本文選題：唐氏綜合征　切入點(diǎn)：影響因素　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本研究欲通過(guò)對(duì)廣東省唐氏綜合征發(fā)生的時(shí)間、空間、人間分布情況進(jìn)行描述分析,并且通過(guò)比較分析胎兒為唐氏綜合征和非唐氏綜合征孕婦孕前職業(yè)、環(huán)境等因素的接觸情況,以探索職業(yè)、環(huán)境因素對(duì)唐氏綜合征發(fā)生的影響,為優(yōu)生優(yōu)育的宣傳及預(yù)防干預(yù)措施的制定提供科學(xué)依據(jù),從而降低唐氏綜合征的發(fā)生率,達(dá)到一級(jí)預(yù)防的目的。方法:通過(guò)對(duì)某婦幼保健院2015年1月1日至2015年12月31日產(chǎn)前診斷科介入性穿刺抽取絨毛、羊水或臍血進(jìn)行染色體G顯帶核型分析的2342名孕婦進(jìn)行現(xiàn)況分析,統(tǒng)計(jì)分析該院2015年唐氏綜合征檢出情況及三間分布情況;通過(guò)系統(tǒng)抽樣法隨機(jī)抽取2015年1月1日至2016年12月31日期間于該院就診經(jīng)絨毛、羊水或臍血染色體G顯帶核型分析診斷胎兒為唐氏綜合征的孕婦97名作為病例組,絨毛、羊水或臍血染色體G顯帶核型分析診斷胎兒為非唐氏綜合征的孕婦373名作為對(duì)照組,采用成組設(shè)計(jì)的病例對(duì)照研究,通過(guò)逐步多因素logistic回歸法比較分析病例組和對(duì)照組孕婦孕前職業(yè)、環(huán)境等因素暴露情況,探索唐氏綜合征發(fā)生相關(guān)的影響因素。結(jié)果:1.抽取2015年1月1日-2015年12月31日期間孕婦進(jìn)行調(diào)查,共收集到研究對(duì)象2342例,胎兒為唐氏綜合征者63例,檢出率為2.69%,其中三體型62例(98.4%),嵌合型1例(1.6%);非唐氏綜合癥2279例;2.唐氏綜合征的發(fā)生有三個(gè)高峰即1月(3.9%)、7月(4.3%)、12月(4.1%)和兩個(gè)低峰即3月(0.9%)、9月(1.7%);3.常住地在城市的孕婦唐氏綜合癥檢出率為1.95%,常住地在農(nóng)村的檢出率為3.57%,唐氏綜合征檢出率城鄉(xiāng)間的差異有統(tǒng)計(jì)學(xué)意義(χ2=7.88,P0.01);4.唐氏綜合征發(fā)生的影響因素按照OR值由大到小依次為:孕前或孕早期服用雌激素類藥物(χ2=0.807,OR=6.860)、孕前曾居住新裝修房屋(χ2=10.664,OR=3.080)、孕婦年齡≥35歲(χ2=16.600,OR=2.755)、孕婦職業(yè)接觸含苯有機(jī)溶劑(χ2=5.789,OR=2.589)、孕前補(bǔ)充葉酸(χ2=0.814,OR=0.107)。結(jié)論:唐氏綜合征的發(fā)生可能受到氣候、城鄉(xiāng)差異的影響,其中,1月、7月、12月為發(fā)病高峰,3月、9月為發(fā)病低峰;農(nóng)村發(fā)病率高于城市。經(jīng)分析孕婦孕前職業(yè)接觸含苯有機(jī)溶劑、孕婦年齡≥35歲、孕前或孕早期服用雌激素類藥物、孕前曾居住新裝修房屋均為唐氏綜合征發(fā)生相關(guān)的危險(xiǎn)因素。孕前補(bǔ)充葉酸可降低唐氏綜合征的發(fā)生風(fēng)險(xiǎn),為唐氏綜合征的保護(hù)因素。嚴(yán)格監(jiān)督各企業(yè)、工廠做好女性從業(yè)者的職業(yè)防護(hù)及育齡女性優(yōu)生優(yōu)育知識(shí)的宣傳教育和孕前遺傳咨詢對(duì)降低唐氏綜合征的發(fā)生極其重要。
[Abstract]:Objective: to describe and analyze the time, space and human distribution of Down's syndrome in Guangdong Province, and to compare the fetal status of pregnant women with Down's syndrome and non-Down 's syndrome before pregnancy. In order to explore the influence of occupational and environmental factors on the occurrence of Down's syndrome, to provide scientific basis for the propaganda of eugenics and eugenics and the formulation of preventive intervention measures, so as to reduce the incidence of Down's syndrome. Methods: from January 1st 2015 to December 31st 2015, the villi were extracted by interventional puncture in a department of prenatal diagnosis in a MCH hospital. The status of 2342 pregnant women with amniotic fluid or umbilical cord blood chromosome G-banding karyotype was analyzed. The detection and distribution of Down's syndrome in the hospital in 2015 were statistically analyzed. From January 1st 2015 to December 31st 2016, 97 pregnant women whose fetuses were diagnosed as Down's syndrome were randomly selected as the case group by G-banding karyotype analysis of chromosomes in amniotic fluid or umbilical cord blood from January 1st 2015 to December 31st 2016. The G-banding karyotype analysis of amniotic fluid or umbilical cord blood chromosomes was performed in 373 pregnant women with non-Down syndrome as control group. Stepwise multivariate logistic regression was used to compare and analyze the pre-pregnancy occupation and environment of pregnant women in the case group and the control group. Results: a total of 2342 pregnant women were selected from January 1st 2015 to December 31st 2015 to investigate the incidence of Down's syndrome. 63 fetuses were born with Down's syndrome. The detection rate was 2.69. 62 cases of trisomia were involved with 98.4G and 1 case with chimeric type. 2279 cases of non-Down syndrome were diagnosed. There were three peaks in the occurrence of Down's syndrome, that is, on January, 3.9, July and December, respectively.) and two low peaks, namely, December, 0.934, #dateatis, 1.70.There are three peaks in the occurrence of Down's syndrome: Tang Jiao, a pregnant woman who lives in the city, usually lives in the city. The detection rate of Down's syndrome was 1.95 and 3.57 in rural areas. The difference between urban and rural areas was statistically significant (蠂 ~ 2 / 7.88 / P 0.01p ~ (0.01)). The influencing factors of Down's syndrome were as follows: prepregnancy or pregnancy according to OR value. Early use of estrogen drugs (蠂 2 + 0.807) (蠂 2 + 0.807), living in newly decorated houses before pregnancy (蠂 2 / 10.664), pregnant women aged more than 35 years (蠂 ~ 216.600), occupational exposure of pregnant women to benzene-containing organic solvents (蠂 ~ (2) 5.789OR2.589N), supplementation of folic acid before pregnancy (蠂 ~ (2 +) 0.814) OR0.1077.Conclusion: the occurrence of Down's syndrome may be affected by climate, The influence of urban and rural differences, including January, July, December as the peak incidence, December, December as the low peak, the incidence in rural areas is higher than in urban. After analysis of pregnant women before pregnancy occupational exposure to benzene-containing organic solvents, pregnant women aged more than 35 years old, Taking estrogen drugs before pregnancy or early pregnancy, and living in newly decorated houses before pregnancy are all risk factors associated with Down's syndrome. Folic acid supplementation before pregnancy can reduce the risk of Down's syndrome. In order to protect Down's syndrome, it is very important to strictly supervise the occupational protection of female practitioners, to publicize and educate women's knowledge of eugenics and to consult before pregnancy in order to reduce the incidence of Down's syndrome.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R714.5

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