不同喂养方式对6～12月龄婴儿铁营养状况的影响

The influence of different feeding practices on iron nutritional status in infants aged 6-12 months

目的了解不同喂养方式下6～12月龄婴儿的铁营养状况。方法选择2016年2月至2017年1月在江西省儿童医院保健科及清华大学附属北京清华长庚医院儿科生长发育门诊就诊的6～12月龄婴儿210例,按照喂养方式分为母乳喂养组(n=69)、混合喂养组(n=73)和人工喂养组(n=68),采集静脉血测定各项铁营养状况指标和CRP,比较不同喂养方式婴儿的铁营养状况及铁缺乏、缺铁性贫血的发生率。结果母乳喂养组婴儿Hb含量为(108.26±11.65)g/L,明显低于混合喂养组的(120.32±8.51)g/L及人工喂养组的(122.82±9.21)g/L,差异有统计学意义(P <0.05),缺铁性贫血及铁缺乏发生率分别为63.77%和18.84%,明显高于其他两组,差异有统计学意义(P <0.05),平均红细胞体积(mean corpus?cular volume, MCV)[(76.15±5.63)fl]、平均血红蛋白量(mean corpuscular hemoglobin, MCH)[(25.18±2.98)pg]、平均血红蛋白浓度(mean corpuscular hemoglobin concentration, MCHC)[(323.26±16.94)g/L]均低于其他两组[(80.82±4.18)fl,(26.85±1.81)pg,(330.93±9.49)g/L;(79.54±4.65)fl,(26.61±1.61)pg,(333.83±12.96)g/L],差异有统计学意义(P <0.05);母乳喂养组婴儿血清铁(serum iron, SI)为(11.25±2.81)μmol/L,血清铁蛋白(serum ferritin, SF)中位数为23.2 ng/ml,均低于其他两组[(13.05±2.63)μmol/L,48.69 ng/ml;(12.16±2.84)μmol/L,51.19 ng/ml],除SI与人工喂养组比较差异无统计学意义外(P> 0.05),其余差异均有统计学意义(P <0.05);而混合喂养组与人工喂养组相比较,上述各指标的差异均无统计学意义(P> 0.05)。结论 6～12月龄母乳喂养婴儿的Hb、MCV、MCH、MCHC均明显低于人工喂养及混合喂养婴儿,缺铁性贫血和铁缺乏发生率高于人工喂养及混合喂养婴儿,提示母乳喂养婴儿易发生铁缺乏,需关注和改善6～12月龄母乳喂养婴儿的铁营养状况问题。

Objective To study the iron nutrition status of aged 6-12 months infants under different feeding practices.Methods A total of 210 subjects aged 6-12 months were chosen from the health care clinic of Children's Hospital of Jiangxi and outpatient department of pediatrics of Beijing Tsinghua Changgung Hospital,who were divided into breast feeding group(n=69),mixed feeding group(n=73)and formula feeding group(n=68).Blood samples was collected to test CRP and iron status indicators which were used to compare the iron nutrition status,the incidence rates of iron deficiency and iron deficiency anemia under different ways of feeding.Results The Hb of infants in breast feeding group[(108.26±11.65)g/L]was evidently lower than that in the mixed feeding group[(120.32±8.51)g/L]and formula feeding group[(122.82±9.21)g/L],the differences were statistically significant(P<0.05).The incidence rates of iron deficiency anemia and the iron deficiency were separately 63.77%and 18.84%,which were evidently higher than those of other two groups and the difference were statistically significant.The MCV,MCH and MCHC of breast feeding group were(76.15±5.63)fl,(25.18±2.98)pg and(323.26±16.94)g/L respectively,which were lower than the other groups[(80.82±4.18)fl,(26.85±1.81)pg and(330.93±9.49)g/L;(79.54±4.65)fl,(26.61±1.61)pg and(333.83±12.96)g/L]and the difference were statistically significant(P<0.05).Serum iron(SI)of breast feeding group was(11.25±2.81)μmol/L and the median serum ferritin was 23.2 ng/ml,which were both lower than the other two groups[(13.05±2.63)μmol/L,48.69 ng/ml and(12.16±2.84)μmol/L,51.19 ng/ml].Other than the difference of SI(P>0.05)compared with formula feeding group,all the differences were statistically significant(P<0.05).Meanwhile,the differences between the items mentioned above between mixed feeding group and formula feeding group were not statistically significant(P>0.05).Conclusions The Hb,MCV,MCH,MCHC of breast feeding group infants aged 6-12 months are significantly lower than formula feeding group and mixed feeding group infants with same age.Besides that,the incidence rates of iron deficiency anemia and iron deficiency of breast feeding group were higher than the other two groups.This research in?dicates that breastfed infants are vulnerable to iron deficiency.Pediatricians and parents should pay more attention to the statues of iron nutrition of breast feeding infants of aged 6-12 months.