海南省“营养改善计划”某试点地区中小学生贫血状况及影响因素分析

目的 分析海南省“农村义务教育学生营养改善计划”（简称“计划”）某试点地区中小学生贫血的变化趋势及影响因素。方法 2014—2017年采用分层整群随机抽样法,在实施“计划”的重点监测县抽取中小学生进行血红蛋白等生化指标检测及问卷调查。多组均值间比较采用方差分析,率的比较采用χ²检验,贫血影响因素分析采用二分类Logistic回归。结果 2014—2017年共抽取学生2 590人,各年血红蛋白平均水平分别为（138.1±12.0）、（136.4±13.4）、（138.1±12.4）、（138.1±15.4）g/L,差异无统计学意义（P>0.05）。4年来各年贫血率分别为5.4%、5.4%、4.5%、6.7%,变化趋势无统计学意义（P>0.05）;其中2015年初中生贫血率高于小学生（P<0.05）,其余年度小学、初中生间,男、女生间贫血率差异均无统计学意义（均P>0.05）。Logistic回归分析结果显示,少数民族学生（OR=6.947）和维生素A亚临床缺乏/缺乏学生（OR=2.030）发生贫血的风险更高。结论 该地区中小学生贫血状况改善不明显,少数民族和维生素A亚临床缺乏/缺乏学生是需改善贫血的重点人群。

Anemia and its influencing factors among primary and middle school students from nutrition improvement program areas in Hainan Province

Objective To analyze the changing trend and influencing factors of anemia among primary and middle school students from the pilot areas of the “Nutrition Improvement Plan for Rural Compulsory Education Students” （shorten as “Program”） in Hainan Province. Methods From 2014 to 2017, primary and middle school students were selected from the key monitoring counties implementing the “Program” through stratified cluster random sampling method. The biochemical indicators such as hemoglobin were detected and questionnaire survey was carried out. Analysis of variance was used to compare the mean values of multiple groups, chi-square test was used to compare the rates, and the influencing factors of anemia were analyzed by binary Logistic regression. Results From 2014 to 2017, 2 590 students were selected, the students’ average hemoglobin levels were （138.1±12.0）, （136.4±13.4）, （138.1±12.4） and （138.1±15.4） g/L, respectively, and the differences were no statistical significance （P>0.05）. In 4 years, the anemia rates were 5.4%, 5.4%, 4.5% and 6.7%, respectively, there was no obvious change trend （P>0.05）. In 2015, the anemia rate of junior high school students was higher than the primary school students, and the difference was statistically significant （P< 0.05）. But in other years, there were no significant difference in anemia rates between primary and junior high school students, and between boys and girls （both P>0.05）. Logistic regression analysis showed that the ethnic minority students （OR=6.947） and vitamin A subclinical deficiency or deficiency students （OR=2.030） had a higher risk in anemia. Conclusion The anemia status of students from the pilot area of “Program” in Hainan Province is not significantly improved, and the ethnic minority students and vitamin A subclinical deficiency or deficiency students are the key intervention targets.