第一临床医学院知识库

目的：了解兰州市和东乡县两地区汉族与东乡族学龄期儿童缺铁性贫血（Iron deficiency anemia，IDA）的患病情况，评估IDA儿童及经过配对选取的非贫血对照组儿童的智力发育水平，探求缺铁性贫血对学龄期儿童智力发育的影响。方法：于2015年10月在兰州市（城市）及东乡县（农村）两地区，选取有汉族和东乡族学生的两所小学，采取随机分层抽样抽取一年级至三年级6～12岁学龄期儿童396名作为研究对象。进行体格发育指标的相关测量、静脉血采集以及相关问卷调查。分析血常规及血清铁等相关指标。分析儿童缺铁性贫血的患病率，从符合IDA诊断标准的儿童中筛选出30例缺铁性贫血儿童（均为轻度IDA）为贫血组，同时选取背景资料相似的非贫血儿童为对照组，使用中国-韦氏儿童智力量表（C-WISC）评估两组儿童的智力发育水平，进行对照研究。并采用Pearson相关性分析方法试探求贫血组儿童血红蛋白含量与总智商发育水平的相关性。
结果：1.本研究儿童IDA现状。396例学龄期儿童中，IDA的患病率为8.6%。东乡县儿童IDA患病率高于兰州市儿童；东乡族儿童IDA的患病率高于兰州市儿童。两地区不同性别之间IDA的患病率差异无统计学意义（P > 0.05）。2.贫血组及对照组儿童智力发育水平比较。贫血组儿童VIQ、PIQ及FIQ均值低于对照组儿童，且贫血组儿童C因子中各分项得分均低于对照组，存在显著性差异（P < 0.05）。
3.兰州市（城市）及东乡县（农村）城乡两地IDA儿童智力发育水平比较。东乡县（农村）儿童操作智商、B因子分测试中的拼图及C因子分测试中的背数得分低于兰州市（城市）儿童，城乡两地言语智商和总智商比较差异无统计学意义（P > 0.05）。4.两地区贫血儿童血红蛋白值与其总智商的相关性分析。兰州市贫血组儿童相关性系数为0.644（P = 0.032）；东乡县贫血组儿童相关性系数为0.46（P = 0.047）。并且随着血红蛋白水平的下降，儿童的总智商存在下降趋势。结论：兰州市及东乡县学龄期儿童IDA患病率较2013年全国调查水平有所下降；东乡县儿童贫血患病率较兰州市儿童高，东乡族儿童患病率较汉族儿童高，两地区男女童之间贫血患病率差异无统计学意义。贫血组儿童在语言智商、操作智商及总智商方面得分较对照组低。东乡县学龄期贫血儿童在操作智商及B因子分测试中的拼图和C因子分测试中的背数得分较兰州市贫血儿童低，但两地区贫血儿童总智商无差异。IDA对城乡两地学龄期儿童智力发育存在一定影响，且随着血红蛋白水平的下降，学龄期儿童总智商有下降趋势。

Objective: To detect the prevalence of iron deficiency anemia (IDA) among Han and Dongxiang Nationality School - aged Children in Lanzhou and Dongxiang.To evaluate IDA children and matched non-matched The level of intelligence development in children with anemia control group and the control study to explore the impact of IDA on IQ development of school-age children.Methods: Two primary schools with both Han and Dongxiang nationalities in Lanzhou (city) and Dongxiang (rural) in October 2015 were randomly stratified 6 to 12 396 school-age children as the research object. The physical development index measurement, venous blood collection and questionnaire survey, blood and serum iron and other indicators. Children with IDA diagnostic criteria were included in the anemia group. Non-anemia children with similar background data were included in the control group. China-Wechsler Children's Intelligence Scale (C-WISC) was used to evaluate the level of intellectual development in both groups and to study through the relevant control. Pearson correlation analysis was used to analyze the correlation between hemoglobin amount and total IQ.
Results:1. The current status of children's IDA in this study.Among 396 school-age children, the prevalence of IDA was 8.6%. the prevalence of Dongxiang children's is higher than Lanzhou children's. The prevalence of IDA in Dongxiang children is higher than that in Han children. There was no significant difference in the prevalence of IDA between children of different genders in both regions (P > 0.05).
2.The comparison of IQ development in children with IDA group and the control group Children with IDA had lower VIQ, PIQ and FIQ than children in the control group,Children in the scored IDA group in each sub-item of test C were lower than those in the control group,the difference was statistically significant (P < 0.05). 3.The comparison of IQ development of IDA children between urban and rural areas in Lanzhou and Dongxiang.The Dongxiang children's operating IQ, B factor scores in the test and the C factor score test number of memories was lower than that Lanzhou children's,There was no significant difference in VIQ and FIQ between children in Lanzhou and Dongxiang.the difference was statistically significant (P < 0.05).4.The correlation analysis between hemoglobin amount and total IQ of children in IDA group and the control group.the correlation coefficient of IDA group children in Lanzhou was 0.644 (P = 0.032),the correlation coefficient of IDA group children in Dongxiang was 0.46 (P = 0.047).Children's total IQ has a downward trend with a decrease in hemoglobin amount.
Conclusions: The prevalence of Dongxiang children's is higher than Lanzhou children's. The prevalence of IDA in Dongxiang children is higher than that in Han children.Children with IDA had lower VIQ, PIQ and FIQ than children in the control group,Children in the scored IDA group in each sub-item of test C were lower than those in the control group.IDA has some influence on IQ development of school-age children in both urban and rural areas, and children's total IQ has a downward trend with a decrease in hemoglobin amount.