本文選題：雙生子　切入點(diǎn)：嬰兒　出處：《南京醫(yī)科大學(xué)》2010年碩士論文

【摘要】：目的0-3歲是視覺發(fā)育的關(guān)鍵期,任何影響視覺形成的內(nèi)在或外在因素都會(huì)導(dǎo)致視覺發(fā)育的異常。散光眼是引起嬰幼兒視覺發(fā)育異常的常見眼病胎兒眼球在宮內(nèi)發(fā)育過程中,在遺傳與環(huán)境相互作用下,可形成不同的屈光狀態(tài),使嬰兒在出生時(shí)就可能發(fā)生散光。散光的形成受遺傳因素與環(huán)境因素的共同影響,遺傳因素在散光形成中的作用已被證實(shí),環(huán)境因素在散光形成中的作用研究甚少。環(huán)境因素范圍較廣,包括母胎健康狀況、母胎營(yíng)養(yǎng)因素、出生時(shí)情況等,其中營(yíng)養(yǎng)素水平對(duì)散光的影響目前國(guó)內(nèi)外尚未見相關(guān)前瞻性研究。故本文旨在通過對(duì)孕期母嬰營(yíng)養(yǎng)狀況與雙生子生后散光眼發(fā)病情況的研究,來探討孕期營(yíng)養(yǎng)與雙生子散光眼形成的關(guān)系。 方法以2008年3月31日～2009年3月31日分娩于江蘇省人民醫(yī)院的28對(duì)雙生子為研究對(duì)象,其中單卵雙胎11對(duì)(男性5對(duì),女性6對(duì))、雙卵雙胎17對(duì)(男性8對(duì),女性6對(duì),異性3對(duì))。分別于孕4-6月時(shí)、分娩前抽取母親空腹靜脈血及分娩后即刻采集胎盤臍帶殘端中的臍靜脈血進(jìn)行血清營(yíng)養(yǎng)素檢測(cè),其中酶聯(lián)免疫法檢測(cè)血清25-羥維生素D3,高效液相色譜法檢測(cè)血清維生素A,原子吸收光譜法測(cè)定血清鈣、鐵、鎂、鋅。對(duì)28對(duì)雙生子于生后3月、6月、9月、12月、18月進(jìn)行屈光檢查,將雙生子的眼散光狀況與孕母孕期及雙生子在出生前、后等相關(guān)因素進(jìn)行分析。同期隨機(jī)抽取56例單胎兒作為對(duì)照。 結(jié)果雙生子生后3月、12月時(shí)柱鏡≥2D散光眼檢出率分別為53.57%、43.75%,均顯著高于單胎嬰兒(χ2=21.35、18.52,P均0.05)。雙生子散光家族史的有無,兩組間散光值比較(F=6.33,P=0.01)差異有統(tǒng)計(jì)學(xué)意義雙生子組與單胎兒組散光的遺傳相關(guān)性分別為58.33%、57.14%。母親有早孕反應(yīng)(OR=1.40,95%CI 1.10-5.13)、母親孕中期骨密度(OR=1.44,95%CI1.30～6.19)、血色素(OR=1.69,95%CI 1.03-2.78)、分娩時(shí)血清鎂(OR=1.39,95%CI 1.03-1.89)、維生素A(OR=1.03,95%CI 1.01-1.06)、雙生子臍血維生素D(OR=1.02,95%CI 1.00-1.04)和出生體重(OR=1.02,95%CI 1.00-1.03)與雙生子散光眼的關(guān)聯(lián)有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論雙生子散光眼檢出率明顯高于單胎兒；母孕期營(yíng)養(yǎng)狀況影響雙生子散光眼的形成,應(yīng)在整個(gè)孕期針對(duì)性地對(duì)孕母進(jìn)行營(yíng)養(yǎng)指導(dǎo),以降低嬰兒散光眼的發(fā)生率
[Abstract]:Objective 0-3 years old is the key period of visual development. Any internal or external factors affecting visual formation will lead to abnormal visual development.Astigmatism is a common ophthalmopathy that causes the visual dysplasia of infants. During the development of fetal eyeball in the uterus, under the interaction of heredity and environment, different refractive states can be formed, which may lead to astigmatism at birth.The formation of astigmatism is influenced by both genetic and environmental factors. The role of genetic factors in the formation of astigmatism has been confirmed.There are a wide range of environmental factors, including maternal and fetal health status, maternal and fetal nutrition factors, at birth, and so on. The effect of nutrient level on astigmatism has not been studied in China and abroad.The aim of this paper is to explore the relationship between maternal nutrition and the formation of twin astigmatism by studying the nutritional status of mother and child during pregnancy and the incidence of astigmatism after twin birth.Methods from March 31, 2008 to March 31, 2009, 28 pairs of twins in Jiangsu Provincial people's Hospital were studied. Among them, 11 pairs of monozygote twins (5 pairs of males, 6 pairs of females, 17 pairs of dizygotic twins (8 pairs of males and 6 pairs of females) were studied.The opposite sex is 3 pairs.Maternal fasting venous blood was collected before delivery and umbilical vein blood from umbilical cord stump of placenta was collected immediately after delivery to detect serum nutrients.Enzyme-linked immunosorbent assay (Elisa) was used to detect serum 25 hydroxyvitamin D 3, high performance liquid chromatography (HPLC) to detect serum vitamin A, and atomic absorption spectrometry (AAS) to determine serum calcium, iron, magnesium and zinc.Diopter examination was performed on 28 pairs of twins in March, June, September, December and 18 months after birth. The astigmatism of twins and the related factors before and after pregnancy were analyzed.At the same time, 56 cases of single fetus were randomly selected as control.Results the detectable rate of column lens 鈮，

本文編號(hào)：1707568