摘要目的:分析2019年“农村义务教育学生营养改善计划”覆盖地区中小学生贫血状况及其影响因素。方法:研究对象为2019年“农村义务教育学生营养改善计划”覆盖地区47 297名6~17岁中小学生。依据2011年WHO贫血诊断标准，分析比较不同性别、年龄、地区中小学生的血红蛋白水平和贫血率，并采用多因素logistic回归模型分析贫血的影响因素。结果:2019年我国“农村义务教育学生营养改善计划”覆盖地区中小学生血红蛋白均值为135.19 g/L，贫血率为8.7%；女生贫血率（10.0%）高于男生（7.4%），西部地区贫血率（9.8%）高于中部地区（7.1%）；西北、西南、中南、华东、华北及东北地区贫血率分别为10.2%、9.7%、8.3%、7.5%、5.7%和3.5%；6~、11~、14~17岁年龄组贫血率分别为8.0%、8.3%和10.9%。多因素logistic回归分析显示，不使用营养配餐软件的学校（ OR=1.482，95% CI：1.296~1.694， P<0.001）、午餐不供应肉类食物的学校（ OR=1.241，95% CI：1.103~1.395， P<0.001）以及低收入家庭（ OR=1.297，95% CI：1.211~1.389， P<0.001）的学生贫血发生风险更高；模型增加学生饮食相关因素后显示，每周吃≥3次肉类食物的学生贫血发生风险较低（ OR=0.907，95% CI：0.832~0.989， P=0.026）。 结论:“农村义务教育学生营养改善计划”对我国中小学生贫血改善已产生重要影响，但“农村义务教育学生营养改善计划”覆盖地区学生贫血率仍高于全国平均水平，学生家庭收入、学校所在地、学校配餐能力及食物供应种类等是中小学生贫血发生率的主要影响因素，需要各方给予进一步关注和重视。

abstractsObjective:To analyze anemia prevalence and its influencing factors of students involved in the Nutritional Improvement Program for Rural Compulsory Education Students in 2019.Methods:From the 2019 surveillance system of the Nutrition Improvement Program for Rural Compulsory Education Students, 47 297 primary and middle school students aged 6-17 were included in the study. Hemoglobin level was tested according to the criteria of WHO 2011. Anemia prevalence of different genders, ages, and regions was analyzed.Results:The average hemoglobin level was 135.19 g/L, with the prevalence of anemia as 8.7% in the children aged 6-17. The prevalence of anemia was 10.0% in girls, higher than that in boys (7.4%). The prevalence rates in western and central areas were 9.8% and 7.1%, respectively. From northwest, southwest, central and south, east, north to northeast areas of China, the anemia rate appeared gradually decreasing (10.2%, 9.7%, 8.3%, 7.5%, 5.7% and 3.5%). The anemia prevalence rates were 8.0%, 8.3%, and 10.9% in children from the 6-, 11-, and 14-17 years age groups, respectively. Logistic regression models revealed that students from schools not using catering software ( OR=1.482, 95% CI:1.296-1.694, P<0.001), schools not serving lunch ( OR=1.241, 95% CI:1.103-1.395, P<0.001), and from relatively low-income families ( OR=1.297, 95% CI:1.211-1.389, P<0.001) showed as risk factors for anemia. After supplementing students' dietary factors, the results showed that students who ate meat three or more times a week had a lower risk of anemia ( OR=0.907, 95% CI:0.832-0.989, P=0.026). Conclusions:The Nutritional Improvement Program for Rural Compulsory Education Students had an essential impact on improving the anemia prevalence of primary and middle school students. Family income, school location, economic factors, school feeding, and students' diet programs all impacted the prevalence of anemia.