贵州省农村营养改善计划地区中小学生贫血状况分析  

Anemia and its influencing factors among primary and junior middle school students in rural nutrition improvement program areas in Guizhou Province

作　　者：石柱 刘怡娅[2] 贺林娟 吴胜男 黄伊彦文 魏绍峰[1] 雷世光 SHI Zhu;LIU Yiya;HE Linjuan;WU Shengnan;HUANG Yiyanwen;WEI Shaofeng;LEI Shiguang(School of Public Health,Guizhou Medical University,the Key Laboratory of Environmental Pollution Monitoring and Disease Control,Ministry of Education,Guiyang,Guizhou 550025,China;不详)

机构地区：[1]贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州贵阳550025 [2]贵州省疾病预防控制中心

出　　处：《中国预防医学杂志》2023年第6期538-543,共6页Chinese Preventive Medicine

摘　　要：目的 了解贵州省实施“农村义务教育学生营养改善计划”地区中小学生贫血状况及影响因素,为学生营养改善工作提供科学依据。方法 采用多阶段分层随机整群抽样方法,对2021年贵州省8个重点监测县的11 938名中小学生进行血红蛋白检测和体格检查,并对所在学校进行问卷调查。采用MLwiN 2.23拟合两水平logistic回归模型分析贫血的影响因素。结果贵州省农村营养改善计划地区中小学生贫血检出率13.29%。零模型结果显示,学生贫血在学校水平存在聚集性(χ^(2)=24.757, P<0.01),采用多水平模型拟合效果更佳。两水平logistic回归分析结果显示,女生(OR=1.50,95%CI:1.34~1.68)、 1~3年级学生(OR=1.90, 95%CI:1.31~2.76)、营养不足学生(OR=1.53,95%CI:1.28~1.82)的贫血发生风险高;超重肥胖学生(OR=0.74,95%CI:0.62~0.88)、家长额外承担餐费的学生(OR=0.54, 95%CI:0.34~0.86)、学校食谱为带量食谱的学生(OR=0.55,95%CI:0.35~0.86)贫血发生风险低。结论贵州省农村营养改善计划地区中小学生贫血率偏高。学校应注重学生平衡膳食,加强家长和学校的合作,针对重点人群开展干预,改善中小学生贫血状况。Objective To understand the prevalence of anemia and its influencing factors among primary and junior middle school students in areas where the"Nutrition Improvement Program for Rural Compulsory Education Students"was implemented in Guizhou Province,so as to provide scientific evidence for the improvement of students'nutrition.Methods Using multi-stage stratified cluster random sampling method,11938 primary and junior middle school students in 8 key monitoring counties in Guizhou Province in 2021 were selected for hemoglobin test and physical examination,and a questionnaire survey was conducted in their schools.MLwiN 2.23 was used to fit a two-level logistic regression model to analyze the influencing factors of anemia.Results The prevalence of anemia among the selected primary and middle school students in the rural nutrition improvement program area of Guizhou Province was 13.29%.The null model showed clustering of anemia at the school level(χ^(2)=24.757,P<0.01),and the multi-level model had better fitting.Two-level logistic regression showed that girls(OR=1.50,95%CI:1.34-1.68),first to third grade students(OR=1.90,95%CI:1.31-2.76),undernourished students(OR=1.53,95%CI:1.28-1.82)had higher risk of anemia;whereas overweight/obese students(OR=0.74,95%CI:0.62-0.88),students whose parents gave extra payment for meals(OR=0.54,95%CI:0.34-0.86),and the students whose schools adopted recipes tailored for the nutritional and caloric needs of children/adolescents(OR=0.55,95%CI:0.35-0.86)had a lower risk of anemia.Conclusions Anemia is prevalent among primary and middle school students in the rural nutrition improvement program area of Guizhou Province.Schools should pay attention to providing students with balanced diet and strengthening cooperation with parents.Interventions are needed for key groups,in order to reduce anemia among primary and junior middle school students in rural areas.

关 键 词：贫血 营养改善计划 农村学生 多水平模型 

分 类 号：R153.2[医药卫生—营养与食品卫生学]