贫血及小红细胞对婴幼儿体格和神经心理发育的影响

Effect of anemia and small red blood cells on the physical and neuropsychological development of infants

目的了解贫血及无贫血小红细胞对婴幼儿体格生长和神经心理发育的影响,为贫血和小红细胞婴幼儿的管理提供参考依据。方法纳入2021年1—6月在川北医学院附属医院儿童保健科常规健康检查且资料完整的6~36月龄儿童。根据血常规结果将研究对象分为贫血组74例、小红细胞组228例和对照组143例。对不同组婴幼儿体格测量及儿心量表测评结果进行回顾性分析。结果共纳入婴幼儿445名。贫血组婴儿及幼儿体重的Z值(Z_(WA))和身高的Z值(Z_(HA))均较对照组低(F=12.618、3.807、21.266、3.668,P<0.05),小红细胞组婴儿Z_(WA)和Z_(HA)也显著低于对照组(Bonferroni-t=2.433、2.823,P<0.05)。儿心量表测评结果显示贫血组婴儿大运动、精细运动、适应能力、语言、社会行为能区及总发育商均显著低于对照组(Bonferroni-t=2.851、5.554、2.749、2.681、4.508、5.158,P<0.05),小红细胞组婴儿精细动作、语言、社会行为能区及总发育商也较对照组显著降低(Bonferroni-t=4.317、2.506、3.598、3.758,P<0.05)。对于幼儿,贫血组大运动、语言、社会行为能区及总发育商均较对照组显著降低(Bonferroni-t=2.482,3.038,2.861,2.711,P<0.05),小红细胞组幼儿语言、社会行为能区发育商及总发育商也低于对照组(Bonferroni-t=2.715、2.939、2.473,P<0.05)。结论除了贫血外,小红细胞也影响婴幼儿的生长发育,需引起重视并探索合适的干预策略。

Objective To study the effect of anemia and small red blood cells on physical growth and neuropsychological development of infants,so as to provide reference for the management of infants with anemia and small red blood cells.Methods Children aged 6 to 36 months who received routine health examination in Child Health Care Department of Affiliated Hospital of the North Sichuan Medical College from January to June 2021 were included,and were divided into anemia group(n=74),small red blood cell group(n=228)and control group(n=143)according to the results of blood routine examination.The results of anthropometric measures and the revised Children Neuropsychological and Behavior Scale in different groups were analyzed retrospectively.Results A total of 445 infants were included.The Z-score of weight-for-age(Z_(WA))and Z-score of height-for-age(Z_(HA))of children aged 6 to 11 months and 12 to 36 months in the anemia group were significantly lower than those in the control group(F=12.618,3.807,21.266,3.668,P<0.05).The Z_(WA) and Z_(HA) of children aged 6 to 11 months in the small red blood cell group were also significantly lower than those in the control group(Bonferroni-t=2.433,2.823,P<0.05).The results of Children Neuropsychological and Behavior Scale showed that for children aged 6 to 11 months,the development quotients of gross motor,fine motor,adaptability,language and personal-social and total development quotient of anemia group were significantly lower than those of control group(Bonferroni-t=2.851,5.554,2.749,2.681,4.508,5.158,P<0.05),and the development quotients of fine motor,language,personal-social and total development quotients of small red blood cell group were also significantly lower than those of control group(Bonferroni-t=4.317,2.506,3.598,3.758,P<0.05).For children aged 12 to 36 months,the development quotients of gross motor,language,personal-social and total development quotient of anemia group were significantly lower than those of control group(Bonferroni-t=2.482,3.038,2.861,2.711,P<0.05),and the language and personal-social development quotient and total development quotient of small red blood cell group were also lower than those of control group(Bonferroni-t=2.715,2.939,2.473,P<0.05).Conclusions In addition to anemia,microcytosis also affects the growth and development of infants,and requires attention and exploration of appropriate intervention strategies.