目的 调查四川绵阳地区婴幼儿维生素A(VA)、贫血及体格生长水平情况,分析VA缺乏(VAD)与贫血及体格生长间的关系,为制定防控措施提供依据。方法 选取2017年5月-2019年7月在绵阳市妇幼保健院儿童保健科就诊的1 090名0~3岁儿童,进行VA及贫血检测,测量其身长、体重,采用WHO参考值计算Z评分和营养不良率。结果 VA平均水平为(0.28±0.07)mg/dl,可疑亚临床缺乏(SVAD)及VAD的发病率分别为50.1%及9.60%。男女性别间可疑SVAD、VAD发病率差异均无统计学意义(P>0.05);VAD组、可疑SVAD组贫血患病率分别为26.67%、18.50%,均较正常组12.98%显著增高(P<0.05);低体重、生长迟缓、消瘦率分别为1.10%、3.49%、0.73%,不同VA水平婴幼儿低体重、生长迟缓、消瘦发病情况差异无统计学意义(P>0.05),但VA正常组生长优良率明显高于VA异常组(χ2WAZ=9.124,PWAZ=0.003;χ2HAZ=6.014,PHAZ=0.014;χ2WHZ=9.276,PWHZ=0.002)。结论 绵阳地区属于VA轻度缺乏地区,但半数以上婴幼儿有VAD患病风险,VA缺乏及不足儿童易导致贫血及体格生长落后,需积极制定防控措施。
Abstract
Objective To investigate the vitamin A (VA),anemia and growth levels of infants and young children in Mianyang,and to analyze the relationship between vitamin A deficiency (VAD) and anemia and growth,so as to provide evidence for prevention and control measures. Methods Totally 1 090 children aged 0 to 3 years in the Department of Child Health of Mianyang Maternal and Child Health Care Hospital were selected from May 2017 to July 2019.VA level and anemia were tested,and height and weight were measured and calculated by WHO reference value Z score and malnutrition rate. Results The average VA level was (0.28±0.07)mg/dl,and the detection rates of suspected subclinical vitamin A deficiency (SVAD) and VAD were 50.1% and 9.60%,respectively.There were no significant differences on the detection rates of VAD and VAD between male and female (P>0.05).The prevalence rates of anemia in VAD group and suspected SVAD group were 26.67% and 18.50%,respectively,which was higher than that in normal group 12.98%(P<0.05).The rates of low body weight,growth retardation and marasmus were 1.10%,3.49% and 0.73%,respectively.There were no differences on low body weight,growth retardation and malnutrition among different VA levels(P>0.05),but the excellent growth rate in VA normal group was significantly higher than that in VAD group and suspected SVAD group(χ2WAZ=9.124,P WAZ=0.003;χ2HAZ=6.014,PHAZ=0.014;χ2WHZ=9.276,PWHZ=0.002). Conclusion Mianyang is an area with mild VA deficiency,but more than half of infants and young children are at risk of VAD.Children with VA deficiency and insufficiency are prone to cause anemia and growth retardation,and it is necessary to actively develop prevention and control measures.
关键词
维生素A /
贫血 /
生长发育 /
儿童
Key words
vitamin A /
anemia /
growth and development /
children
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] WHO,UNICEF,UNU.Iron deficiencyanaemia:assessment,prevention and control,a guide for programme managers[R].Geneva:World Health Organization,2001.
[2] Schultink W.Use of under-five mortality rate as an indicator for vitamin A deficiency in a population[J].J Nutr,2002,132(Suppl 9):2881-2883.
[3] Imdad A,Mayo-Wilson E,Herzer K,et al.Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age[J].Cochrane Database Syst Rev,2017,3:CD008524.
[4] 赵丽云,于冬梅,刘爱东,等.2006年中国儿童与孕产妇营养健康状况调查结果分析[J].卫生研究,2008,37(1):65-67.
[5] WHO.Indicators for assessing vitamin A deficiency and their application in monitoring and evaluating intervention programmes[R].Geneva:WHO/NUT,1996.13-14.
[6] 杨春,陈竞,云春凤,等.中国中小城市小学生维生素A缺乏和贫血现况调查[J].卫生研究,2016,45(3):489-491.
[7] 金春华,王晓燕,张丽丽,等.儿童维生素A缺乏与血红蛋白水平及呼吸道感染相关性研究[J].临床儿科杂志,2017,35(10):755-758.
[8] 蓝岚,梁克纪,张羽飞,等.维生素A 缺乏对缺铁性贫血的影响-体内外实验对比研究[J].中国食物与营养,2016,22(4):62-64.
[9] Canete A,Cano E,Munoz-Chapuli R,et al.Role of vitamin A/retinoic acid in regulation of embryonic and adult hematopoiesis[J].Nutrients,2017,9(2):159.
[10] da Cunha MSB,Campos Hankins NA,Arruda SF.Effect of vitamin A supplementation on iron status in humans:A systematic review and meta-analysis[J].Crit Rev Food Sci Nutr,2019,59(11):1767-1781.
[11] 刘敬涛,蒋迎佳,许跃忠,等.四川省5岁以下儿童营养现状分析[J].中国儿童保健杂志,2013, 21(11):1126-1128.
[12] 首都儿科研究所.2015年中国九市七岁以下儿童体格发育调查[J].中华儿科杂志,2018,56(3):192-199.
[13] 华天懿.维生素A缺乏对儿童生长发育的影响及我国儿童维生素A营养现状[J].中国儿童保健杂志,2005,13(6):519-521.
[14] Yakoob MY,Lo CW.Nutrition (micronutrients) in child growth and development:a systematic review on current evidence,recommendations and opportunities for further research[J].J Dev Behav Pediatr,2017,38(8):665.
[15] 张英华,颜美玲,许宁峰.身材矮小儿童骨密度与血清维生素A、25-羟维生素D、维生素E水平的关系[J].广西医科大学学报,2019,36(6):965-968.
基金
国家卫生健康委员会医药卫生科技发展研究中心项目(W2016EWSC02)