连云港市2～6岁儿童血清维生素A、D水平及影响因素研究
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摘要
目的了解连云港市学龄前儿童血清维生素A、D水平及其影响因素,以期对学龄前儿童的保健工作提供现实依据。方法选择连云港市两所普通幼儿园及两个经济水平居中的社区,按照花名册随机选取2～6岁健康儿童108名,维生素A采用高效液相色谱法,维生素D采用高效液相色谱-串联质谱法进行检测,应用自拟问卷进行调查。结果维生素D平均(23. 33±6. 43) ng/ml,正常74名,占68. 5%;缺乏7名,占6. 5%;不足27名,占25. 0%。维生素A平均(0. 35±0. 07) mg/L,正常89名,占82. 4%;缺乏2名,占1. 9%;可疑缺乏17名,占15. 7%。两种营养素在男女童间差异均无统计学意义。偏食导致的营养素摄入不足和2岁内维生素A、D补充不足以及缺乏户外活动为主要的影响因素。结论连云港市学龄前儿童维生素D、A依次存在不同程度的缺乏与不足,缺乏发生较为普遍。加强2岁内婴幼儿的维生素D、A的摄入补充,以及学龄前幼儿营养管理、增加户外运动在儿童保健工作中仍需引起更多重视。
Objective To identify the status of serum vitamin A,D levels of preschoolers and its influential factors,in order to provide practical basis for the health care of preschool children. Method 108 children between 2 to 6 years old were randomly sampled from two ordinary kindergarten and two economically centered communities. The levels of Vit A was determined by highperformance liquid chromatography,and the level of 25( OH) D was determined by high-performance liquid chromatography tandem mass spectrometry,the survey was carried with the self-designed questionnaire. Results The average level of Vit D was( 23. 33 ±6. 43) ng/ml. 74 cases were normal( 68. 5%),7 cases were deficient( 6. 5%) and less than 27 cases( 25. 0%). The level of was( 0. 35 ± 0. 07) mg/L,89 cases were normal( 82. 4%),2 cases were deficient( 1. 9%),and 17 cases were suspected deficiency( 15. 7%). There wasn't statistical difference between boys and girls. Inadequate nutrient intake caused by partial diet,inadequate vitamin A and D supplementation within 2 years of age and lack of outdoor activities were the main influencing factors. Conclusions It is common for the preschool children in Lianyungang city to have varying degrees of deficiency and deficiency in vitamin D and vitamin A,It is still necessary to pay more attention to strengthening the intake and supplement of vitamin D and A in infants and young children within 2 years old,and the nutrition management of preschool children,more attention should be paid to increasing outdoor sports in children's health care.
Objective To identify the status of serum vitamin A,D levels of preschoolers and its influential factors,in order to provide practical basis for the health care of preschool children. Method 108 children between 2 to 6 years old were randomly sampled from two ordinary kindergarten and two economically centered communities. The levels of Vit A was determined by highperformance liquid chromatography,and the level of 25( OH) D was determined by high-performance liquid chromatography tandem mass spectrometry,the survey was carried with the self-designed questionnaire. Results The average level of Vit D was( 23. 33 ±6. 43) ng/ml. 74 cases were normal( 68. 5%),7 cases were deficient( 6. 5%) and less than 27 cases( 25. 0%). The level of was( 0. 35 ± 0. 07) mg/L,89 cases were normal( 82. 4%),2 cases were deficient( 1. 9%),and 17 cases were suspected deficiency( 15. 7%). There wasn't statistical difference between boys and girls. Inadequate nutrient intake caused by partial diet,inadequate vitamin A and D supplementation within 2 years of age and lack of outdoor activities were the main influencing factors. Conclusions It is common for the preschool children in Lianyungang city to have varying degrees of deficiency and deficiency in vitamin D and vitamin A,It is still necessary to pay more attention to strengthening the intake and supplement of vitamin D and A in infants and young children within 2 years old,and the nutrition management of preschool children,more attention should be paid to increasing outdoor sports in children's health care.
引文
[1]杨晓光,翟凤英.中国居民营养与健康状况调查报告之三:2002居民体质与营养状况[M].北京:人民卫生出版社,2006:17-21.
[2]王丽敏,张雪玲,王文娟,等.佳木斯地区6岁以下儿童血清维生素A、25-羟基维生素D、维生素E水平分析[J].检验医学,2017,32(4):276-279.
[3]中华医学会儿科学分会儿童保健学组,《中华儿科杂志》编辑委员会.儿童微量营养素缺乏防治建议[J].中华儿科杂志,2010,48(7):502-509.
[4] Harvey NC,Holroyd C,Ntani G,et al. Vitamin D supplementation in pregnancy:a systematic review[J].Health Technol Assess,2014,18(45):1-190.
[5]全国佝偻病防治科研协作组,中国优生科学协会小儿营养专业委员会.维生素D缺乏及维生素D缺乏性佝偻病防治建议[J].中国儿童保健杂志,2015,23(7):781-782.
[6]赵静,张倩,张环美,等.北京市怀柔区儿童维生素D营养状况及其与体成分的关系[J].中华流行病学杂志,2010,31(1):34-38.
[7]刘玄华,阮青,董邕晖,等.广西2012-2013年农村学生营养改善项目实施地区学生膳食和营养状况[J].中国学校卫生,2015,36(8):1130-1138.
[8]王丽敏,张雪玲,王文娟,等.佳木斯地区6岁以下儿童血清维生素A、25-羟基维生素D、维生素E水平分析[J].检验医学,2017,32(4):276-279.
[9]程茜.预防儿童维生素D缺乏[J].中国儿童保健杂志,2014,22(8):785-787.
[10]李娜,王建红,金春华,等. 67例儿童血清维生素水平研究[J].中国儿童保健杂志,2015,23(10):1093-1095.
[11]隋凤轩,吴琼,鹏妹,等.深圳市龙华新区0~6岁儿童维生素D营养状态的调查[J].中国妇幼保健,2017,32(20):5106-5107.
[12]冯慧敏,姚梅,郑义婷.皖北地区0~14岁儿童维生素D营养状况分析[J].中国学校卫生,2017,38(4):594-595.
[13]王卫平.儿科学[M]. 8版.北京:人民卫生出版社,2013:69-74.
[14]王陇德.中国居民营养与健康状况调查报告之—2002综合报告[M].北京:人民卫生出版社,2005:41-45.
[15]曾婧,李兆林,辜伟伟,等.十堰市城区3-6岁儿童维生素A营养状况分析及比较[J].营养学报,2012,34(3):229-232.
[16]孙丽芳,尹有会,梁利,等.北京市平谷区2~6岁儿童血清维生素A水平分析[J].中国妇幼健康研究,2016,27(4):510-512.
[17]徐柏荣,张佩斌,王福德,等.江苏省5岁以下儿童血浆维生素A水平及影响因素的研究[J].中国儿童保健杂志,2001,9(2):83-84.
[2]王丽敏,张雪玲,王文娟,等.佳木斯地区6岁以下儿童血清维生素A、25-羟基维生素D、维生素E水平分析[J].检验医学,2017,32(4):276-279.
[3]中华医学会儿科学分会儿童保健学组,《中华儿科杂志》编辑委员会.儿童微量营养素缺乏防治建议[J].中华儿科杂志,2010,48(7):502-509.
[4] Harvey NC,Holroyd C,Ntani G,et al. Vitamin D supplementation in pregnancy:a systematic review[J].Health Technol Assess,2014,18(45):1-190.
[5]全国佝偻病防治科研协作组,中国优生科学协会小儿营养专业委员会.维生素D缺乏及维生素D缺乏性佝偻病防治建议[J].中国儿童保健杂志,2015,23(7):781-782.
[6]赵静,张倩,张环美,等.北京市怀柔区儿童维生素D营养状况及其与体成分的关系[J].中华流行病学杂志,2010,31(1):34-38.
[7]刘玄华,阮青,董邕晖,等.广西2012-2013年农村学生营养改善项目实施地区学生膳食和营养状况[J].中国学校卫生,2015,36(8):1130-1138.
[8]王丽敏,张雪玲,王文娟,等.佳木斯地区6岁以下儿童血清维生素A、25-羟基维生素D、维生素E水平分析[J].检验医学,2017,32(4):276-279.
[9]程茜.预防儿童维生素D缺乏[J].中国儿童保健杂志,2014,22(8):785-787.
[10]李娜,王建红,金春华,等. 67例儿童血清维生素水平研究[J].中国儿童保健杂志,2015,23(10):1093-1095.
[11]隋凤轩,吴琼,鹏妹,等.深圳市龙华新区0~6岁儿童维生素D营养状态的调查[J].中国妇幼保健,2017,32(20):5106-5107.
[12]冯慧敏,姚梅,郑义婷.皖北地区0~14岁儿童维生素D营养状况分析[J].中国学校卫生,2017,38(4):594-595.
[13]王卫平.儿科学[M]. 8版.北京:人民卫生出版社,2013:69-74.
[14]王陇德.中国居民营养与健康状况调查报告之—2002综合报告[M].北京:人民卫生出版社,2005:41-45.
[15]曾婧,李兆林,辜伟伟,等.十堰市城区3-6岁儿童维生素A营养状况分析及比较[J].营养学报,2012,34(3):229-232.
[16]孙丽芳,尹有会,梁利,等.北京市平谷区2~6岁儿童血清维生素A水平分析[J].中国妇幼健康研究,2016,27(4):510-512.
[17]徐柏荣,张佩斌,王福德,等.江苏省5岁以下儿童血浆维生素A水平及影响因素的研究[J].中国儿童保健杂志,2001,9(2):83-84.