儿童营养性缺铁性贫血的危险因素分析

Risk factors for nutritional iron deficiency anemia in children

目的探讨营养性缺铁性贫血(IDA)的临床特点,分析影响贫血及其程度的危险因素,为预防和临床诊治提供参考依据。方法回顾性分析372例IDA患儿临床资料,调查其发病及贫血程度的影响因素。结果 372例患儿中,男女比例为2.72:1;6月龄至2岁患儿占79.9%;早产儿占30.7%;出生体重<2.5 kg者占22.9%,≥2.5 kg者占77.1%;自然分娩者占36.0%,剖宫产64.0%;未适时添加辅食者占79.3%;既往患过下呼吸道或反复上呼吸道感染、腹泻、有外伤、手术史者占46.2%。单因素分析显示年龄、出生体重、孕周、是否适时添加辅食、既往有上述病史与贫血严重程度有关。多因素分析显示,出生体重、既往有上述病史者是贫血严重程度的主要危险因素。结论 IDA高发于6月龄至2岁儿童;喂养不当仍是导致缺铁性贫血的主要原因之一;贫血严重程度主要与出生体重、既往有下呼吸道或反复上呼吸道感染、腹泻、外伤、手术史密切相关。

Objective To investigate the clinical features of nutritional iron deficiency anemia （IDA） and analyze the risk factors for the severity of anemia, and to provide a basis for the prevention and clinical diagnosis and treatment of this disease. Methods A retrospective analysis was performed on the clinical data of 372 children with IDA to investigate the risk factors for the severity of IDA. Results Of 372 cases, the male-to-female ratio of these patients was 2.72 ： l. Of all cases, 79.9% were aged 6 months to 2 years, and 30.7% were premature infants; 22.9% had a birth weight of 〈 2.5 kg, and 77.l% had a birth weight of 〉_2.5 kg; 36.0% were delivered by natural birth, and 64.0% were delivered by caesarean section; 79.3% were not given solid foods in time; 46.2% had a history of lower respiratory tract infection/recurrent upper respiratory tract infection, diarrhea, trauma, or surgery. The univariate analysis showed that age, birth weight, gestational age, timely introduction of solid foods, and a history of lower respiratory tract infection/ recurrent upper respiratory tract infection, diarrhea, trauma, or surgery were associated with the severity of anemia. The multivariate analysis showed that birth weight and the mentioned medical history were associated with the severity of anemia. Conclusions Nutritional IDA is common in children aged 6 months to 2 years. Nowadays, improper feeding pattern is still one of the main causes of IDA. Birth weight and a history of lower respiratory tract infection/recurrent upper respiratory tract infection, diarrhea, trauma, or surgery are closely associated with the severity of anemia.