云南贫困少数民族地区婴幼儿微量元素锌、铁、铜与膳食营养的关系分析
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摘要
目的了解云南省少数民族贫困地区婴幼儿微量元素锌、铁、铜的水平、膳食摄入情况及营养包添加情况,分析微量元素与膳食营养的关系,为制定云南省儿童微量元素干预措施提供参考依据。方法采用多阶段分层整群抽样的方法,抽取云南省不同程度贫困地区,并对所抽取的4个贫困少数民族地区大理剑川县、怒江泸水县、昭通彝良县、普洱墨江县1 136名6～23月龄婴幼儿进行全血微量元素锌、铁、铜检测和连续3 d 24 h膳食营养调查。比较不同地区、年龄、性别、儿童血中微量元素锌、铁、铜水平的差异;分析膳食摄入情况以及对微量元素检测量正常率的影响。结果共调查1 136名婴幼儿,其血锌缺乏率为68.9%,铜缺乏率为0.2%,铜超标率为13.9%,铁缺乏率为21.1%。是否给孩子添加营养包和膳食摄入铁元素是否达标均与血中铁元素含量正常率之间有统计学意义(P<0.05),是否添加营养包是锌、铜元素的影响因素(P<0.05)。结论云南省贫困少数民族地区6～23月龄婴幼儿微量元素锌、铁缺乏患病率高,部分儿童血铜含量超标,给孩子添加营养包和膳食摄入达标均为血中微量元素水平的影响因素因素。加强儿童家长的喂养指导,合理添加辅食,指导家长适时添加营养素尤为重要。
Objective To understand the levels of zinc, iron and copper, dietary intake and dietary supplements of infants in poor areas of ethnic minorities in Yunnan province, and to analyze the relationship between micronutrients and dietary nutrition. Methods This study adopts the method of multistage stratified cluster sampling to extract different degrees in poor ethnic minority areas in Yunnan province, including JianChuan county of Dali, Lushui county of NuJiang,YiLiang County of ZhaoTong,MoJiang County of Puer.1136 infants aged 6 to 23 months were given whole blood trace elements(zinc, iron and copper) detection and 24 hours' dietary nutrition survey for three days. The levels of zinc, iron and copper in the blood of children were compared among different regions, ages, genders and children. The effect of dietary intake on the normal rate of micronutrient detection was analyzed. Results A total of 1136 infants and young children were investigated, the rate of serum zinc deficiency was 68.9%, the rate of copper deficiency was 0.2%, the rate of copper overshooting was 13.9% and the rate of iron deficiency was 21.1%. There was a statistical difference between the standard of iron intake and the normal rate of iron content in blood, and the addition of nutrition packs was the influencing factor of zinc and copper elements(P values were all < 0.05). Conclusion The prevalence rate of micronutrient zinc and iron deficiency in infants aged 6-23 months in poor ethnic minority areas of Yunnan province is high,and some children have excessive copper content in blood. The addition of nutrition packs and dietary intake to children are all factors influencing the levels of trace elements in blood. It is particularly important to strengthen the feeding guidance of children's parents, rationally add supplementary food and timely guide parents to add nutrients.
Objective To understand the levels of zinc, iron and copper, dietary intake and dietary supplements of infants in poor areas of ethnic minorities in Yunnan province, and to analyze the relationship between micronutrients and dietary nutrition. Methods This study adopts the method of multistage stratified cluster sampling to extract different degrees in poor ethnic minority areas in Yunnan province, including JianChuan county of Dali, Lushui county of NuJiang,YiLiang County of ZhaoTong,MoJiang County of Puer.1136 infants aged 6 to 23 months were given whole blood trace elements(zinc, iron and copper) detection and 24 hours' dietary nutrition survey for three days. The levels of zinc, iron and copper in the blood of children were compared among different regions, ages, genders and children. The effect of dietary intake on the normal rate of micronutrient detection was analyzed. Results A total of 1136 infants and young children were investigated, the rate of serum zinc deficiency was 68.9%, the rate of copper deficiency was 0.2%, the rate of copper overshooting was 13.9% and the rate of iron deficiency was 21.1%. There was a statistical difference between the standard of iron intake and the normal rate of iron content in blood, and the addition of nutrition packs was the influencing factor of zinc and copper elements(P values were all < 0.05). Conclusion The prevalence rate of micronutrient zinc and iron deficiency in infants aged 6-23 months in poor ethnic minority areas of Yunnan province is high,and some children have excessive copper content in blood. The addition of nutrition packs and dietary intake to children are all factors influencing the levels of trace elements in blood. It is particularly important to strengthen the feeding guidance of children's parents, rationally add supplementary food and timely guide parents to add nutrients.
引文
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[10]苏宜香.《中国居民膳食营养素参考摄人量,2013版》儿童相关DRIs修订要点解读[J].中国儿童保健杂志,2015,23(7):673-675.
[11]刘晖.儿童血镁、铁、锌、铜、铅含量现状分析[J].中国当代医药,2010,17(22):203-204.
[12]李玥,李鹏,杜文鹏.2015-2016年长春市南关区3260例体检儿童5种微量元素检测结果分析[J].中国卫生产业,2017,14(12):157-158.
[13]曾雁玲,钟逶迤,莫礼峰.某市部分地区儿童血铅水平与钙、铁和锌缺乏对儿童生长发育的影响[J].国际检验医学杂志,2011,32(02):173-174.
[14]刘洪玉,郑福兰,杨华贤,等.云南部分贫困地区少数民族儿童血清元素水平的调查[J].中国妇幼保健,2005,11(22):100-102.
[15] NOJILANA B,NORMAN R,DHANSAY M A,et al.Estimating the buden of disease attributable to iron deficiency anaemia in South Africa in 2000[J].S Aft Med J,2007,97(8Pt2):741-746.
[2]童方,姚德佳.首都儿科研究所门诊体检儿童指血5种微量元素检测结果分析[J].中国妇幼保健,2001,16(10):641-642.
[3]中国儿童铁缺乏症流行病学调查协作组.中国7个月-7岁儿童铁缺乏症流行病学的调查研究[J].中华儿科杂志,2004,42(08):886-891.
[4]初瑞雪,崔晞.儿童肺炎患者体内五种常微量元素的检查结果分析[D].济南:山东大学硕士学位论文,2013.
[5] CAO J,GAO Z,YAN J.Evaluation of trace elements and their relationship with growth and development of young children[J].Biological trace element research,2016,171(2):270-274
[6] LAZZERINI M,WANZIRA H.Oral zinc for treating diarrhoea in children[J].The Cochrane database of systematic reviews,2016,12(20):12.
[7] DEMIR N,BASARANOGLU M,HUYUT Z.The relationship between mother and infant plasma trace element and heavy metal levels and the risk of neural tube defect in infants[J].The journal of maternal-fetal&neonatal medicine:the official journal of the European Association of Perinatal Medicine,the Federation of Asia and Oceania Perinatal Societies,the International Society of Perinatal Obstetricians,2017,11(3):1-8.
[8]贾妮,戴耀华.儿童全血钙、铁、锌等矿物质测定参考值的研究现状[J].中国妇幼健康研究,2014,25(05):898-905.
[9]程义勇.《中国居民膳食营养素参考摄入量》2013修订版简介[J].营养学报,2014,36(4):313-318.
[10]苏宜香.《中国居民膳食营养素参考摄人量,2013版》儿童相关DRIs修订要点解读[J].中国儿童保健杂志,2015,23(7):673-675.
[11]刘晖.儿童血镁、铁、锌、铜、铅含量现状分析[J].中国当代医药,2010,17(22):203-204.
[12]李玥,李鹏,杜文鹏.2015-2016年长春市南关区3260例体检儿童5种微量元素检测结果分析[J].中国卫生产业,2017,14(12):157-158.
[13]曾雁玲,钟逶迤,莫礼峰.某市部分地区儿童血铅水平与钙、铁和锌缺乏对儿童生长发育的影响[J].国际检验医学杂志,2011,32(02):173-174.
[14]刘洪玉,郑福兰,杨华贤,等.云南部分贫困地区少数民族儿童血清元素水平的调查[J].中国妇幼保健,2005,11(22):100-102.
[15] NOJILANA B,NORMAN R,DHANSAY M A,et al.Estimating the buden of disease attributable to iron deficiency anaemia in South Africa in 2000[J].S Aft Med J,2007,97(8Pt2):741-746.