中小学生血红蛋白水平持续性低下危险因素病例对照研究  

Case-control study of risk factors for recurrent low hemoglobin level among primary and middle school students

作　　者：何丹丹[1] 温晓飒[1] 汤红梅[1] 陈迪迪[1] 徐晓莉 程华[2] HE Dan-dan;WEN Xiao-sa;TANG Hong-mei;CHEN Di-di;XU Xiao-li;CHENG Hua(Minhang District Center for Disease Control and Prevention,Shanghai 201101,China;Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China)

机构地区：[1]上海市闵行区疾病预防控制中心,上海201101 [2]上海市疾病预防控制中心,上海200336

出　　处：《上海预防医学》2020年第8期675-680,共6页Shanghai Journal of Preventive Medicine

基　　金：上海市闵行区自然科学研究课题(2018MHZ010)。

摘　　要：【目的】探索上海市闵行区6~13岁学生血红蛋白水平持续性低下的危险因素,为制定公共卫生政策提供依据。【方法】基于闵行区所有中小学生年度健康体检队列,2013、2014年连续2年对闵行区6~13岁所有参加体检的71742名学生进行血红蛋白检测。以2次检测血红蛋白均低于标准值的为病例组,正常者为对照组;根据性别、年龄、学校以1︰1配对,进行问卷调查。以Cox模型拟合1︰1配对的logistic回归分析危险因素。【结果】母亲孕期贫血(OR=2.32,95%CI:1.49~3.63)、非孕期贫血(OR=4.65,95%CI:1.22~17.69)、孕期与非孕期均贫血(OR=2.51,95%CI:1.50~4.21)、孩子喜好喝浓茶(OR=2.56,95%CI:1.27~5.13)、偏食(OR=1.94,95%CI:1.45~2.59)是血红蛋白持续低下的独立危险因素。经常咬玩具(OR=1.79,95%CI:1.10~2.86)、经常咬铅笔(OR=1.80,95%CI:1.25~2.59)、消瘦(OR=3.37,95%CI:1.11~10.21)是血红蛋白持续低下的可能危险因素。【结论】6~13岁学生血红蛋白持续性低下的危险因素与母亲的贫血状态有关,也与自身饮食偏好有关。应加强孕龄期女性健康宣教,培养子女合理饮食习惯,同时尽早治疗。消瘦的学生应是血红蛋白持续性低下的重点关注人群。[Objective]To explore the risk factors of recurrent low hemoglobin(RLH)level among students from 6 to 13 years old,and to formulate strategies and policies in this regard.[Methods]Surveillance on hemoglobin concentration was conducted among 71742 students aged from 6 to 13y between 2013-2014 based on the annual physical examination for primary and middle school in Minhang District.Of those students,670 were diagnosed with low hemoglobin level according to WHO criteria.A 1︰1 matched case-control study was conducted based on gender,age and school type.Questionnaire surveys for data collection were analyzed using Cox′s proportional hazards regression.[Results]Factors as pregnancy anemia(OR=2.32,95%CI:1.49-3.63),non-pregnancy anemia(OR=4.65,95%CI:1.22-17.69),maternal anemia(OR=2.51,95%CI:1.50-4.21),drinking strong tea(OR=2.56,95%CI:1.27-5.13)and dietary bias(OR=1.94,95%CI:1.45-2.59)were risk factors of recurrent low hemoglobin level.Chewing pencils(OR=1.80,95%CI:1.25-2.59)or toys(OR=1.79,95%CI:1.10-2.86)and wasting(OR=3.37,95%CI:1.11-10.21)might be the risk factors.[Conclusion]The risk factors of recurrent low hemoglobin level among students aged from 6 to 13 years are related to maternal anemia status and their dietary habits.We should strengthen education for women of child-bearing age,and help to develop healthy eating practices for their babies.Emaciated students should be focused on in this regard.

关 键 词：血红蛋白 持续贫血 匹配的病例对照 

分 类 号：R179[医药卫生—妇幼卫生保健]