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[富含铁和抗坏血酸的奶粉作为基层医疗保健机构中治疗儿童缺铁性贫血的干预措施]

[Powdered milk enriched with iron and ascorbic acid as an intervention measure for treating iron deficiency anemia in children seen at a Basic Health Care Unit].

作者信息

Torres M A, Sato K, Juliano Y, Queiroz S de S

机构信息

Centro de Referência de Sańde, da Mulher, Nutrição, Alimentação e Desenvolvimento Infantil.

出版信息

Arch Latinoam Nutr. 1996 Jun;46(2):113-7.

PMID:9239287
Abstract

This study was undertaken to verify the influence of the use of iron and Vitamin C fortified powdered whole milk on the hemoglobin levels of 238 children, aged 6 to 18 months, seen at a Basic Health Care Unit in the State of São Paulo. The powdered milk was fortified with 9 mg of iron (ferrous sulfate) and 65 mg of Vitamin C for each 100 g of powder. 4 kg/month were distributed to children under one year and 2 kg/month to those over one year of age. Clinical, anthropometric and hematological (hemoglobin level measurements) evaluations were performed at the onset of the study and at three month intervals after the beginning of the supplementation. At the end of the trial, there was still enough milk available to extend the intervention for a group of 39 children who had presented the worst evolution in the first six months. At the onset of the study, 72.6% of the children presented anemia. After 3 and 6 months, these percentages had decreased to 38.9% and 18.5%, respectively. Among the children that were followed-up for 9 months, their were only 2.5% who presented anemia at the end of the intervention. The highest prevalences were found in the 6 to 12 months age group and the best results in the 10 to 18 month group. There was intrafamilial dilution of the milk in 30.7% of the cases. With or without intrafamilial milk sharing, there were significant decreases in anemia occurrences with no differences between the two groups. The use of fortified milk did not affect the children nutritional condition. This study permitted the conclusion that the fortification of foodstuffs, besides being the method of election for the prevention of iron deficiency, is an excellent alternative for the treatment of and recovery from iron deficient anemia in children under two years of age.

摘要

本研究旨在验证使用铁和维生素C强化的全脂奶粉对圣保罗州一家基层医疗单位收治的238名6至18个月大儿童血红蛋白水平的影响。每100克奶粉中添加了9毫克铁(硫酸亚铁)和65毫克维生素C。一岁以下儿童每月分发4千克,一岁以上儿童每月分发2千克。在研究开始时以及补充开始后的三个月间隔进行临床、人体测量和血液学(血红蛋白水平测量)评估。试验结束时,仍有足够的牛奶可用于对在前六个月中情况最差的39名儿童延长干预。研究开始时,72.6%的儿童患有贫血。3个月和6个月后,这些百分比分别降至38.9%和18.5%。在接受9个月随访的儿童中,干预结束时只有2.5%的儿童患有贫血。患病率最高的是6至12个月年龄组,而10至18个月组的效果最佳。30.7%的案例中存在家庭内奶粉稀释情况。无论是否存在家庭内奶粉共享,贫血发生率均显著下降,两组之间无差异。强化奶粉的使用未影响儿童的营养状况。本研究得出结论,食品强化除了是预防缺铁的首选方法外,还是治疗两岁以下儿童缺铁性贫血并使其康复的极佳选择。

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