婴幼儿营养性缺铁性贫血的智能发育、气质行为及相关因素的研究

目的探讨缺铁性贫血对婴幼儿智能发育及气质行为的影响。方法选择儿童保健门诊查体的1～2岁幼儿600名,用日本Xs-800i血细胞分析仪检测血常规;北京博晖BH-5100五通道原子吸收光谱仪检测铁元素;用Gesell婴幼儿发育诊断量表检测发育商;用Carey儿童气质量表中的幼儿气质评估表（TTS）测评幼儿气质;自拟婴幼儿情况问卷调查。结果①贫血的发病率18.34%。②铁缺乏检出率为31.34%。③Gesell诊断量表贫血组各能区DQ低于对照组5～7分,差异有统计学意义（P〈0.01）;④贫血组幼儿的体重、身长在均值以上的比率低于对照组;差异有统计学意义（P〈0.05）。⑤贫血组幼儿气质偏积极型的较对照组低;气质偏消极型的较对照组高。差异有统计学意义（P〈0.05）。结论贫血影响幼儿的体格生长发育和智能发育,影响良好气质性格特征的形成。     

静脉营养辅助治疗婴幼儿急性病程较长水样腹泻病80例疗效观察

目的探讨静脉营养辅助治疗婴幼儿急性病程较长水样腹泻病的疗效。方法对我院儿科2006年3月-2008年12月住院的婴幼儿水样腹泻、病程在5～14d、腹泻次数≥8次/d的153例患儿,按入院顺序分成治疗组（静脉营养组）80例,采用静脉营养辅助治疗,对照组73例,未采用静脉营养,观察两组患儿的疗效。结果总有效率静脉营养组95%,对照组80.8%,两组比较差异有统计学意义（P〈0.01）;48h内止泻率静脉营养组75%,对照组49.3%,两组比较差异有统计学意义（P〈0.005）。结论静脉营养辅助治疗婴幼儿急性病程较长水样腹泻病疗效显著。     

Eye contact and emotional face processing in 6-month-old infants: Advanced statistical methods applied to event-related potentials

Event-related potential (ERP) studies with infants are often limited by a small number of measurements. We introduce a weighted general linear mixed model analysis with a time-varying covariate, which allows for the efficient analysis of all available event-related potential data of infants. This method allows controlling the signal to noise ratio effect on averaged ERP estimates due to small and varying numbers of trials. The method enables analyzing ERP data sets of infants, which would often not be possible otherwise. We illustrate this method by analyzing an experimental study and discuss the advantages in comparison to currently used methods as well as its potential limitations. In this study, 6-month-old infants saw a face showing a neutral or an angry expression in combination with direct or averted eye gaze. We examined how the infant brain processes facial expressions and whether the direction of eye gaze has an influence on it. We focused on the infant Negative Central ERP component (Nc). The neutral expression elicited larger amplitude and peaked earlier than the angry expression. An interaction between emotion and gaze was found for Nc latency, suggesting that emotions are processed in combination with eye gaze in infancy.     

75例婴儿喘息型肺炎的临床分析

目的：为探讨婴儿喘息型肺炎的临床特点及诱发因素。方法：分析在2008年12月至2009年1月我科收治的75例婴儿喘息型肺炎的临床表现,实验室检查结果。结果：喘息型肺炎除咳嗽气喘外,尚伴有发热（20%）、呕吐（26.6%）、腹泻（33.3%）、烦燥不安（26.6%）等,且易伴发心肌受损。肥胖、先心病、低IgG血症是其诱发因素。结论：婴儿喘息型肺炎临床表现为多系统受损,肥胖、先心病、免疫缺陷促使其发生。     

Risk indicators for hearing loss in infants treated in different Neonatal Intensive Care Units

Aim: To assess which infants’ characteristics and specialized procedures are risk indicators for unilateral or bilateral hearing loss (HL) and to evaluate whether these risk indicators are associated with variation in prevalence of HL between Neonatal Intensive Care Units (NICUs). Methods: For 2002–2005, data from the NICU hearing screening database in the Netherlands were matched with the national neonatology database in which all NICU infants with their patient characteristics and specialized procedures are registered. Multivariate logistic regression analyses were performed to assess risk indicators for HL and to explain differences in prevalence rates between NICUs. Results: A total of 10 830 infants were available for analyses. The prevalence of HL was 1.8% and ranged from 0.7 to 3.7% between NICUs. Infants’ characteristics that significantly increased the risk of HL were the presence of craniofacial anomalies, chomosomal/syndromal anomalies, central nervous system conditions, circulatory system conditions and intra‐uterine infections. The specialized procedures involving ≥12 days of intensive care and high frequency oxygenation ventilation were independent risk indicators for HL. Approximately 20% of the variance can be explained by the studied risk indicators. Differences in prevalence rates between NICUs were slightly reduced after adjustment for these risk indicators. NICUs with the highest prevalence rates of HL were situated in the largest cities in the Netherlands with a mixed population because of immigration. Therefore, ethnicity may be a risk indicator. Conclusions: Several independent risk indicators for HL were found, but they could not explain all differences in prevalence rates of HL between NICUs.     

Association of higher adiposity and wheezing in infants with lower respiratory illnesses

Aim: The incidences of asthma and obesity have been steadily increasing over the past two decades, with several studies showing a relationship between these conditions. We investigated the influence of higher weight for height (WFH) Z‐score on wheezing in infants with lower respiratory tract infections (LRTI). Methods: We reviewed the medical charts of all infants younger than l year of age who were admitted with the first episode of LRTI between 2000 and 2008. Subjects were classified into six groups according to WFH Z‐score. Results: Wheezing was more frequent in infants with higher WFH Z‐scores. Especially, wheezing infants aged 3–6 months and 6–9 months had significantly higher WFH Z‐scores than had their non‐wheezing counterparts (p = 0.05 and p < 0.01 respectively). Multivariate logistic regression showed that age (OR = 0.76, p < 0.001), male gender (OR = 1.61, p = 0.005) and WFH Z‐score (OR = 1.12, p = 0.007) were independently associated with wheezing. Conclusion: In this study we could show that a higher WFH Z‐score was independently associated with wheezing in infancy. Attainment of appropriate weight for age may reduce the risk of wheezing in infants with respiratory diseases.     

丙种球蛋白对毛细支气管炎治疗疗效观察

目的探究丙种球蛋白对毛细支气管炎治疗疗效。方法对照组给予常规综合治疗,观察组在此基础上联合丙种球蛋白(IVIG)治疗,观察对比记录两组患儿临床疗效、临床症状及体征消失时间及住院天数。结果观察组总有效率为93.15%,明显高于对照组的76.71%,两组比较差异具有统计学意义,P<0.05。观察组咳嗽、憋喘、肺部体征消失时间及住院天数均明显短于对照组,差异具有统计学意义,P<0.05。结论丙种球蛋白静脉注射佐治毛细支气管炎的临床效果确切,明显改善憋喘、呼吸困难等临床症状及体征,有效减轻病情及阻滞病程进展,减少住院天数,且用药安全性高,值得临床应用和推广。     

多层螺旋CT扫描婴幼儿先天性心脏病条件设置研究

目的:探讨64排螺旋CT在扫描婴幼儿先天性心脏病中,选择适当的扫描参数以减少伪影的产生,降低婴幼儿在扫描中受到的辐射。方法:使用64排螺旋CT扫描机,采用造影剂跟踪(Blous tracking)技术,对35例婴幼儿先心病患者行CT检查。结果:35例患儿所有图像均显示心脏各心腔、肺动脉、静脉和升、降主动脉对比剂充盈良好,图像显示清晰。上腔静脉对比剂密度适中,各血管CT值近似,未见硬化伪影,心脏各房室及血管对比剂充盈饱满,边界清晰,无明显伪影,对影像重组无影响。结论:适当调整扫描参数,可减少硬化伪影的产生和伪影对图像重组的影响。遵守"合理使用低剂量(ALARA)"原则,在获得可诊断的图像同时减少CT扫描辐射对婴幼儿的伤害。     

长沙地区婴儿肺炎356例病原学检测结果

目的了解婴儿肺炎病原学分布,为临床经验性用药提供参考。方法对2011年10月-2012年9月在长沙市第一医院儿科住院临床诊断为婴儿肺炎的356例患儿,采集鼻咽部分泌物,进行痰细菌培养及直接免疫荧光法检测呼吸道病毒,分析病原学分布情况及细菌耐药性。结果 356例患儿188例检出病毒阳性或痰细菌培养阳性,病原检出率52.8%,其中呼吸道病毒及痰细菌培养检出率分别为34.8%、42.1%。痰细菌培养以肺炎克雷伯菌(28.1%)最常见,混合感染率高达24.2%;超广谱β-内酰胺酶(ESBLs+)及耐青霉素肺炎链球菌(PRSP)菌检出率较高,分别达68.3%、90.0%,细菌的耐药性较强。病毒感染以冬季好发,以呼吸道合胞病毒(RSV)(57.8%)及副流感病毒3(PIV3)(17.2%)为主。结论婴儿肺炎患儿应及时进行病原学检查,以便临床医师根据其结果合理用药。