【作者】 薛世萍；

【导师】 王玉；

【作者基本信息】 兰州大学 ， 卫生毒理学， 2008， 硕士

【摘要】 目的了解兰州市城区3-6岁儿童全血中钙、镁、铜、铁、锌、铅的水平,以及这几种金属元素对儿童体格发育的影响,为指导儿童保健工作者和家长预防儿童矿物元素缺乏和铅中毒提供参考;同时调查儿童家中主要的膳食制作人的营养知识水平和其饮食习惯及影响其膳食制作行为的因素,为在家长中普及营养知识,促进儿童全面营养提供依据。方法选择兰州市城关区四所幼儿园388名儿童,对其采集指尖末梢血测定其血中钙、镁、铜、铁、锌、铅的水平和血红蛋白浓度,并对儿童的身高、体重、胸围、头围进行测量,用体格发育评价参考标准进行评价。随后对其家庭中主要膳食制作人进行营养知识和饮食行为问卷调查,对调查结果进行分析。结果兰州市城区3-6岁儿童的钙、镁、铜、铁四种元素的水平与其它城市儿童相比处于中等水平,而铁元素则高于其它城市儿童。这五种元素中,锌的缺乏率最高,达38.92%,其次是钙缺乏和铁缺乏。此次检测的儿童铅中毒率是12.63%,其中3岁组儿童的铅中毒率最高,为28.57%。兰州市城区3-6岁儿童生长发育状况较好,只有0.5%的儿童属于低体重(WAZ＜-2),0.8%的儿童属于生长迟缓(HAZ＜-2),0.8%的儿童为消瘦(WHZ＜-2)。有28.6%的儿童头围低于评价标准平均值,54.4%的儿童胸围低于评价标准平均值。儿童贫血患病率为10.8%,6岁组的儿童患病率最高,为17.2%。锌缺乏组儿童的身高z评分低于正常儿童,但差异无统计学意义(P＞0.05)。铅中毒儿童和正常儿童的HAZ、WAZ、WHZ比较,差别没有统计学意义(P＞0.05)。儿童血红蛋白的含量与血铅和血铁有线性回归关系,其中与血铅负相关。对儿童家庭膳食制作人的调查结果显示,儿童家庭膳食制作人的营养知识评分平均是8.65分,不同身份的家庭膳食制作人其营养知识得分比较无显著性差异(P＞0.05),影响膳食制作人营养知识的因素主要是职业、对营养知识的兴趣和学历。膳食制作人主要是通过书籍、报刊、杂志(78.7%)和电视广播(53.2%)获得营养知识。有81.4%的膳食制作人自己有挑食或偏食的不良饮食习惯。挑食的膳食制作人其家中儿童的挑食行为发生率比不挑食的高,两组对比有显著的统计学差异。膳食制作人最不喜欢的食物是动物内脏。52.8%的膳食制作人很少购买和制作自己不喜欢吃的食物。影响膳食制作人购买和制作食物的因素由高到低依次是卫生和质量(64.5%)、孩子喜欢(47.7%)、营养(46.6%)、价格(29.0)、自己的喜好(25.7%)、购买和制作方便(21.3%)。对待孩子挑食,66.5%的家长会想办法给予纠正,14.2%的家长会强迫孩子吃他不喜欢的食物。如果孩子缺乏某种矿物元素,33.5%的家长首先选择通过食物给孩子补充,41%的家长在孩子缺乏较轻时选择食物补充,缺乏较重时再给服用补充剂,而15.3%的家长则直接给孩子服用矿物元素补充剂。77.2%的家长曾经给孩子服用过矿物元素补充剂。结论①兰州市3-6岁儿童的锌缺乏率较高,铅中毒率下降明显;②兰州市3-6岁儿童的生长发育状况较好,营养不良和生长迟缓率较低,但贫血患病率较高;③铁元素不足影响着儿童的身高、体重发育以及血红蛋白含量,血铅含量升高可使血红蛋白浓度降低;④儿童家庭膳食制作人的职业、对营养知识的兴趣和学历影响其营养知识的水平,其不良饮食行为也影响着儿童的饮食习惯,对待儿童服用矿物元素补充剂家长应该有正确的态度和方法。更多还原

【Abstract】 Objective: To comprehend the level of the total blood calcium, magnesium, copper, iron, zinc and leads of children aged 3-6 in Lanzhou City, as well as influence of several mineral elements on the physical development of children, and thus provide reference for guidancing health-care workers and parents to prevent deficiency mineral elements and lead poisoning. At the same time, investigate the nutrition knowledge and impact on their eating habits and dietary factors of production of the main producers of food in children’s home,to provide a comprehensive basis for all parents of the knowledge about nutrition and nutrition for children.Methods: 388 children of Lanzhou City’s four kindergarten were choiced, to acquisite their fingertip peripheral blood and ditermine determined blood calcium, magnesium, copper, iron, zinc, lead and hemoglobin concentration level, and measured all the children’s height, weight, chest circumference, head circumference and evaluated physical development using reference standards. Then surveied their families’s main producer of dietary’s nutrition knowledge and eating behavior, and analysised the survey results.Results: The four elements of calcium, magnesium, copper and iron of children aged 3-6 in Lanzhou City was in the middle level compared with other cities, and the level of the blood iron were higher than that of other urban children.The lack of zinc was the highest rate about 38.92%, followed by the lack calcium and iron.The lead poisoning rate is 12.63% in the tested childhood, and which was the highest rate about 28.57% in the three-years-old group childhood.Children aged 3-6 in Lanzhou City were well in the growth and development, only 0.5 percent of the children are low weight (WAZ <-2), 0.8 percent of the children belong to growth retardation (HAZ <-2), and 0.8 percent of children are the thin (WHZ<-2). 28.6 percent of the children head circumference were below average, 54.4 percent of the children chest circumference were below average. Anemia prevalence rate of children is 10.8%, 6-years-old group of children had the highest prevalence rate about 17.2 %.Zinc deficiency group of children’s height was lower than that of nomal children, but the difference was not statistically significant (P>0.05). Compareding the HAZ, WAZ, WHZ of lead poisoning of children and normal children, the consequence was no statistically significant difference (P>0.05). The multiple regression analysis showed that the level of blood lead and iron were significantly correlated with the concentration of hemoglobin of children , which negatively correlated with the level of blood lead.The result showed that children’s family meals producer’s score of nutrition knowledge was an average of 8.65 points.There was no significant difference (P> 0.05) among nutrition knowledge score of different identity of the family meal producer’s .The impact factors to meal producer’s nutrition knowledge included occupation, the interest on the nutrition knowledge and educational background. Dietary producers received nutrition knowledge from books, newspapers, periodicals, magazines (78.7%) and television (53.2%). 81.4% of the meals producer themselves are picky eaters .Their children were pickier for food than other’s children, there was significant difference between the two groups.The most of meals maker do not like the food animal offal. 52.8 percent of people rarely don’t buy or product food that they don’t like.The factors that impact meal pruducter buying and producting food from higher to lower were depuratory and quality (64.5%), the children’s appetite (47.7%), nutrition (46.6 %), price (29.0%), themselves’ appetite (25.7%), convenient of the purchase and production (21.3%).If children were picky eater, 66.5% of the parents would think of ways to rectify, 14.2% of the parents would forced children to eat food they didn’t like, but there are also 15.1 % of the parents said no ways to this.If children lacked a certain mineral, 33.5 percent of the parents first choice add mentary elements from food to children, 41 percent woild also choice in this way if the lack of mentary elements were trivial, otherwise, they woild choice to provide mineral replenisher if their mineral were severe deficiency, in the absence of parents choosing the lesser supple mentary food, the lack of time to give heavier taking supplements, but 15.3 percent of parents directly supplement mineral elements replenisherto children in these circumstances.77.2 percent of parents have supplemented the mineral elements replenisher to their children.Conclusion:①The zinc deficiency rate were comparative high and the rate of lead poisoning of children aged 3-6 in Lanzhou City were low.②Growth and development of conditions children aged 3-6 in Lanzhou City is better, malnutrition rate and growth retardation rate were lower, but a higher prevalence of anemia.③Iron shortage affects children’s height, weight and hemoglobin content development,Elevated blood lead levels can lower hemoglobin concentration.④Family meals producer’s occupation, interest on the nutrition knowledge and academic career affect their the level of knowledge of nutrition.Their unhealthy dietary behaviors also affected children’s eating habits.The parents should have a correct attitude and approach to take mineral elements replenisher for children.更多还原