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缺铁性贫血对婴幼儿及儿童认知能力的影响。

Effect of iron-deficiency anaemia on cognitive skills in infancy and childhood.

作者信息

Walter T

机构信息

Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago.

出版信息

Baillieres Clin Haematol. 1994 Dec;7(4):815-27. doi: 10.1016/s0950-3536(05)80126-x.

Abstract

Animal experimentation has shown that early iron deficiency irreversibly affects brain iron content and distribution, resulting in neutransmitter and behavioural alterations. Even though extrapolation of animal data is often misleading, iron-deficiency anaemia has been consistently shown to be associated with psychomotor delays in infancy. The areas most involved are language and body balance. In these infants iron therapy, in most cases was not sufficient to reverse psychological effects even after complete correction of haematological measures. These findings may imply that the impact of iron-deficiency anaemia during infancy may be associated with irreversible adverse effects on cognitive performance. Careful follow-up studies of these infants at 5-6 years of age has shown that cognitive disadvantages persist, now assessed with a comprehensive set of psychological tests that reliably predict future competence. Thus, if once anaemia ensues, even timely and adequate iron therapy seems to be ineffective in reversing these behavioural and cognitive disadvantages; the only practical way to approach this problem is by prevention of iron deficiency in infancy. Health authorities, having been shown that treatment of iron deficiency anaemia is already too late to reverse potential deficits, should strive to prevent iron deficiency with adequate food fortification strategies or by supplementing targeted population groups.

摘要

动物实验表明,早期缺铁会不可逆地影响大脑铁含量及分布,导致神经递质和行为改变。尽管动物实验数据的外推常常具有误导性,但缺铁性贫血一直被证明与婴儿期的精神运动发育迟缓有关。受影响最严重的方面是语言和身体平衡。在这些婴儿中,即使血液学指标完全恢复正常,铁剂治疗在大多数情况下也不足以逆转心理影响。这些发现可能意味着婴儿期缺铁性贫血的影响可能与对认知能力的不可逆不利影响有关。对这些5至6岁婴儿的仔细随访研究表明,认知缺陷依然存在,现在通过一套全面的心理测试进行评估,这些测试能够可靠地预测未来的能力。因此,如果一旦出现贫血,即使及时且充分的铁剂治疗似乎也无法有效逆转这些行为和认知缺陷;解决这个问题的唯一可行方法是预防婴儿期缺铁。鉴于治疗缺铁性贫血为时已晚,无法逆转潜在缺陷,卫生当局应通过适当的食品强化策略或对目标人群进行补充来努力预防缺铁。

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