营养不良对维吾尔族儿童甲型肝炎康复时间的影响

Correlation between malnutrition and prognosis of hepatitis A in Uygur children

目的分析新疆和田地区维吾尔族甲型肝炎患儿营养不良与预后时间的关系。方法回顾性分析2014年1月-2015年5月新疆和田地区传染病专科医院收治的342例甲型肝炎患儿,根据Z值评分法分为营养不良组(136例)和营养正常组(206例)。比较两组患儿血常规、肝功能、生化指标、血脂、凝血功能、住院天数和费用的差异。计数资料组间比较采用χ2检验,计量资料组间比较采用t检验。结果营养不良组母乳喂养率低,血红蛋白、平均红细胞压积、平均血红蛋白含量、平均血红蛋白浓度、血清铁、血清铁蛋白、葡萄糖、白蛋白、凝血酶原活动度低于正常组,ALT、TBil、总胆汁酸、胆固醇、住院天数以及费用高于正常组,差异均有统计学意义(P值均<0.05)。结论营养不良的甲型肝炎患儿缺铁性贫血、肝功能损伤程度更重,糖类、脂肪代谢异常,因此预后恢复时间长,所需治疗费用高。为了有效保护维吾尔族儿童,建议及时注射甲型肝炎疫苗并监测生长发育状况。

Objective To analyze the correlation between malnutrition and prognosis in Uyghur pediatric patients with hepatitis A in Hetian of Xinjiang Uyghur Autonomous Region,China. Methods The clinical data of 342 children with hepatitis A admitted to the Infectious Disease Hospital of Hetian from January 2014 to May 2015 were retrospectively analyzed and the patients were divided into malnutrition group with 136 patients and normal nutrition group with 206 patients according to the Z- scores. The data of complete blood count,liver function test,biochemical indices,blood lipids,blood coagulation,and hospitalization days and costs were compared between the two groups. Comparison of categorical data between the two groups was made by chi- square test and comparison of continuous data between the two groups was made by t test. Results Compared with the normal nutrition group,the malnutrition group had significantly lower values of breastfeeding rate,hemoglobin,mean corpuscular volume,mean corpuscular hemoglobin,mean corpuscular hemoglobin concentration,serum iron,serum ferritin,glucose,serum albumin,and plasma thromboplastin antecedent but higher values of alanine transaminase,total bilirubin,total bile acid,cholesterol,and hospitalization days and costs（ P 0. 05）. Conclusion Compared with the normal nutrition pediatric patients with hepatitis A,the malnutrition pediatric patients with hepatitis A have more severe iron deficiency anemia,hepatic damage,and abnormal metabolism of carbohydrates and fatty acids,so their recovery time is longer and the hospitalization costs are higher. To effectively protect Uygur children,hepatitis A vaccination in due course and the children＇s growth and development monitoring are recommended.