拉萨市农村藏族孕妇血红蛋白水平调查  

Study on the Hemoglobin levels among the Tibetan pregnant women in rural Lhasa

作　　者：康轶君[1] 李芳珍 党少农[1] 颜虹[1] 曾令霞[1] 程悦[1] 李强[1] 毕育学[1] 

机构地区：[1]西安交通大学医学部公共卫生学院陕西省营养与食品安全工程研究中心,710061 [2]西藏自治区拉萨市达孜县卫生局妇幼保健科

出　　处：《中华预防医学杂志》2014年第5期396-400,共5页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金（300771835）;中华医学基金会项目（#02-778）;高等学校博士学科点专项科研基金（20070698084）

摘　　要：目的 了解拉萨市农村藏族孕妇血红蛋白（Hb）水平及影响因素.方法 2008年8月至2011年5月,以医院为基础,选取拉萨市、县和乡镇不同级别的医院产科门诊或住院的孕妇,在自愿知情的情况下,调查了农牧区藏族孕妇1 530名.采用B-Hemoglobin血红蛋白仪,取孕妇指末梢血10μl测量Hb含量.运用美国CDC法对Hb进行海拔调整,估计孕妇贫血率,采用WHO贫血诊断标准.结果 调查地区孕妇所在乡镇的海拔平均为（3 716.4±69.1）m,实测孕妇Hb水平为（122.0±17.5）g/L,Hb水平在孕早、中和晚期分别为（125.5±18.0）、（122.5±16.9）、（120.6±17.4）g/L（P＜0.05）.用美国CDC法海拔调整后,孕妇的贫血率为85.6％（1 310/1 530）,孕早、中、晚期贫血率分别为：79.5％ （206/259）、86.1％（395/459）和87.3％（698/800）（P＜0.05）.在贫血孕妇中,中、重度贫血者占46.7％（612/1310）.多因素线性回归分析结果显示,控制了孕周等因素后,家庭经济收入高孕妇的Hb水平高于经济收入低的孕妇（β=2.74,95％CI：1.73 ～3.74）,无不良嗜好孕妇的Hb水平高于有不良嗜好（喝酒或吸烟）的孕妇（β =7.34,95％ CI：4.87 ～9.81）,孕产次数多孕妇的Hb水平低于孕产次数少的孕妇（β=-1.62,95％CI：-2.93～-0.31）.结论 拉萨市农村藏族孕妇Hb水平较低.增加收入、延长生育间隔、戒掉不良嗜好,可以提高孕妇的Hb水平.Objective To understand the level of hemoglobin （Hb） and determine the risk factors of Hb concentration among the Tibetan pregnant women in rural Lhasa.Methods Between August 2008 and May 2011,a hospital-based study was conducted among l 530 Tibetan pregnant women after getting their informed consent in agricultural and pastoral areas in maternity clinic or hospital in city,county and township level of Lhasa.Their blood samples were tested and related socio-demographic information was collected.Blood was collected on tip of finger and the Hb concentration was measured using B-Hemoglobin photometer.American Centers for Disease Control and Prevention（CDC） method was used to adjust the Hb measurements based on altitude for estimating the prevalence of anemia.Anemia was assessed according to WHO criteria.A hemoglobin concentration of less than 110 g/L in a pregnant woman was considered an indication of anemia.Results From August 2008 to May 2011,1 530 Tibetan pregnant women living at （3 716.4 ± 69.1） m above sea level in rural Lhasa were examined.The findings indicated that average Hb concentration was （122.0 ± 17.5） g/L; the Hb concentration of 1st,2nd and 3rd trimester were （125.5 ± 18.0）,（122.5±16.9） and （120.6 ± 17.4） g/L,respectively.The Hb concentration of pregnant women decreased with the increase of gestational age（P ＜0.05）.Based onCDC method and the adjusted Hb level,the prevalence of anemia in pregnant women were 85.6％ （1 310/1 530）,the prevalence of anemia of 1st,2nd,and 3rd trimester were 79.5％ （206/259）,86.1％ （395/459）and 87.3％ （698/800）,respectively （P ＜0.05）.The rate of moderate and severe anemia were 46.7％ （612/1 310） among pregnant women.Multiple linear regression analysis showed that high Hb level was associated significantly with low family income status （β =2.74,95 ％ CI：1.73-3.74）,no bad habits （drinking or smoking） （β =7.34,95 ％ CI：4.87-9.81） and fewer times of pregnancies （β =-1.62,95％ CI：-2.9

关 键 词：血红蛋白测定 妊娠 影响因素 拉萨市农村 

分 类 号：R715.3[医药卫生—妇产科学]