拉萨藏族农村地区0～12月龄婴儿体格发育的纵向随访研究

摘要

目的 探索藏族婴儿出生到1岁时体重和身长生长规律,为体格发育评价提供参考.方法 对拉萨农村地区253名藏族婴儿,纵向随访12个月,监测0、1、3、6、12月龄共5个时间点,得到体格发育及婴儿基本情况数据,计算婴儿的重量指数(PI)值.应用广义线性混合效应模型,控制出生体重、身长后,分析不同性别婴儿身长、体重变化.结果 6月龄和12月龄婴儿体重较出生时分别增加1倍和3倍,6月龄身高增加约15 cm,12月龄增加约23 cm.混合效应模型结果显示,藏族婴儿体重、身长均显著增加(体重:β=1.69,P＜0.000 1;身长:β=6.527 1,P＜0.000 1);但体重、身长的增加无性别差异(体重:β=0.1184,P=0.604 3;身长:β=1.4704,P=0.078 8),出生体重/身长对后期的增量有显著影响(体重:β=-0.681 9,P＜0.000 1;身长:β=-0.957 1,P＜0.000 1).藏族各月龄男女婴体重和身长均低于WHO和“中国九市儿童体格发育调查”标准,随着月龄增加,男婴体重和身长与“两标准”的差距逐渐增大,女婴在6月龄后与“两标准”差距缩小,但藏族男女婴各月龄PI值均高于中国儿童平均标准.结论 藏族儿童婴儿期体格发育的性别差异无统计学意义,但出生体重或身长对后期体重或身长的增长有显著影响.藏族婴儿体格发育低于WHO和“中国九市儿童体格发育调查”标准,但反映身体充盈度的PI值较高,提示藏族婴儿体格发育有其自身特点.%Objective To investigate the growth pattern of rural Tibetan children in the first year after birth.Methods In rural area of Lhasa,Tibet,252 subjects were recruited and their weight,length were measured longitudinally from birth to 12th months of age.Frequency of monitoring reached 5 times in total and Ponderal index (PI) was calculated for each visit.Mixed model was used to analyze the changes of length and weight by gender after controlling for birth weight.Results Birth weight and length showed great influence on children' s growth (weight:β =-0.681 9,P＜0.000 1,length:β =-0.957 1,P＜0.000 1).Weight and length of Tibetan male infants at each age point were lower than WHO new standard on growth and the Reference from 2005 National Survey on growth of children in China.The gap seemed widened by time but the gap between Tibetan female infants and Chinese standard narrowed 6 months after birth.Data showed that the higher PI of Tibetan infants than that of other Chinese infants which might infer that Tibetan infants had a more solid body mass under their own height.Conclusion The growth pattern of Tibetan infants might have its own feature.Tibetan infants appeared to have had higher PI,which was contradictory to the general conclusion that poor growth and development status had been seen in Tibetan children.