目的 了解新疆学龄前儿童贫血、铁缺乏和缺铁性贫血的现况。方法 2023年采用多阶段分层抽样法选取新疆5个地(州、市)的 15个社区卫生服务中心(乡镇卫生院),于 2023 年 2月调查6 月龄~6岁儿童共 2 108 名,按年龄分为三组婴儿组(6~11月龄)、幼儿组(12~35月龄)和学龄前组(3~6岁)。通过问卷了解儿童及家庭基本信息,体格测量,采集末梢血检测血红蛋白和血清铁蛋白。采用χ2检验和Logistic回归模型,分析民族、区域等因素分别对贫血检出率、铁缺乏检出率和缺铁性贫血检出率的影响。结果 有效调查人数 2 107 例,其中男童 1 046 例,女童 1 061 例;婴儿组、幼儿组、学龄前儿童组占比分别为 13.9%(292例)、28.5%(600例)、57.6%(1 215例)。新疆儿童Hb 为(126.7±16.7)g/L,血清 SF 平均水平为(27.5±21.7)μg/L;贫血、铁缺乏、缺铁性贫血检出率分别为11.7%、 48.2%、7.0%。Logistic回归分析显示,母亲初中及以下学历(OR=1.803),民族为维吾尔族(OR=4.090)、回族(OR=2.361)和哈萨克族(OR=3.493)是儿童贫血发生的危险因素(P<0.05),地处中部(OR=0.413)和南疆地区(OR=0.489)是儿童贫血发生的保护因素(P<0.05);常住乡村(OR=3.042)、中部地区(OR=5.225)、家庭收入＜5万(OR=1.444)、维吾尔族(OR=1.796)和哈萨克族(OR=2.524)是儿童铁缺乏的危险因素(P<0.05);母亲初中及以下学历(OR=3.371),民族为维吾尔族(OR=6.875)、回族(OR=3.757)、哈萨克族(OR=8.146)和其他民族(OR=5.366)是儿童缺铁性贫血的危险因素(P<0.05)。结论 新疆地区6月龄~6岁儿童的贫血、铁缺乏和缺铁性贫血发生的高危因素和地区存在显著差异,进一步降低新疆地区儿童贫血、铁缺乏和缺铁性贫血的发生率仍是今后儿童健康管理的重点。
Abstract
Objective To investigate the current status of anemia, iron deficiency, and iron deficiency anemia among preschool children in Xinjiang. Methods In 2023, a multi-stage stratified sampling method was used to select 15 community health service centers(township health centers) in 5 prefectures(autonomous prefectures, cities) in Xinjiang. A total of 2 108 children aged 6 months to 6 years were surveyed in February 2023 and divided into three age groups: infants(6 - 11 months old), toddlers(12 - 35 months old), and preschoolers(3 - 6 years old). Basic information on children and their families was collected through questionnaires, physical measurements were conducted, and capillary blood was collected for hemoglobin(Hb) and serum ferritin testing. The χ2 test and Logistic regression models were used to analyze the impact of factors such as ethnicity and region on the detection rates of anemia, iron deficiency, and iron deficiency anemia. Results Finally, 2 107 children were included, with 1 046 boys and 1 061 girls. The proportions of infants, toddlers, and preschoolers were 13.9%(292 cases), 28.5%(600 cases), and 57.6%(1 215 cases), respectively. The mean Hb level of children in Xinjiang was(126.7±16.7)g/L, and the mean serum ferritin(SF) level was(27.5±21.7)μg/L. The detection rates of anemia, iron deficiency, and iron deficiency anemia were 11.7%, 48.2%, and 7.0%, respectively. Logistic regression analysis showed that maternal education at the junior middle school level or below(OR=1.803), and being of Uyghur(OR=4.090), Hui(OR=2.361), or Kazakh(OR=3.493) ethnicity were risk factors for anemia among children(P<0.05). Residing in central Xinjiang(OR=0.413) and southern Xinjiang(OR=0.489) were protective factors against anemia(P<0.05). Residing in rural areas(OR=3.042), being in central Xinjiang(OR=5.225), having a family income of less than 50 000 Chinese yuan(OR=1.444), and being of Uyghur(OR=1.796) or Kazakh(OR=2.524) ethnicity were risk factors for iron deficiency among children(P<0.05). Maternal education at the junior middle school level or below(OR=3.371), and being of Uyghur(OR=6.875), Hui(OR=3.757), Kazakh(OR=8.146), or other ethnicities(OR=5.366) were risk factors for iron deficiency anemia among children(P<0.05). Conclusions Significant high-risk factors and regional differences exist in the occurrence of anemia, iron deficiency, and iron deficiency anemia among children aged 6 months to 6 years in Xinjiang. Further reducing these conditions among children in Xinjiang remains a priority for future child health management.
关键词
新疆 /
儿童 /
贫血 /
铁缺乏 /
缺铁性贫血
Key words
children /
anemia /
iron deficiency /
iron deficiency anemia
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基金
中华国际医学交流基金会项目(Z-2017-27-2102)
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