Grant G A
Br J Gen Pract. 1990 Mar;40(332):112-3.
Screening for iron deficiency was offered to 485 pre-school children in one practice. A questionnaire asking for details of the child's birth, diet, medical history and social status was sent to all the families of these children. Three hundred and eleven children (64% of the total) had blood samples taken for haemoglobin concentration, mean corpuscular volume and serum ferritin levels. Fifty four of the children (17%) were iron deficient (serum ferritin less than 10 micrograms l-1 or mean corpuscular volume less than 75 fl), while 10 (3%) had iron deficiency anaemia (haemoglobin level less than 10.5 g dl-1). The prevalence of iron deficiency and iron deficiency anaemia were not significantly associated with any social class. However, there was a higher prevalence among social class 3 children than children from other social classes, 29% of them having covert iron deficiency, while 6% were frankly anaemic. As there are no ethnic minorities in the practice, dietary inadequacy was likely to be the main cause of iron deficiency. After receiving iron supplements for up to three months, all the children who were iron deficient or anaemic and attended for follow up had normalized blood values. In view of the high prevalence of iron deficiency throughout the social classes, and its association with developmental delay and behavioural disorders, screening will be offered to all children when they attend for measles, mumps and rubella immunization, and those who do not attend will be followed up.
在一家诊所,对485名学龄前儿童进行了缺铁筛查。向这些儿童的所有家庭发放了一份问卷,询问孩子的出生细节、饮食、病史和社会地位。311名儿童(占总数的64%)采集了血样,检测血红蛋白浓度、平均红细胞体积和血清铁蛋白水平。其中54名儿童(17%)缺铁(血清铁蛋白低于10微克/升或平均红细胞体积低于75飞升),10名儿童(3%)患有缺铁性贫血(血红蛋白水平低于10.5克/分升)。缺铁和缺铁性贫血的患病率与任何社会阶层均无显著关联。然而,社会阶层3的儿童患病率高于其他社会阶层的儿童,其中29%有隐匿性缺铁,6%有明显贫血。由于该诊所没有少数民族,饮食不足可能是缺铁的主要原因。在接受长达三个月的铁补充剂治疗后,所有缺铁或贫血且前来接受随访的儿童血液指标均恢复正常。鉴于缺铁在各个社会阶层的高患病率及其与发育迟缓及行为障碍的关联,将在所有儿童接种麻疹、腮腺炎和风疹疫苗时进行筛查,未前来接种的儿童将进行随访。