上海市闵行区6～11岁在校学生血红蛋白连续监测结果分析

摘要

目的 了解上海市闵行区6～11岁在校学生贫血流行特征,为制定新形势下中小学生贫血预防措施和策略提供依据.方法 2012-2015学年连续4年对本区所有6～11岁在校学生42 872名进行血红蛋白测定.应用SPSS 18.0统计软件完成所有资料分析.结果 6～11岁在校学生贫血患病率为5.05％ (95％CI:4.84～5.26),女生贫血患病率为5.28％,显著高于男生4.84％(x2 =4.24,P=0.037).男、女生贫血易患年龄为6岁.持续就读于希望学校学生较公办学校学生更易患贫血(男生:OR=2.37,95 ％CI:2.03～2.76;女生:OR=2.08,95％CI:1.74～2.49).持续超重或肥胖的学生贫血患病风险较营养正常学生低(男生:OR=0.65,95％ CI:0.55～0.76;女生:OR=0.75,95％CI:0.61～0.92).贫血3年累积发病率为12.80％ (95％CI:12.49～13.12％),其中女生为14.52,显著高于男生的11.28％(x2=100.26,P＜0.001).6岁组男生3年累积发病风险最高,10～11岁组女生贫血3年累积发病率最高.持续就读于希望学校的学生贫血发病风险最高(男生:RR=1.93,95％CI:1.72～2.16;女生:RR=1.20,95％CI:1.04～1.39),持续超重或肥胖是贫血发病的保护因素(男生:RR=0.75,95％CI:0).67～0).84;女生:RR=0.77,95％CI:0.68～0.88).贫血单次检出率为14.58％,复发性贫血检出率为2.54％.不同年龄、不同性质学校、不同营养状况的男、女生贫血检出次数均以1次为主(P＜0.05).结论 上海市闵行区6～11岁在校学生贫血处于轻度流行状态.有必要继续开展全年龄段学龄儿童贫血的普查普治工作,并根据监测结果辅以个性化干预措施,加强学龄儿童家长和青春期女生健康宣教,重点关注希望学校和复发性或持续性贫血的学生.%Objective To analyze the epidemic features of anemia among students aged 6-11 years old in Minghang District,to provide basis for the control and prevention strategies of anemia among school students.Methods Surveillance on hemoglobin concentration was conducted among 42 872 students aged from 6 to 11 years old between 2012 and 2015.All data analyses were completed by SPSS 18.0 statistical software.Results The prevalence rate of anemia among school students 6-11 years old was 5.05％ (95％CI:4.84-5.26).The prevalence rate of anemia among girls was 5.28％,which was significantly higher than that 4.84％ among boys (x2 =4.24,P =0.037).Six-year-old boys and girls were most susceptible to anemia.Compared to students in Hope Schools,public school students are more vulnerable to anemia (boys:OR =2.37,95 ％ CI:2.03-2.76;girls:OR =2.08,95 ％ CI:1.74 -2.49).Overweight and obese students had a lower risk of anemia than average students (boys:OR =0.65,95 ％ CI:0.55-0.76;girls:OR =0.75,95 ％ CI:0.61-0.92).The three-year cumulative incidence of anemia was 12.80％ (95 ％CI:12.49-13.12).The cumulative incidence among girls was 14.52％,which was significantly higher than that of 11.28％ among boys (x2 =100.26,P＜0.001).Six-year-old boys have the highest three-year cumulative risk among all students,while 10-11-year-old girls have the highest three-year cumulative incidence.The risk of anemia in Hope School was found highest in all schools (boys:RR =1.93,95％CI:1.72-2.16;girls:RR =1.20,95 ％CI:1.04-1.39).Overweight and obesity were considered protective factors to anemia (boys:RR =0.75,95％CI:0.67-0.84;girls:RR =0.77,95％CI:0.68-0.88).The primary and recurrent detection rates of anemia were 14.58％ and 2.54％.The anemia among students was mainly detected during the first examination despite the differences in ages,schools and nutrition conditions (P ＜ 0.05).Conclusions The prevalence of anemia among primary school students in Minhang District is at a mild level.Control measures should be adopted,including monitoring of hemoglobin in all school children and adolescents,taking individual intervention measures based on results,promoting the health education for adolescent girls and parents of school children,and paying special attention to Hope School and students with recurrent and continuous anemia.