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目的了解学龄前儿童维生素B12(VB12)的营养水平,探讨血清VB12水平与营养性贫血的关系,并对相关因素进行分析。方法随机对重庆市四所幼儿园351名2~7岁儿童进行体格测量及血常规筛查,对其中177名进行膳食调查、血清VB12测定。结果学龄前儿童血清VB12平均水平为552pg/m l,VB12缺乏(血清VB12<200pg/m l)检出率为4.5%(8/177),边缘性缺乏(血清VB12200~300pg/m l)检出率为10.7%(19/177)。学龄前儿童血清VB12无性别和年龄差异(P>0.05)。血清VB12水平与血红蛋白水平无相关性。多因素逐步回归分析显示血清VB12水平主要受膳食VB12摄入量的影响(P=0.03)。8例VB12缺乏儿童体格发育正常,仅1例为小细胞性贫血,其余7例红细胞数目、红细胞平均体积及平均红细胞血红蛋白量均在正常范围内。结论学龄前儿童血清VB12水平明显高于成人,提示血清VB12水平存在年龄差异,2~7岁儿童血清VB12较稳定。血清VB12水平与血红蛋白水平无相关性,儿童VB12缺乏不一定是典型的大细胞性贫血。膳食中VB12含量是影响儿童血清VB12水平的重要因素。
Objective To understand the nutritional status of vitamin B12 (VB12) in preschool children and explore the relationship between serum VB12 level and nutritional anemia and to analyze the related factors. Methods 351 children from 2 to 7 years old in four kindergartens of Chongqing were randomly divided into physical measurement and blood routine screening. 177 of them were subjected to dietary survey and serum VB12 determination. Results The average level of VB12 in preschool children was 552pg / ml, the detection rate of VB12 deficiency (serum VB12 <200pg / ml) was 4.5% (8/177), the marginal lack of serum VB12200 ~ 300pg / ml 10.7% (19/177). Serum VB12 in preschool children had no difference in sex and age (P> 0.05). There was no correlation between serum VB12 level and hemoglobin level. Multi-factor stepwise regression analysis showed that the level of serum VB12 was mainly affected by dietary VB12 intake (P = 0.03). 8 cases of VB12 lack of physical development in children with normal, only 1 case of small cell anemia, the remaining 7 cases of red blood cell number, the average volume of red blood cells and the average amount of red blood cells hemoglobin within the normal range. Conclusion The serum level of VB12 in pre-school children is significantly higher than that in adults, suggesting that there is a difference in age between the levels of serum VB12 and the level of serum VB12 in children aged 2 to 7 years. There was no correlation between serum VB12 level and hemoglobin level. Children with VB12 deficiency are not necessarily typical large cell anemia. VB12 dietary content is an important factor affecting the level of serum VB12 in children.