| Objective:Anemia is a common disease in infants and young children,and there is no clinical data about anemia in infants and young children in Qingdao.Acute fever is the most common cause of pediatric outpatient.The purpose of this study is to understand the incidence,influencing factors and outcomes of anemia in infants with fever as the first diagnosis in a single center in Qingdao,and to establish appropriate intervention and diagnosis and treatment programs,so as to provide reference for clinical work.At the same time,it can guide family members how to feed and take care of infants and young children more reasonably,and add supplementary food,so as to prevent the occurrence of anemia;early detection and treatment of anemia,so as to reduce the adverse impact of anemia on children’s health and society.Methods:A total of 707 infants and young children with fever who visited the pediatric clinic of Affiliated Hospital of Qingdao University from June 2019 to June 2020 were selected as the research objects.Questionnaire survey was conducted among the parents.The general data were collected by means of on-site questionnaire and telephone follow-up.Their general data were collected,and their clinical characteristics,hematology and other relevant examination indexes,treatment plan and prognosis were recorded,and comprehensive analysis was conducted.Results:1.Incidence of anemia: a total of 707 cases were included,140 cases had different degrees of anemia,the incidence of anemia was 19.80%,which was lower than the national average level of infant anemia(25.1%),and even lower than the incidence of anemia in some inland cities of Taian(24.06%).2.Analysis of clinical characteristics and influencing factors: univariate chi square analysis showed that anemia in children was related to age,education level of caregivers,feeding methods and complementary food addition.The incidence of anemia in children with 1-6 months old,education level of caregivers above high school and artificial feeding was low.The incidence of anemia in children with less than 6 months old who added complementary food and more seafood such as fish and shrimp was low.3.Types of anemia: among 140 cases of anemia,128 cases(91.43%)were mild anemia,12 cases(8.57%)were moderate anemia,no severe or very severe anemia.In 128 cases of mild anemia,116 cases(90.63%)were positive cell hypochromic anemia,which was significantly higher than 12 cases(9.38%)of small cell hypochromic anemia;in 12 cases of moderate anemia,8 cases(66.67%)were small cell hypochromic anemia,which was significantly higher than 4 cases(33.33%)of positive cell hypochromic anemia.Fisher exact probability showed that the more severe the anemia was,the more likely it was to be complicated with small cell hypochromic anemia(P < 0.001).Anemia caused by fever is mainly mild,mild anemia is mainly positive cell and positive pigment anemia,moderate anemia is mainly small cell and low pigment anemia.4.Treatment and outcome: in 128 cases of mild anemia,120 cases recovered from anemia after normal temperature,the average days of reexamination was 6.75 days,the average increase of Hb was 15.25g/L,the average increase rate was 17.22%.Among the12 cases of moderate anemia,6 cases were diagnosed as Kawasaki disease and did not take oral iron;among the other 6 cases,1 case had complete bone marrow cytology examination and did not support iron deficiency anemia Anemia,(IDA),no oral iron,active anti infection treatment,5 days after the review of blood routine increased significantly(85-96 g / L),2 months after the recovery of anemia;2 cases of children with definite diagnosis of IDA,oral iron treatment,2 months after the recovery of anemia;3cases of incomplete anemia related examination,empirical oral iron treatment,of which 2cases in January review anemia correction.Therefore,mild anemia does not need oral iron treatment,moderate anemia need to further clarify the cause,moderate nutritional anemia children oral iron treatment.5.Etiology of fever: 650 cases(91.94%)of 707 children were diagnosed as acute infection,including 568 cases of respiratory tract infection and 41 cases of urinary tract infection;57 cases(8.06%)were diagnosed as Kawasaki disease,of which 30 cases were complicated with anemia,which is a common symptom of Kawasaki disease.The children with Kawasaki disease and moderate anemia did not receive iron supplementation,and the anemia gradually recovered during the follow-up of 3 weeks to3 months.One child with Kawasaki disease developed hemolysis during the treatment and was treated with glucocorticoid.During the follow-up,anemia gradually recovered.Conclusion:1.In this study,the incidence of anemia was 19.8%,which was lower than the national and provincial average level of infant anemia.The incidence of anemia in single center in Qingdao is lower than that in other areas.2.The incidence of anemia is high in children aged from 6 months to 3 years old,whose parents’ educational level is below high school and who are only breast fed.The time and type of complementary food can also affect the occurrence of anemia.Multivariate logistic regression showed that age,education level of caregivers,feeding style and CRP were the risk factors of anemia.3.Mild anemia(91.43%)was the main anemia in children,and no severe or very severe anemia was found.75% of mild anemia was positive cell positive pigment anemia,and 66.67% of moderate anemia was small cell low pigment anemia.The degree of anemia increased with the increase of CRP level.4.Mild anemia does not need intervention treatment,anemia gradually recovers after body temperature is stable;children with moderate anemia need to further clarify the cause,moderate nutritional anemia need to be supplemented with iron treatment.5.Among 707 children with fever,acute infection accounted for 91.94%,mainly respiratory tract infection;8.06% of children with fever and anemia were diagnosed as Kawasaki disease... |
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