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评估印度北部一家三级护理中心收治的 6-59 月龄严重急性营养不良儿童的维生素 B 和叶酸状况及其决定因素。

Assessment of vitamin B and folate status and their determinants in children aged 6-59 months with severe acute malnutrition admitted to a tertiary-care centre in North India.

机构信息

Department of Pediatrics, Uttar Pradesh University of Medical Sciences, Saifai, India.

Department of Community Medicine, BRD Medical College, Gorakhpur, India.

出版信息

Paediatr Int Child Health. 2024 Sep-Nov;44(3-4):122-130. doi: 10.1080/20469047.2024.2407703. Epub 2024 Oct 1.

Abstract

BACKGROUND

Vitamin B and folate are essential micronutrients, a deficiency of which causes anaemia, poor growth and an increased risk of infections, along with irreversible neurological damage to the developing brain in children.

METHODS

A hospital-based prospective observational study was conducted in 100 children with severe acute malnutrition (SAM) aged 6-59 months admitted to a tertiary-care facility in northern India from July 2021 to June 2022. A structured proforma was used to record socio-demographic information, a detailed clinical history, results of general and systemic physical examination and a detailed anthropometric assessment. Serum folate and vitamin B were estimated by electrochemiluminescence.

RESULTS

The mean age of the children was 24.18 months, and 64.0% were aged 6-12 months. The male-to-female ratio was 1.08:1. Anaemia was present in 87.0% of the children, and it was severe in 35% of them. There was serum vitamin B and folate deficiency in 61.0% and 19.0%, respectively. A deficiency of vitamin B was significantly associated with delayed developmental milestones in all domains, a mid-upper-arm circumference of <11.5 cm, severe anaemia, a low platelet count and folate deficiency, and a folate deficiency was significantly associated with older age, delayed developmental milestones in all domains, severe anaemia, a low platelet count and vitamin B deficiency.

CONCLUSION

Vitamin B deficiency is highly prevalent in children aged 6-59 months with SAM, but the prevalence of folate deficiency is much lower. Apart from iron and folic acid supplementation, government programmes should consider vitamin B supplementation for children aged 6-59 months.

摘要

背景

维生素 B 和叶酸是必需的微量营养素,缺乏它们会导致贫血、生长不良和感染风险增加,以及儿童发育中的大脑出现不可逆转的神经损伤。

方法

在印度北部的一家三级保健机构,对 2021 年 7 月至 2022 年 6 月期间入院的 100 名患有严重急性营养不良(SAM)的 6-59 个月大的儿童进行了一项基于医院的前瞻性观察研究。使用结构化的表格记录社会人口统计学信息、详细的临床病史、一般和系统体格检查的结果以及详细的人体测量评估。使用电化学发光法估计血清叶酸和维生素 B。

结果

儿童的平均年龄为 24.18 个月,64.0%的年龄为 6-12 个月。男女比例为 1.08:1。87.0%的儿童存在贫血,其中 35%的儿童贫血严重。分别有 61.0%和 19.0%的儿童存在血清维生素 B 和叶酸缺乏。维生素 B 缺乏与所有领域的发育迟缓里程碑显著相关,中上臂围<11.5cm、严重贫血、血小板计数低和叶酸缺乏,叶酸缺乏与年龄较大、所有领域的发育迟缓里程碑显著相关、严重贫血、血小板计数低和维生素 B 缺乏显著相关。

结论

6-59 个月患有 SAM 的儿童中,维生素 B 缺乏的发生率很高,但叶酸缺乏的发生率要低得多。除了铁和叶酸补充外,政府计划还应考虑为 6-59 个月的儿童补充维生素 B。

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