论文部分内容阅读
目的了解母乳与非母乳喂养儿童中血清维生素A水平是否存在差异以及造成差异可能原因。方法研究数据来自人群为基础的儿童维生素A营养状况横断面调查,共调查401名 0-23月龄儿童。采用改良的荧光方法测定血清中视黄醇含量来反映维生素A水平,通过问卷方法调查儿童的家庭社会经济、围产期保健、2周内患病情况;半定量膳食频率问卷调查前1周内儿童膳食情况。利用SAS 8．1软件进行统计分析。结果 401名2岁内儿童中,母乳喂养率为50．37％;非母乳喂养组维生素A平均水平为(30．67±0．57)μg／dl,母乳喂养组为(27．60±0．56)μg/dl,两组差异有统计学意义(P<0．01);在控制其他因素影响后,调整后的非母乳喂养组均值为(31．82±0．98)μg／dl, 母乳喂养组为(29．46±0．96)μg／dl,差异有统计学意义(P<0．01)。按年龄组分层分析显示,0月龄～、6月龄～、12月龄～和18月龄～组的母乳喂养率分别92．1％、70．1％、32．0％和17．1％。各年龄组内两组间(非母乳喂养组-母乳喂养组)维生素A均值差值及其95％可信区间(CI)分别为4．70 (-2．52-1.92)、0．82(-2.32-3．95)、2．95(-0．68-6．58)和6．05(2．34-9．77)μg／dl;控制其他混杂因素后,调整后的两组均值差值及其95％CI分别为0．00(-7．18-7．19)、1．35(-1．76-4．45)、 2．92(-0．82-6．65)和4.26(0．71-7．81)μg/dl;调整前、后只有18月龄组非母乳喂养组和母乳喂养组维生素A水平差异有统计学意义(P<0．01)。趋势x2检验表明12月龄以后母乳喂养儿童辅食添加频率均比非母乳喂养儿童低。结论与非母乳喂养儿童相比,母乳喂养儿童的体内维生素A水平有所降低,但差别只是局限在18月龄以后儿童中。母乳中维生素A含量不足以及辅食添加不充分可能是造成这种差异潜在原因。控制人群中维生素A缺乏应该采取综合干预措施。
Objective To investigate the differences of serum vitamin A levels in breast-fed and non-breast-fed children and the possible causes. METHODS Data from a population-based cross-sectional survey of vitamin A status in children were enrolled and 401 children aged 0-23 months were enrolled. A modified fluorescence method was used to measure the content of retinol in serum to reflect the level of vitamin A. The questionnaire was used to investigate children’s family socioeconomic and perinatal health care and the prevalence within two weeks. Semi-quantitative dietary frequency Dietary conditions. Using SAS 8.1 software for statistical analysis. Results Among 401 children aged 2 years, the rate of breastfeeding was 50.37%. The average level of vitamin A in non-breastfeeding group was (30.67 ± 0.57) μg / dl and that in breastfeeding group was (27.60 ± 0) .56) μg / dl, the difference between the two groups was statistically significant (P <0.01). After adjusting for the influence of other factors, the mean of adjusted non-breastfeeding group was (31.82 ± 0.98) μg / dl , Breastfeeding group was (29.46 ± 0.96) μg / dl, the difference was statistically significant (P <0.01). The results of stratified analysis by age group showed that breastfeeding rates of 0 months, 6 months, 12 months and 18 months were 92.1%, 70.1%, 32.0% and 17%, respectively. 1%. Mean differences in vitamin A and 95% confidence intervals (CI) between the two groups (non-breastfeeding-breastfeeding group) within each age group were 4.70 (-2.52-1.92), 0.82 ( -2.32-3.95), 2.95 (-0.68-6.58) and 6.05 (2.34-9.77) μg / dl, respectively. After controlling for other confounding factors, the adjusted mean of the two groups The difference and its 95% CI were 0.00 (-7.18-7.19), 1.35 (-1.76-4.45), 2.92 (-0.82-6.65) And 4.26 (0.71-7.81) μg / dl, respectively. Before and after adjustment, there was significant difference in vitamin A level between non-breastfeeding group and breast-feeding group only in 18-month old group (P <0.01). The trend x2 test showed that the supplementation of breastfeeding children after 12 months of age was lower than that of non-breastfeeding children. Conclusions Compared with non-breastfeeding children, the level of vitamin A in the breastfeeding children is reduced, but the difference is only limited to children after 18 months of age. Insufficient vitamin A supplementation in breast milk and inadequate supplementation may be the underlying cause of this discrepancy. Control of vitamin A deficiency in the crowd should take a comprehensive intervention.