中国10个省、自治区、直辖市学龄前儿童铁缺乏的流行病学调查研究  

Epidemiological investigation of iron deficiency among preschool children in 10 provinces,autonomous regions,or municipalities in China

作　　者：王蕾 邵洁[1] 董文红 郑双双 朱冰泉[1] 舒强[1] 陈卫 樊利春 孙瑾 高越 胡幼芳 王念蓉[7] 王朝晖 牛婷婷 骆艳[10] 高举[11] 童梅玲[12] 胡燕[13] 向伟 赵正言[1] 毛萌[14] 江帆[15] Wang Lei;Shao Jie;Dong Wenhong;Zheng Shuangshuang;Zhu Bingquan;Shu Qiang;Chen Wei;Fan Lichun;Sun Jin;Gao Yue;Hu Youfang;Wang Nianrong;Wang Zhaohui;Niu Tingting;Luo Yan;Gao Ju;Tong Meiling;Hu Yan;Xiang Wei;Zhao Zhengyan;Mao Meng;Jiang Fan(Department of Child Health Care,Children′s Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou 310003,China;Department of Child Health Care,the Third Affiliated Hospital of Zhengzhou University(Maternal and Child Health Hospital of Henan Province),Zhengzhou 450052,China;Department of Child Health Care,Hainan Women and Children′s Medical Center,Haikou 570206,China;Department of Child Health Medicine,Dalian Women and Children′s Medical Group,Dalian 116033,China;Department of Child Health Care,Urumqi Maternal and Child Health Hospital,Urumqi 830001,China;Department of Children′s Health Care,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Jiangsu Women and Children Health Hospital,Nanjing 210036,China;Department of Child Health Care,Chongqing Health Center for Women and Children,Women and Children′s Hospital of Chongqing Medical University,Chongqing 401147,China;Health Center of the Children,Xi′an People′s Hospital(Xi′an Fourth Hospital),Xi′an 710004,China;Department of Child Health Care,Maternal and Child Health Care Hospital of Shandong Province,Jinan 250014,China;Department of Child Health Care,Guiyang Maternal and Child Health Care Hospital,Guiyang 550001,China;Department of Hematology/Oncology,West China Second University Hospital,Sichuan University,National Health Commission Key Laboratory of Chronobiology,Sichuan University,Chengdu 610041,China;Department of Child Health Care,Women′s Hospital of Nanjing Medical University(Nanjing Women and Children′s Healthcare Hospital),Nanjing 210004,China;Health Care Center,Beijing Children′s Hospital,Capital Medical University,Beijing 100045,China;Department of Child Health Care,West China Second University Hospital,Sichun

机构地区：[1]浙江大学医学院附属儿童医院儿童保健科,国家儿童健康与疾病临床医学研究中心,杭州310003 [2]郑州大学第三附属医院(河南省妇幼保健院)儿童保健科,郑州450052 [3]海南省妇女儿童医学中心儿童保健科,海口570206 [4]大连市妇女儿童医疗中心(集团)儿童保健医学部,大连116033 [5]乌鲁木齐市妇幼保健院儿童保健科,乌鲁木齐830001 [6]南京医科大学第一附属医院,江苏省人民医院,江苏省妇幼保健院儿童保健科,南京210036 [7]重庆市妇幼保健院,重庆医科大学附属妇女儿童医院儿童保健科,重庆401147 [8]西安市人民医院(西安市第四医院)儿童保健中心,西安710004 [9]山东省妇幼保健院儿童保健科,济南250014 [10]贵阳市妇幼保健院儿童保健科,贵阳550001 [11]四川大学华西第二医院血液肿瘤科,国家卫生健康委时间生物学重点实验室,成都610041 [12]南京医科大学附属妇产医院(南京市妇幼保健院)儿童保健科,南京210004 [13]首都医科大学附属北京儿童医院保健中心,北京100045 [14]四川大学华西第二医院儿童保健科,成都610041 [15]国家儿童医学中心,上海交通大学医学院附属上海儿童医学中心发育与行为儿科,上海200127

出　　处：《中华儿科杂志》2024年第5期416-422,共7页Chinese Journal of Pediatrics

基　　金：中央引导地方科技发展资金项目(2023ZY1058);中华国际医学交流基金会项目(Z-2017-27-2102);国家中心自主设计项目(G20A0011)。

摘　　要：目的了解我国学龄前儿童贫血、铁缺乏和缺铁性贫血的现况。方法横断面研究,采用多阶段分层抽样法选取我国10个省、自治区、直辖市(东部地区江苏、浙江、山东、海南,中部地区河南,西部地区重庆、陕西、贵州、新疆,东北地区辽宁)的150个街道或乡镇。2022年5月至2023年4月调查接受儿童保健服务的散居儿童(0.5~<3.0岁)和幼儿园的集居儿童(3.0~<7.0岁)共21470名,按年龄分为3组(0.5~<1.0岁为婴儿组、1.0~<3.0岁为幼儿组、3.0~<7.0岁为学龄前组)。调查儿童性别、出生日期等基本信息,采集末梢血检测血常规和血清铁蛋白。分析儿童贫血、铁缺乏及缺铁性贫血率,采用χ^(2)检验比较不同年龄、性别、城市与农村、地区间的患病率差异。结果有效调查人数21460名,其中男10780名(50.2%);婴儿、幼儿、学龄前组分别为2645名(12.3%)、6244名(29.1%)、12571名(58.6%);血红蛋白(126.7±14.8)g/L,血清铁蛋白32.3(18.5,50.1)μg/L;总贫血率、铁缺乏率、缺铁性贫血率分别为10.4%(2230/21460)、28.3%(6070/21460)、3.9%(845/21460)。男童贫血率高于女童[10.9%(1173/10780)比9.9%(1057/10680),χ^(2)=5.58,P=0.018];婴儿、幼儿、学龄前组儿童的贫血率差异有统计学意义[18.0%(475/2645)、10.6%(662/6244)、8.7%(1093/12571),χ^(2)=201.81,P<0.01];农村儿童贫血率高于城市[11.8%(1516/12883)比8.3%(714/8577),χ^(2)=65.54,P<0.01];各地区贫血率差异有统计学意义(χ^(2)=126.60,P<0.01),其中中部地区儿童贫血率最高,为15.8%(343/2173),东北地区最低,为5.3%(108/2053)。婴儿、幼儿、学龄前组铁缺乏率分别为33.8%(895/2645)、32.2%(2011/6244)、25.2%(3164/12571),男、女童铁缺乏率分别为30.0%(3229/10780)、26.6%(2841/10680),东部、中部、西部、东北地区铁缺乏率分别为21.7%(1913/8821)、40.0%(870/2173)、27.1%(2283/8413)、48.9%(1004/2053),差异均有统计学意义(χ^(2)=147.71、29.73、773.02,均P<0.01)。城市和农村儿童缺铁性�Objective To understand the current status of anemia,iron deficiency,and iron-deficiency anemia among preschool children in China.Methods A cross-sectional study was conducted with a multi-stage stratified sampling method to select 150 streets or townships from 10 Chinese provinces,autonomous regions,or municipalities(East:Jiangsu,Zhejiang,Shandong,and Hainan;Central:Henan;West:Chongqing,Shaanxi,Guizhou,and Xinjiang;Northeast:Liaoning).From May 2022 to April 2023,a total of 21470 children,including community-based children aged 0.5 to<3.0 years receiving child health care and kindergarten-based children aged 3.0 to<7.0 years,were surveyed.They were divided into 3 age groups:infants(0.5 to<1.0 year),toddlers(1.0 to<3.0 years),and preschoolers(3.0 to<7.0 years).Basic information such as sex and date of birth of the children was collected,and peripheral blood samples were obtained for routine blood tests and serum ferritin measurement.The prevalence rates of anemia,iron deficiency,and iron-deficiency anemia were analyzed,and the prevalence rate differences were compared among different ages,sex,urban and rural areas,and regions using the chi-square test.Results A total of 21460 valid responses were collected,including 10780 boys(50.2%).The number of infants,toddlers,and preschoolers were 2645(12.3%),6244(29.1%),and 12571(58.6%),respectively.The hemoglobin level was(126.7±14.8)g/L,and the serum ferritin level was 32.3(18.5,50.1)μg/L.The overall rates of anemia,iron deficiency,and iron-deficiency anemia were 10.4%(2230/21460),28.3%(6070/21460),and 3.9%(845/21460),respectively.The prevalence rate of anemia was higher for boys than for girls(10.9%(1173/10780)vs.9.9%(1057/10680),χ^(2)=5.58,P=0.018),with statistically significant differences in the rates for infants,toddlers and preschoolers(18.0%(475/2645),10.6%(662/6244),and 8.7%(1093/12571),respectively,χ^(2)=201.81,P<0.01),and the rate was significantly higher for children in rural than that in urban area(11.8%(1516/12883)vs.8.3%(714/8577),χ^(2)=65.54,P<0.01),wit

关 键 词：贫血 缺铁性 贫血 儿童 学龄前 铁缺乏 

分 类 号：R725.5[医药卫生—儿科]