综合干预对北方农村离乳期营养性贫血儿童的效果研究  

Study on effect of assistant weaning intervention for infants with nutritional anemia in China north rural area.

作　　者：张淑一[1] 李烨[2] 孙兴磊 张海凤[1] 马玉霞[4] 朱宗涵[5] 张霆[1] 

机构地区：[1]首都儿科研究所(儿童发育营养组学北京市重点实验室),北京100020 [2]首都医科大学附属北京安贞医院,北京100029 [3]赵县妇幼保健院,河北石家庄051530 [4]河北医科大学,河北石家庄050017 [5]中国医师协会儿科医师分会,北京100020

出　　处：《中国儿童保健杂志》2016年第1期15-18,共4页Chinese Journal of Child Health Care

基　　金：卫生部卫生行业科研专项项目(201002006)

摘　　要：目的观察铁剂补充结合喂养指导的综合干预对离乳期营养性贫血儿童的血红蛋白浓度升高和贫血纠正的效果。方法对2012年5月河北省赵县两个乡镇体检发现的6-11月龄营养性贫血（Hb〈110g/L）的儿童分别入选干预组和对照组,两组分别有136名和87名儿童完成了全程随访,两组儿童都接受常规补充铁剂3个月。干预组每月由卫生室的医生提供一次家长离乳食指导。分别在1、3、12个月后复查儿童血红蛋白浓度和评估离乳食期喂养。结果相对于入选时,随访时干预组和对照组的儿童自身血红蛋白浓度上升,3个月随访时分别为（14.85±14.85）g/L和（8.07±12.90）g/L,12个月随访时分别为（17.17±16.44）g/L和（5.77±13.87）g/L;各组每次随访时的上升值皆有统计学意义（P=0.000）;两次随访时干预组的上升值高于对照组,皆有统计学意义（P=0.002和0.000）。干预组和对照组儿童的贫血纠正率在3个月随访时分别为52.2%和32.3%（P=0.004）,12个月随访时为56.6%和31.0%（P=0.001）。相对于对照组的常规措施,干预组的离乳食干预对纠正儿童贫血的关联强度（RR）在3、12个月时分别为1.62和1.83,归因危险度（AR）分别为19.9%和25.6%。结论在我国农村地区对离乳期营养性贫血的儿童进行喂养指导干预,短期内能够促进补铁治疗效果,而且通过长久影响儿童的营养状况,在补铁停止之后持续稳定纠正和预防儿童贫血,对婴幼儿营养改善具有长期意义。Objective To explore the effects of assistant wean feeding interventions on anemic infants of 6to 11 months age to increase hemoglobin（Hb）concentration and anemia-correct. Methods A total of 223 nutritional anemic children of 6-11months age were enrolled and assigned to intervention group（n=136）and control group（n=87）,and completed the whole 12 months of investigation.Besides 3 months of iron supplement for all children,intervention group provided wean feeding counselling for caregivers once a month by village health workers conducting.The effect was evaluated via Hb and feeding practices indicators（WHO 2008version）during follow up at 1,3and 12 months. Results The main effects of Hb increasing in the two groups were（14.85±14.85）g/L（P=0.000）vs（8.07±12.90）g/L（P=0.000）in 3months,and（17.17±16.44）g/L（P=0.000）and（5.77±13.87）g/L（P=0.000）in 12 months,the differences between two groups were significant（P=0.002,P=0.000）.The proportion of anemia-corrected in the two groups were52.2% and 32.3%（P=0.004）in 3months,56.6% and 31.0%（P=0.001）in 12 months.RR of experimental intervention on children＇s anemia-correction was 1.62 in 3months and 1.83 in 12months,while the AR was 19.9% and 25.6%respectively. Conclusion This study implies effects on Hb increasing and anemia correction for nutritional anemic infants in weaning period via feeding counselling in China rural areas,which could consolidate and strengthen the short-term and longterm effect of iron supplement.

关 键 词：婴幼儿 营养性贫血 离乳食 动物性食物 农村 

分 类 号：R179[医药卫生—妇幼卫生保健]