学龄前儿童维生素A及铁缺乏对红细胞参数的影响分析

Influence of vitamin A deficiency and iron depletion on erythrocyte parameters in preschool children

目的了解东莞市学龄前儿童维生素A的缺乏现状,明确维生素A及血清铁蛋白影响红细胞参数的特点。方法于2017年3月至10月采用随机抽样调查的方法选取在东莞市第八人民医院体检、无现患疾病的3～6岁学龄前儿童2 805例为研究对象,对其进行血常规、血清铁蛋白、血红蛋白电泳及维生素A浓度检测,分析维生素A、血清铁蛋白及红细胞参数是否存在年龄及性别差异,比较维生素A及血清铁蛋白对红细胞参数的影响。结果学龄前儿童贫血、维生素A不足及储存铁减少的比例分别为6.52%(183/2 805)、32.09%(900/2 805)和6.60%(185/2 805)。各年龄组及性别间维生素A水平差异均无统计学意义(均P>0.05),而女童血清铁蛋白水平显著高于男童(t=4.540,P=0.000)。储存铁减少可引起平均红细胞血红蛋白含量(MCH)显著降低(OR=1.490,P<0.05);而维生素A不足可导致除平均红细胞体积(MCV)以外所有的红细胞参数降低,明显影响血红蛋白浓度(HGB)、MCH、平均红细胞血红蛋白浓度(MCHC)、红细胞压积(HCT)和红细胞计数(OR值分别为2.519、1.272、1.562、2.072、2.088,均P<0.05)。结论东莞市学龄前儿童维生素A缺乏及储存铁减少的状况较严重,需要采取积极措施进行干预;两者对红系造血的影响各有其特点,可作为初步分析贫血病因的依据。

Objective To investigate the present situation of vitamin A deficiency in preschool children in Dongguan and to determine the influence of vitamin A and serum ferritin on red blood cell parameters.Methods Altogether 2 805 preschool children(3-6 years old)without present diseases receiving physical checks in Dongguan Eighth People’s Hospital from March to October 2017 were selected by random sampling method.Routine blood count,serum ferritin,hemoglobin electrophoresis and vitamin A concentration of them were measured.Differences in vitamin A,serum ferritin and red blood cell parameters among different age groups and genders were analyzed.Influence of vitamin A and serum ferritin on erythrocyte parameters was compared.Results Proportion of anemia,vitamin A deficiency and iron depletion in preschool children was 6.52%(183/2 805),32.09%(900/2 805)and 6.60%(185/2 805),respectively.There was no significant difference in level of vitamin A in all age groups and between sexes(all P>0.05),and serum ferritin level in girls was significantly higher than that in boys(t=4.540,P=0.000).Iron depletion could cause a significant decrease in mean corpuscularhemoglobin(MCH)(OR=1.490,P<0.05).However,vitamin A deficiency could lead to reductions of all red blood cell parameters except mean corpuscular volume(MCV),and it significantly affected hemoglobinconcentration(HGB),MCH,mean corpuscular hemoglobinconcentration(MCHC),hematocrit(HCT)and red bloodcell count(OR value was 2.519,1.272,1.562,2.072 and 2.088,respectively,all P<0.05).Conclusion Situation of vitamin A deficiency and iron depletion in preschool children in Dongguan is still serious,and we need to take active measures to intervene.Influence of each factor on hematopoiesis has its characteristics,which can be used as basis for preliminary analysis of etiology of anemia.