妊娠中期母亲铁营养对婴儿早期铁营养状况影响的研究

目的 研究母亲妊娠中期铁营养对婴儿早期铁营养状况的影响.方法 测定母亲妊娠中、后期及脐血血清铁蛋白(zerum ferritin,SF)及血常规,随访至婴儿3～5月龄测婴儿血常规、血清可溶性转铁蛋白受体(soluble transferrin receptor,sTIR).比较母亲不同铁营养状况与婴儿血清sTIR水平关系.结果 (1)100对母亲-婴儿完成全程随访,婴儿有39例铁缺乏,92.31%(36/39)的母亲妊娠中期铁缺乏.(2)母亲妊娠中期患铁缺乏症的婴儿早期铁缺乏检出率明显高于母亲中期铁营养正常婴儿(X2=11.567,P<0.005),母亲妊娠中期为缺铁性贫血的婴儿铁缺乏症检出率明显高于母亲妊娠中期为隐性铁缺乏的婴儿铁缺乏症检出率(X2=7.356,P<0.01);母亲妊娠中期缺铁的婴儿早期血清sTIR值明显增高(P<0.005);妊娠中期母亲存在缺铁性贫血、隐性铁缺乏的婴儿血清sTfR值差异无统计学意义(P>0.05).(3)妊娠中期母亲SF水平与3～5月龄婴儿sTIR值存在负相关性(r=-0.7552,P<0.01).结论 3～5月龄健康婴儿的贫血可能同胎儿期铁贮存不足有关;母亲妊娠中期缺铁可减少胎儿期铁贮存,影响婴儿早期的铁营养水平.     

小儿免疫及原发性免疫缺陷病

030635胰岛素样生长因子1、视黄醇结合蛋白和前白蛋白作为新生儿营养指标的探讨/林满华…//实用儿科临床杂志一2002,17(4)一346一347 采用放射免疫分析法检测80名新生比脐血(IGF一l)水平。采用酶联免疫法检测其视黄醇结合蛋白(RBP)和前白蛋白(PA)水平.并按小于胎龄儿(SGA)和适于胎龄儿(AGA)进行分组比较。结果:AGA组IGF一1和RBP明显高于SGA组(P<0.05),AGA组PA显著高于SGA组(P<0.01)。提示:新生儿脐血IGF一1、RBP和PA可成为反映因围生因素造成胎儿宫内营养不良的良好生化指标。表1参8(张忠) 030636脐血T淋巴细胞及其亚群低…     

佝偻病患儿血清微量元素水平测定及相关分析

目的：人体内某些微量元素与儿童佝偻病的发病密切相关,该文探讨佝偻病患儿体内微量元素(钙、锌、铜、镁、铅)变化及其水平与佝偻病的相互关系。方法：选择46例佝偻病患儿和68例正常儿童采用火焰原子吸收法测定血清钙(Ca)、锌(Zn)、铜(Cu)和镁(Mg),采用石墨炉原子吸收法测定血清铅(Pb)。结果：佝偻病患儿血钙和血锌水平低于正常对照组,血铜和血铅高于正常对照组,差异均有显著性意义;血镁稍高于正常对照组,但两组之间差异无显著性。相关分析显示,佝偻病与血钙和血锌水平呈负相关(r=-0.538,P<0.01;r=-0.316,P<0.05),与血铅水平呈正相关(r=0.253,P<0.05),佝偻病患儿血钙与血锌呈正相关(r=0.523,P<0.01),与血镁、血铅呈负相关(r=-0.231,P<0.05;r=-0.367,P<0.05)。结论：该组检测结果提示低锌和高铅可能参与了佝偻病的发病及骨骼改变;对于佝偻病正规治疗效果不显著者,应注意检查血锌和血铅水平。     

孕妇血,脐血的锌,铜,铁变化及其与新生儿出生体重关系的探讨

孕妇微量元素的变化不仅会对其自身健康产生影响,而且可能累及胎儿,因此备受人们关注。我们于1991年4月～1993年12月检测了盐城市区不同孕期的孕妇及相应脐血清锌(Zn),铜(Cu)、铁(Fe)值和新生儿体重,作相关探讨,现报告如下。     

母血、脐血微量元素配对分析

本文测定了40对母血脐血血清的铜(Cu)、锌(Zn)和铁(Fe)含量,试图了解妊娠时母体及胎儿微量元素的相互关系,为围产医学提供可靠的临测及治疗依据。 对象与方法     

不同胎龄新生儿脐血前白蛋白、免疫球蛋白及微量元素的研究及相关分析

长期以来 ,临床上常用血清总蛋白、白蛋白作为新生儿营养的指标。近年来的研究证明 ,前白蛋白作为蛋白质 -能量的指标更准确、更敏感[1] 。为探讨前白蛋白与总蛋白、白蛋白、免疫球蛋白及微量元素的关系 ,1999～ 2 0 0 1我们测定了 188例不同胎龄新生儿前白蛋白、总蛋白、白蛋白、免疫球蛋白ＩｇＧ及铁、铜、锌、钙、镁等微量元素的水平 ,并进行相关分析。对象和方法1 对象 :本组 188例均来自本院产科。产妇及新生儿均无感染征象。 1ｍｉｎＡｐｇａｒ评分≥ 8分。足月儿组 :148例 ,产妇年龄 2 2～ 3 4岁 ;胎龄 3 7～ 40周 ;男 86例 ,女 62例…     

不同胎龄母婴血清前清蛋白测定的意义

目的　探讨不同胎龄母婴血前清蛋白水平。方法　采用免疫单向扩散法检测母婴血清前清蛋白(PA)。结果　 14 8对足月及 4 0对早产母亲血清PA显著高于足月儿及早产儿 (P <0 .0 0 1) ,早产儿脐血血清PA显著低于足月儿 (P <0 .0 0 1) ,早产儿血清PA水平与出生体重呈显著正相关 (r =0 .4 1　P <0 .0 1)。结论　围生期各孕周母婴间各种营养物质有密切关系 ,孕周越小 ,体重越低 ,体内PA水平越低。     

脐血脂联素、瘦素水平与胎儿发育的相关性

目的 探讨脐血脂联素、瘦素水平与胎儿生长发育的关系.方法 选择2006年10月至2007年10月在我院产科出生的新生儿86例,根据不同出生体质量分为小于胎龄儿(SGA)组16例,适于胎龄儿(AGA)组41例,大于胎龄儿(LGA)组29例.胎儿娩出后立即断脐留脐血20ml,采用放射免疫分析法测定血清脂联素、瘦素水平,同时检测其血脂水平,测量新生儿生长参数,计算体质量指数(BMI).结果 (1)3组脐血瘦素和脂联素水平差异有统计学意义(P<0.001),LGA组明显高于AGA及SAG组(P<0.01);(2)脐血瘦素水平与体质量、胎龄、头围、身长、足长及胎盘重量呈正相关(P<0.01),脐血脂联素水平与出生体质量、头围、足长、BMI水平呈正相关(P<0.05).(3)脐血瘦素与脂联素水平呈显著正相关(P<0.01).(4)3组血脂水平比较差异无统计学意义;脐血脂联素、瘦素水平与血脂各指标间无明显相关性(P>0.05).结论 瘦素与脂联素在胎儿宫内生长和发育过程中起重要的调节作用.     

红细胞铁蛋白测定在母婴铁代谢关系中的意义

评价红细胞铁蛋白 (EF)在母婴铁代谢关系中的作用。方法 :采用放射免疫法测定EF。结果 :母血脐血EF之间呈显著正相关关系 (r=0 2 5 3,P <0 0 1) ,母血EF值高的婴儿脐血铁指标显著高于母血EF值低的婴儿 (P <0 0 5 )。结论 :EF在母婴铁代谢关系中起重要作用 ,母亲EF含量对婴儿铁营养状态有直接影响     

妊娠期肝内胆汁淤积症对正常新生儿HPA轴及肾上腺皮质功能的影响

目的：探讨妊娠期肝内胆汁淤积症(ICP)对正常新生儿下丘脑 垂体 肾上腺轴(HPA)及肾上腺皮质功能的影响。方法：问卷调查收集32名ICP孕产妇(ICP组)和32名对照孕产妇（对照组）的人口统计学信息、分娩前心理焦虑和抑郁状况、分娩时应激自我评价。在新生儿娩出后即刻收集脐静脉血,记录出生结局,并用放射免疫法检测脐血中皮质醇(CORT)、促肾上腺皮质激素(ACTH)和硫酸脱氢表雄酮(DHEAS)的含量。结果：ICP组产前心理焦虑和抑郁得分显著高于对照组(P<0.05,P<0.01),分娩时应激自评两组差异无显著性。ICP组脐血中CORT和ACTH水平均显著低于对照组(P<0.01,P<0.01),而DHEAS显著高于对照组(P<0.01)。ICP组DHEAS/ACTH比值显著高于对照组(P<0.01),CORT/DHEAS比值显著低于对照组(P<0.01)。ICP孕产妇的甘胆酸水平与脐血中的DHEAS水平存在显著正相关(r=0.47,P<0.01)。结论：ICP可导致新生儿HPA轴的反应性下降,DHEAS分泌亢进,CORT与DHEAS存在分离现象,肾上腺皮质胎儿带可能存在功能损伤。［中国当代儿科杂志,2010,12（1）：5-8］     

Pubertal growth and development and prenatal and lactational exposure to polychlorinated biphenyls and dichlorodiphenyl dichloroethene

OBJECTIVES: Polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) are ubiquitous toxic environmental contaminants. Prenatal and early life exposures affect pubertal events in experimental animals. We studied whether prenatal or lactational exposures to background levels of PCBs or DDE were associated with altered pubertal growth and development in humans.Study design: Follow-up of 594 children from an existing North Carolina cohort whose prenatal and lactational exposures had previously been measured. Height, weight, and stage of pubertal development were assessed through annual mail questionnaires. RESULTS: Height of boys at puberty increased with transplacental exposure to DDE, as did weight adjusted for height; adjusted means for those with the highest exposures (maternal concentration 4+ ppm fat) were 6.3 cm taller and 6.9 kg larger than those with the lowest (0 to 1 ppm). There was no effect on the ages at which pubertal stages were attained. Lactational exposures to DDE had no apparent effects; neither did transplacental or lactational exposure to PCBs. Girls with the highest transplacental PCB exposures were heavier for their heights than other girls by 5.4 kg, but differences were significant only if the analysis was restricted to white girls. CONCLUSIONS: Prenatal exposures at background levels may affect body size at puberty.     

Hypokalemia and Hyperkalemia in Infants and Children: Pathophysiology and Treatment

Potassium is the second most abundant cation in the body. About 98% of potassium is intracellular and that is particularly in the skeletal muscle. Electrical disturbances associated with disorders of potassium homeostasis are a function of both the extracellular and intracellular potassium concentrations. Clinical disorders of potassium homeostasis occur with some regularity, especially in hospitalized patients receiving many medications. This article will review the pathophysiology of potassium homeostasis, symptoms, causes, and treatment of hypo- and hyperkalemia.     

Prevention and treatment of overweight and obesity in children and adolescents

Increasing numbers of obese children and adolescents all over the world demand an investment in the primary and secondary prevention of obesity and overweight in this age group. The goal of preventive measures in children is to avoid the negative short- and long-term health problems associated with obesity. Primary prevention aims at establishing a healthy, active lifestyle and keeping children and adolescents within a range of body weight which is considered to be healthy. Constant availability and affordability of palatable and energy-dense food in the affluent society of the western world demands preventive strategies. Universal or public health prevention seems to be the most suitable form because several other cofactors of morbidity and mortality of affluent societies can also be prevented. However, in most European countries there is a lack of awareness of the necessity of prevention programmes, not only among the general population but also among the medical society. More awareness and consciousness to the problem of obesity must be generated in order to lead to effective therapeutic programmes. For those children and adolescents who are already obese, secondary prevention is mandatory. Therapeutic intervention programmes for the obese aim at long-term weight maintenance and normalisation of body weight and body fat. They have to modify eating and exercise behaviour of the obese child and establish new, healthier behaviour and lifestyle. Treatments programmes must include behavioural components in order to permanently change nutrition and physical exercise of the obese children and adolescents. However, long-term results of treatment programmes in European countries are scarce and the reported results, even of multidisciplinary regimens, are not impressive. Conclusion In most European countries there is an urgent need not only for a growing awareness of the problem of obesity in children and adolescents but also for development of new comprehensive approaches in treating this group.