缺铁性贫血对婴幼儿智能发育影响的探讨

EFFECT OF IRON DEFICIENCY ANEMIA ON MENTAL DEVELOPMENT IN INFANTS AND CHILDREN

本文利用因素分析方法及3个月的配对补铁试验,确立了缺铁性贫血(Iron Deficiency Anemia,IDA)与智能发育的关系。 选择6～36月龄婴幼儿333名进行社会调查、体格检查、血液学检测及智能发育商(Deveopmental Quotient,DQ)的测定。结果表明,IDA患儿的DQ(95.32±9.24)明显低于正常儿(101.62±10.28),P<0.01。以IDA为一个独立变量,对婴幼儿的DQ进行多元逐步回归分析表明,IDA以第七位被纳入方程,对DQ作用显著,两者呈负相关,说明在控制混杂因素影响的情况下,IDA对DQ仍作用显著。配对补铁试验先一步证实缺铁对婴幼儿智能发育的不良作用,IDA患儿补铁3个月后,Hb平均升高1.53g/dL,红细胞内游离原卟啉(Free Erythrocyte Protoporphyrin,FEP)及血清铁蛋白(Serum Ferritin,SF)均恢复正常,DQ较补铁前明显升高(P<0.01),平均升高12.47,而服用安慰剂的IDN患儿及非缺铁儿童实验前后各项指标均无明显变化,说明通过补铁治疗,可使IDN患儿的智能发育恢复正常。

In this article, we applied single multiple factor analysis and paired iron supplement test to determine the effect of IDA on mental development in 6-36 months infants and children.333 infants and children aged from 6 to 36 months in kindergarten were selected for the experiment. The social environment, physical condition, developmental quotient (DQ), and so on were investigated. The results showed that the DQ in IDA infants (95.32, 9.47) was lower than that of the normal (101.62,10.28) P<0.01. When IDA was set as an independent variable, the step-down multiple regression of DQ showed that IDA was taken into the equation at the 7th factor, suggesting that IDA still has adverse effect on DQ when controlling 28 other factors such as diet, growth, perinatal period, and family environment.This was further verified by paired iron supplement test. After treatment with iron fortified jam for three months, the DQ scores of IDA patients increased 12.47, P<0.01, meanwhile, the Hb level increased 1.53 g/dl, FEP and SF also recovered. While in the other two control groups, IDA patients and normal infants taking placebo jam no significant changes in DQ scores and blood indices were observed as compared to its pre-test.