目的 了解贫血及无贫血小红细胞对婴幼儿体格生长和神经心理发育的影响,为贫血和小红细胞婴幼儿的管理提供参考依据。方法 纳入2021年1—6月在川北医学院附属医院儿童保健科常规健康检查且资料完整的6~36月龄儿童。根据血常规结果将研究对象分为贫血组74例、小红细胞组228例和对照组143例。对不同组婴幼儿体格测量及儿心量表测评结果进行回顾性分析。结果 共纳入婴幼儿445名。贫血组婴儿及幼儿体重的Z值(ZWA)和身高的Z值(ZHA)均较对照组低(F=12.618、3.807、21.266、3.668,P<0.05),小红细胞组婴儿ZWA和 ZHA也显著低于对照组(Bonferroni-t=2.433、2.823,P<0.05)。儿心量表测评结果显示贫血组婴儿大运动、精细运动、适应能力、语言、社会行为能区及总发育商均显著低于对照组(Bonferroni-t=2.851、5.554、2.749、2.681、4.508、5.158,P<0.05),小红细胞组婴儿精细动作、语言、社会行为能区及总发育商也较对照组显著降低(Bonferroni-t=4.317、2.506、3.598、3.758,P<0.05)。对于幼儿,贫血组大运动、语言、社会行为能区及总发育商均较对照组显著降低(Bonferroni-t= 2.482,3.038,2.861,2.711,P<0.05),小红细胞组幼儿语言、社会行为能区发育商及总发育商也低于对照组(Bonferroni-t=2.715、2.939、2.473,P<0.05)。结论 除了贫血外,小红细胞也影响婴幼儿的生长发育,需引起重视并探索合适的干预策略。
Abstract
Objective To study the effect of anemia and small red blood cells on physical growth and neuropsychological development of infants, so as to provide reference for the management of infants with anemia and small red blood cells. Methods Children aged 6 to 36 months who received routine health examination in Child Health Care Department of Affiliated Hospital of the North Sichuan Medical College from January to June 2021 were included, and were divided into anemia group(n=74), small red blood cell group(n=228) and control group(n=143) according to the results of blood routine examination. The results of anthropometric measures and the revised Children Neuropsychological and Behavior Scale in different groups were analyzed retrospectively. Results A total of 445 infants were included. The Z-score of weight-for-age (ZWA) and Z-score of height-for-age (ZHA) of children aged 6 to 11 months and 12 to 36 months in the anemia group were significantly lower than those in the control group (F=12.618, 3.807, 21.266, 3.668, P<0.05). The ZWA and ZHA of children aged 6 to 11 months in the small red blood cell group were also significantly lower than those in the control group (Bonferroni-t= 2.433,2.823, P<0.05). The results of Children Neuropsychological and Behavior Scale showed that for children aged 6 to 11 months, the development quotients of gross motor, fine motor, adaptability, language and personal-social and total development quotient of anemia group were significantly lower than those of control group (Bonferroni-t=2.851, 5.554, 2.749, 2.681, 4.508, 5.158, P<0.05), and the development quotients of fine motor, language, personal-social and total development quotients of small red blood cell group were also significantly lower than those of control group(Bonferroni-t=4.317, 2.506, 3.598, 3.758, P<0.05). For children aged 12 to 36 months, the development quotients of gross motor, language, personal-social and total development quotient of anemia group were significantly lower than those of control group (Bonferroni-t=2.482, 3.038, 2.861, 2.711, P<0.05), and the language and personal-social development quotient and total development quotient of small red blood cell group were also lower than those of control group (Bonferroni-t=2.715, 2.939, 2.473, P<0.05). Conclusions In addition to anemia,microcytosis also affects the growth and development of infants, and requires attention and exploration of appropriate intervention strategies.
关键词
贫血 /
小红细胞 /
体格生长 /
神经心理发育 /
铁缺乏
Key words
anemia /
small red blood cells/ microcytosis /
physical growth /
neuropsychological development /
iron deficiency
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参考文献
[1] WHO. The global prevalence of anaemia in 2011[M]. Geneva:WHO, 2015.
[2] WHO. Guideline:updates on the management of severe acute malnutrition in infants and children[M]. Geneva:Switzerland, 2019.
[3] 贾伟丽,张玉梅,刘琪,等. 贫血与认知功能障碍的相关性研究进展[J].中华老年心脑血管病杂志,2020,22(12):1339-1341.
[4] Stevens GA,Finucane MM, De-Regil LM, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011:a systematic analysis of population-representative data[J]. Lancet Glob Health,2013,1:e16-e25.
[5] WHO. Iron defciency anaemia:assessment, prevention and control:a guide for programme managers[EB/OL]. [2018-05-01].http://www.who.int
[6] Muckenthaler MU, Rivella S, Hentze MW, et al. A red carpet for iron metabolism[J]. Cell, 2017, 168:344-361.
[7] WHO. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity[M]. Geneva:Switzerland, 2011.
[8] Johnson-Wimbley TD, Graham DY. Diagnosis and management of iron deficiency anemia in the 21st century[J]. Therap Adv Gastroenterol, 2011, 4(3):177-184.
[9] Li QR, Liang F, Liang WL, et al. Prevalence of anemia and its associated risk factors among 6-months-old infants in Beijing[J]. Front Pediatr,2019,7:286.
[10] 张海凤,冯超,张霆,等.北京6～35月龄流动儿童营养性贫血及其与维生素A相关性研究[J].中国儿童保健杂志,2021,29(2):129-133.
[11] Xin QQ, Chen BW, Yin DL, et al. Prevalence of anemia and its risk factors among children under 36 months old in China[J]. J Trop Pediatr,2017,63 (1):36-42.
[12] 詹建英,郑双双,董文红,等.血常规指标对儿童铁缺乏的预测作用[J].中华儿科杂志, 2020,58(3):201-205.
[13] Molla A, Egata G, Mesfin F, et al. Prevalence of anemia and associated factors among infants and young children aged 6~23 months in Debre Berhan Town, North Shewa, Ethiopia[J]. J Nutr Metab, 2020,2020:2956129.
[14] Yang WF, Li X, Li Y, et al. Anemia, malnutrition and their correlations with socio-demographic characteristics and feeding practices among infants aged 0-18 months in rural areas of Shaanxi province in northwestern China:a cross-sectional study[J]. BMC Public Health,2012,12:1127.
[15] 林菊清,王志华,张瑛,等.长治市城区婴幼儿贫血现状调查及其对儿童智能行为发育的影响[J].中国妇幼保健,2017,32(18):4494-4497.
[16] Tan B, Venketasubramanian N, Vrooman H, et al. Haemoglobin, magnetic resonance imaging markers and cognition:a subsample of population-based study[J].Alzheimers Res Ther,2018,10(1):114.
[17] Ishikura N, Hino K, Kimura T, et al. Postweaning iron deficiency in male rats leads to long-term hyperactivity and decreased reelin gene expression in the nucleus accumbens [J]. J Nutr,2020,150(2):212-221.
基金
川北医学院附属医院博士启动资金(202004)
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