湖南省学生营养健康状况监测地区中小学生铁缺乏和贫血患病现状及影响因素  

Analysis of the prevalence and influencing factors of iron deficiency and anemia among students in monitoring area of the nutritional health status of students in Hunan Province

作　　者：唐嘉鹏 谭雅卿 陈艳华[1] 王非[1] 李开宇[1] 孙梦婷 罗曼君 魏剑晖 阮霄睿 秦家碧[2,3] TANG Jiapeng;TAN Yaqing;CHEN Yanhua;WANG Fei;LI Kaiyu;SUN Mengting;LUO Manjun;WEI Jianhui;RUAN Xiaorui;QIN Jiabi(Department of School Health,Hunan Prouincial Center for Disease Control and Prevention,Changsha 410153,China;Department of Epidemiology and Health Statistics,Xiangya School of Public Health,Central South University,Changsha 410013,China;Department of Epidemiology and Health Statistics,School of Public Health,Kunming Medical University,Kunming 650500,China)

机构地区：[1]湖南省疾病预防控制中心学校卫生科,长沙410153 [2]中南大学湘雅公共卫生学院流行病与卫生统计学系,长沙410013 [3]昆明医科大学公共卫生学院流行病与卫生统计学系,昆明650500

出　　处：《中华疾病控制杂志》2025年第2期171-177,共7页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(82073653;81803313);湖南省杰出青年基金(2022JJ10087);湖南省卫生健康委科研计划项目(20221203326)。

摘　　要：目的了解湖南省2023年农村义务教育学生营养改善计划(简称营养改善计划)地区中小学生铁缺乏(iron deficiency,ID)及贫血患病现状,并探索潜在影响因素。方法2023年10―12月采用多阶段分层整群随机抽样的方法,纳入4652名中小学生,其中1108名中小学生进行了血清铁蛋白(serum ferritin,SF)检测。采用logistic回归分析模型分析贫血、ID以及缺铁性贫血(iron deficiency anemia,IDA)的影响因素。结果湖南省2023年营养改善计划地区中小学生血红蛋白(hemoglobin,Hb)均值为(131.49±12.92)g/L,贫血率为11.54%(95%CI:10.62~12.46);SF平均水平为53.47(34.53,81.35)μg/L,ID患病率为5.23%(95%CI:3.92~6.55),IDA患病率为1.35%(95%CI:0.67~2.04)。多因素分析显示,女性(OR=1.482,95%CI:1.125~1.778)、学校所在地为乡镇/村(OR=1.420,95%CI:1.138~1.771)的中小学生贫血的风险更高,而10~15岁组中小学生的贫血风险较6~10岁组低。在ID和IDA中,女性和学段为初中者的患病风险更高(ID:OR_(女性)=3.523,95%CI:1.898~6.542,OR_(初中)=4.120,95%CI:2.251~7.541;IDA:OR_(女性)=6.933,95%CI:1.551~130.984,OR_(初中)=8.837,95%CI:1.979~39.462)。结论湖南省营养改善计划地区仍需进一步加大中小学生ID和贫血的防控力度,加强营养监测,关注重点人群健康,给予针对性的膳食指导和健康教育。Objective To investigate the current status of iron deficiency(ID)and anemia among students in the nutrition improvement programme areas of Hunan Province in 2023,and to explore the the potential factors.Methods During the period October-December 2023,a total of 4652 students were included in this study using a multistage stratified whole cluster random sampling method,out of which 1108 students were tested for serum ferritin(SF).Logistic regression was used to analyze the factors influencing anemia,ID and iron deficiency anemia(IDA).Results The average hemoglobin(Hb)level of students in the 2023 nutrition improvement program area of Hunan Province was(131.49±12.92)g/L,and the prevalence of anemia was 11.54%(95%CI:10.62-12.46);the average SF level was 53.47(34.53,81.35)μg/L,and the prevalence of ID and IDA was 5.23%(95%CI:3.92-6.55)and 1.35%(95%CI:0.67-2.04),respectively.Multifactorial analysis showed that girls(OR=1.482,95%CI:1.125-1.778)and students whose school location was a township or village(OR=1.420,95%CI:1.138-1.771)had a higher risk of anemia,while students aged 10-15 years had a lower risk of anemia compared to those aged 6-10 years(OR=0.806,95%CI:0.656-0.992).In the analysis of ID and IDA,girls and junior high school students had a higher risk of the diseases(ID:OR_(female)=3.523,95%CI:1.898-6.542,OR_(junior high school)=4.120,95%CI:2.251-7.541;IDA:OR_(female)=6.933,95%CI:1.551-130.984,OR_(junior high school)=8.837,95%CI:1.979-39.462).Conclusions Nutrition Improvement Program areas in Hunan Province still need to further increase the prevention and control of ID and IDA among students,strengthen nutritional monitoring,pay attention to the health of key populations,and give targeted dietary guidance and health education.

关 键 词：贫血 铁缺乏 中小学生 营养改善计划 回归分析 

分 类 号：R181[医药卫生—流行病学] G479[医药卫生—公共卫生与预防医学]