北京山区学龄儿童铁营养状况及亚临床铁缺乏的干预效果

Iron status and effect of early iron supplementation on sub-clinical iron deficiency in rural school-age children from mountainous areas of Beijing

目的 调查北京山区学龄儿童机体铁营养状况、亚临床铁缺乏 (SID)患病率及观察采用乙二胺四乙酸钠铁 (NaFeEDTA)间断补充与早期铁干预效果。方法 对北京市房山山区 7～ 13岁学龄儿童 10 12名进行膳食调查、膳食频率调查与体内铁生化指标检测 ,依现行标准筛检贮存铁减少(IDs)、红细胞生成缺铁 (IDE)和缺铁性贫血 (IDA)儿童共 2 6 7名 ,给予口服NaFeEDTA胶囊 ( 6 0mgFe/粒 ) ,每次 1粒 ,IDs与IDE儿童 ,每周 1次 ;IDA儿童每周 3次 ,连续 9周。重复测定体内铁生化指标 ,并与干预前进行比较。结果 各年龄组儿童能量、蛋白质、铁和维生素C平均每日摄入量均达到推荐的膳食营养素摄入量 ,但膳食铁构成中血红素铁所占比例较低 ;该人群血液铁生化指标检测平均值 :血清铁蛋白含量为 ( 5 0 83± 33 0 9) μg/L ,红细胞游离原卟啉 (FEP)含量为 ( 489 44± 2 19 6 1) μg/L ,FEP/血红蛋白 (Hb)比值为 ( 3 83± 1 96 ) ,Hb含量为 ( 130 5 7± 10 82 )g/L ;总铁缺乏 (IDs+IDE +IDA)儿童检出率为 2 6 5 %,其中IDs占 15 5 %,IDE占 7 1%,IDA占 3 9%,SID占缺铁总人数的 85 4%,为IDA儿童的 5 8倍。进行铁干预后 ,体内各项铁指标显著提高并恢复至正常水平。结论 SID是值得重视的隐匿人群 ,采取早期鉴定、干预与综合?

Objective To understand iron nutritional status in school-age children, incidence of the sub-clinical iron deficiency (SID) and effect of iron supplementation on SID in the rural school-age children from mountainous areas of Beijing. Methods The dietary survey and food frequency questionnaire survey were conducted in 1 012 school children aged 7-13 at rural mountainous areas of Fangshan District, Beijing, and their blood samples were collected for analyzing biochemical indicators for iron nutrition. Two hundred and sixty-seven children with IDs(iron deficiency store) and IDE(iron deficiency erythropoiesis), based on screening criteria for iron-deficiency anemia, received an iron supplementation (NaFeEDTA) capsule (containing 60 mg iron element) weekly, and those with IDA(iron deficiency anemia) received NaFeEDTA capsule thrice weekly for nine weeks. Blood biochemical indicators for iron nutrition were determined repeatedly and compared with those before and after the intervention. Results The daily average intakes of energy, protein, iron and vitamin C in school children of all age groups reached the daily recommended criteria (>85% of the RNIs), but the proportion of heme in dietary iron constitution was lower. The average blood biochemical indicators for iron nutrition were as follows: serum ferritin (SF) (50.83±33.09)μg/L, free erythrocyte protoporphyrin (FEP) (489.44±219.61)μg/L, hemoglobin (Hb)(130.57±10.82)g/L, and the ratio of FEP/Hb(3.83±1.96), respectively. Incidence of total iron deficiency in rural children was 26.5%, with proportions of iron deficiency (IDs), iron deficiency erythropoiesis (IDE), and iron deficiency anemia (IDA) of 15.5%, 7.1%, and 3.9% respectively. SID accounted for 85.4% of the total iron deficiency, which was 5.8 times as much as IDA. With iron supplementation for 9 weeks, the hematdogical index of iron increased significantly and returned to the normal level. Conclusions The incidence of subclinical iron deficiency in the rural school-age children was insidious and should be attached more importance, which was helpful to its early recognition and intervention. Iron supplementation is important for children with SID to prevent and decrease the occurrence of IDA.