:上海市儿童青少年贫血患病率为19.9%,主要是缺铁性贫血,实测膳食铁和调查血红素铁的摄入量病例组低于对照组。贫血组血铅高于对照组,铅超载与贫血的关系有待进一步研究。

STUDY ON IRON DEFICIENCY AND ANEMIA WITH RISK FACTORS AMONG CHILDREN AND ADOLESCENTS IN SHANGHAI

Objective: To assess current anemia prevalence and related factors of children and adolescents in Shanghai. Method: 948 students aged from 6 to 17 y were randomly selected in this study by using stratified sampling method, health questionnaire survey and anemia screening according to WHO criteria. Case-control study at ratio of 1 anemic to 1 non anemic subject was undertaken. Fasting blood samples were obtained to measure iron status, folic acid、VB12、Cu、Pb and fecal samples were examined for parasitic infection. Dietary survey and duplicate plate analysis for iron contents were conducted. Results: The total anemia prevalence among the subjects investigated was 19.9%, mostly belonging to mild anemia. Iron status of anemic subjects was lower than control group, while blood lead was significantly higher than control (P<0.05); There was no relation between anemia and serum VB12, folic acid, Cu, and parasitic infection. Total iron intakes obtained from dietary survey among subjects exceeded RNI of iron, but actual iron contents from diet duplicate plate analysis were only 71%~85% of the dietary survey value, lower in the anemic group. Blood lead in anemic group was higher than control group with the value exceeding the upper limit of normal level. Conclusion: The prevalence rate of anemia among children and adolescents in Shanghai was 19.9% in this study. The main cause of anemia was iron deficiency, irrelevant to VB12, folic acid,Cu and parasitic infection. Whether lead overload was the risk factor remained further study.