运用人体测量法评估中国西部40个县农村3岁以下儿童的营养状况

目的运用人体测量法评估中国西部40个县3岁以下儿童的营养状况。方法采用横断面调查设计和分层多阶段随机抽样法,获得7252名3岁以下儿童,以身长和体重作为衡量儿童营养状况的指标,采用Z值法以WHO/NCHS参考人群为标准评估该儿童群体的营养状况。结果年龄别身高(HA)Z值的标准差波动在1.10～1.30,年龄别体重(WA)Z值的标准差波动范围较大在1.06～1.40,特别是对1岁以内的儿童。与WHO/NCHS参考分布相比,该儿童群体的HAZ值和WAZ值显著左移约1个单位,身高别体重(WH)Z值左移约0.4个单位,生长迟缓、低体重和消瘦的总患病率分别为23.0%、22.6%和7.5%,各地区县儿童的营养不良患病情况差异较大。营养不良患病情况在出生后3月龄内较低,其生长迟缓的患病率为5.9%～9.0%,低体重患病率为1.1%～3.5%,6月龄后患病率迅速上升,在15月龄左右达到20%～30%,此后有所下降但维持在较高的水平上。低体重与生长迟缓和消瘦间有显著的正相关关系,Pearson相关系数分别为0.815和0.636(P＜0.01),发育迟缓与消瘦间没有发现显著的相关关系。结论40个县儿童的整体营养状况受到了不良影响,意味着该地区儿童的营养不良不仅仅是个别或部分儿童的健康问题,相对于WHO/NCHS参考人群营养不良患病率较高,低的HA可能是该地区儿童的主要问题。单独使用WA时解释要谨慎,因为它无法区分生长迟缓或低体重。准确收集年龄数据和准确测量身长体重是运用人体测量法评估儿童营养状况的关键。

Assessment on nutritional status among children under 3 years using anthropometry in 40 counties of western China

Objective To assess nutritional status among children younger than 3 years in 40 counties of western China,using anthropometry. Methods With cross-sectional study and random sampling,a survey with a sample size of 7252 was conducted in 40 counties of western China on children under 3 years old. Height and weight were measured and nutrition status was evaluated with WHO/NCHS reference using Z scores. Results SD of height for age(HA) and weight for age(WA) were (1.10-)(1.30) and (1.06-)(1.40),respectively and SD of WAZ for infants varied.The distribution of HA Z and WAZ shifted downward to 1 unit and 0.4 unit for distribution of weight for height(WHZ). The prevalence of stunting, underweight and wasting were (23.0)%,(22.6)% and (7.5)% respectively. The prevalence rates were low among those yourger than 3 months. Stunting and underweight increased sharply after 6 months and reached (20%-)30%. Significant correlation was found between underweight and stunting or wasting with coefficients of (0.815) and (0.636),respectively.No correlation was found between stunting and wasting. Conclusion The nutrition status adversely affected children as a whole but not only for individuals.There was a higher prevalence of malnutrition mainly on low height to children. Weight for age must be interpreted cautiously because of the inability of this indicator in distinguishing stunting and wasting just by itself. Assessment by anthropometry called for accurate information on age and measurement of height and weight.