广东省中小学生贫血与体质影响因素分析

Prevalence and related physical factors of anemia among primary and high school students in Guangdong province

目的掌握广东省中小学生血红蛋白现状及体质影响因素,为学生提高身体素质提供科学依据。方法在2014年广东省参与的"全国学生体质与健康调研"项目中,选取7、9、12、14岁年龄组4 783名学生为研究对象,采用改良叠氮化高铁血红蛋白法检测血红蛋白,用逐步回归统计方法分析血红蛋白值影响因素。结果广东省中小学生血红蛋白平均值为(134.28±12.234)g/L,男生为(136.33±13.022)g/L,女生为(132.21±11.013)g/L;城市学生为(134.89±11.931)g/L,农村学生为(133.66±12.504)g/L。贫血患病率为10.6%,男生为9.8%,女生为11.5%;城市学生为8.7%,乡村学生为12.6%。近20年来广东省中小学生贫血患病率每5年呈现一个上升/下降的波动,波幅5%左右;2014年学生贫血率高于2010年。逐步回归分析结果显示,肺活量、上臂部皮脂厚度、握力与血红蛋白值呈正相关,脉搏、肩胛部皮脂厚度、臀围、仰卧起坐/斜身引体/引体向上、50 m跑、年龄与血红蛋白值呈负相关。结论广东省中小学生贫血患病率属于轻度水平,但有回升趋势,应密切监测;血红蛋白与生长发育和体能指标有关,应实施营养干预,提高学生血红蛋白浓度。

Objective To explore the level and related physical factors of blood hemoglobin among primary and high school students in Guangdong province and to provide evidences for improving physique of the students. Methods Data on4 783 primary and high school students aged 7, 9, 12 and 14 years were extracted from the dataset of National Student Physique and Health Research conducted in Guangdong province in 2014. Blood hemoglobin concentration was determined with modified azide methemoglobin method. Factors related to hemoglobin level were analyzed with stepwise regression.Historical data on the prevalence of anemia among primary and high school students in Guangdong province were also collected. Results For primary and middle school students in Guangdong, the mean concentration of blood hemoglobin was134.28 ± 11.931 g/L for all the students（133.33 ± 12.504 and 132.21 ± 11.013 g/L for the boys and girls; 134.89 ± 11.931 and 133.66 ± 12.504 g/L for the urban and rural students）. The prevalence rate of anemia among the students was 10.6%（9.8% and 11.5% among the boys and girls; 8.7% and 12.6% among the urban and rural students）. During the recent 20 years,the prevalence rate of anemia among primary and high school students in the province fluctuated every 5 years, with a variation of 5% around the mean, and the prevalence rate in 2014 was higher than that in 2011. The results of stepwise regression analysis revealed that vital capacity, sebum thickness of upper arm, and grip strength were positively correlated to hemoglobin concentration; while pulse, sebum thickness of scapular region, hip circumference, the numbers of sit-ups or pull-ups, the time of 50 meters running, and age were reversely accociated with hemoglobin concentration. Conclusion The prevalence rate of anemia was at a low level among primary and high school students in Guangdong province but showed an upward trend, suggesting relevant monitoring is needed; physical factors and development indexes are associated with blood hemoglobin level and nutrition intervention needs to be carried out for increasing the students′ hemoglobin level.