厌食症儿童补锌前后锌、铁营养状况的变化

RELATIONSHIP BETWEEN ZINC AND IRON STATUS BEFORE AND AFTER ZINC TREATMENT IN CHILDREN WITH ANOREXIA

本文观察了203名2～7岁厌食儿童的锌、铁营养状态。用三日记录法了解膳食摄入情况,并对其中密切合作的147人进行补锌后(补充硫酸锌3～7mg·kg^(-1)·d^(-1),补充时间2个月)的纵向观察。 膳食调查表明,热能、蛋白质、锌、铁摄入量分别为994kcal/d、30.8g/d、4.9mg/d、7.6mg/d,仅达RDA的71％、68％、49％、76％。补锌后分别达RDA的91％、89％、70％、113％。 根据本文暂定的本市学龄前儿童血锌、发锌正常下限值,将厌食儿童的锌营养状态分为三种:锌缺乏、锌不足、锌正常。 补锌前锌缺乏儿童的血红蛋白,铁蛋白水平较低。经单相关分析,血锌、发锌与血红蛋白的相关系数分别为0.286(P<0.01),0.200(P<0.01);与铁蛋白的相关系数为0.156(P<0.05)、0.293(P<0.01)。补锌后部分儿童铁营养状态好转,部分下降。通过对两组补锌前各指标的分析,找出有差别者作判别分析,得判别式:Y=3.591-0.175X_(年龄)-0.0152X_(发锌)-0.144X_(血红蛋白)+0.706X_(生长)。Y<0时补锌后铁易下降,Y>0时铁不易下降。说明年龄越小、发锌越低、血红蛋白越低。生长缓慢者补锌后铁不易下降。

A comprehensive evaluation of zinc and iron nutritional status was conducted in 203 children aged 2-7 years with anorexia. 147 of them took 3-7 mg of zinc sulfate·kg-1·d-1 for 60 days. The purpose of the study were to explore the relationship between zinc supplementation and the nutritional status of iron.Nutritional survey by 3-day-record method pre-and post zinc treatment showed that the average intakes of energy, protein, zinc, iron before treatment were 994kcal/d, 30.8g/d, 4.9mg/d, 7.6mg/d and were only 71%, 68%, 49%, 76% of RDA respectively. After treatment they reached 91%, 89%, 70%, 113% of RDA.There were significant positive correlations between zinc contents in serum or hair and hemoglobin (HB) or serum ferritin (SF) of the children with anorexia. After administration of zinc , the iron status of the children improved in some and fell in others. There were significant differences in some indices between the two groups before treatment. By stepwise discriminant analysis, a discriminant equation was obtained;Y = 3.591 - 0.175X1- 0.0152X2- 0.144X3+ 0.706X4(X1 = age, X2 = hair zinc,X3 = Hb, X4 = growth)If Y<0, it means that iron status may fall following zinc treatment, ifY>0, iron status may improve.