湿疹婴儿血嗜酸细胞阳离子蛋白和总IgE的检测及意义探讨

【目的】探讨湿疹婴儿血清中嗜酸细胞阳离子蛋白(ECP)和总IgE(tIgE)含量及其意义。【方法】采用Pharmacia Uni CAP检测系统荧光免疫法对31 例湿疹婴儿, 25 例正常婴儿血ECP, tIgE 水平检测。【结果】湿疹婴儿ECP(54.63±23.25)μg/L ,tIgE(56.00±22.47)μg/L,明显高于正常婴儿血ECP(7.39±1.57)μg/L,tIgE(17.11±6.69)μg/L,差异有显著性(P<0.01),湿疹婴儿ECP与tIgE两者之间显著正相关(r=0.72,P<0.01)。【结论】ECP,tIgE在婴儿湿疹发病机制中起了重要作用。     

孕晚期糖脂代谢与子代出生体质量及早期生长发育的相关性研究

目的:探讨孕晚期母血及脐血糖脂代谢与子代出生体质量及早期生长发育的关系。方法:随机选择950例母子配对样本,检测孕36~38周母血及脐血中血糖(glucose,Glu)、胰岛素、C-肽(C-peptide,C-P)、三酰甘油(triglycerides,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)及低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C);采集母亲孕期及婴儿出生时的一般资料以及婴儿出生后42 d、3月、6月、9月及12月龄的来院体检资料。结果:(1)低出生体质量(low birth weight,LBW)、正常出生体质量(normal birth weight,NBW)及高出生体质量(high birth weight,HBW)组新生儿间母血、脐血的LDL-C、胰岛素及C-P含量差异有统计学意义;其中LBW组LDC-C含量显著高于NBW组,HBW组胰岛素含量、C-P含量显著高于NBW组。(2)孕晚期母血与脐血的TG、TC、HDL-C、LDL-C、Glu、胰岛素及C-P含量均呈正相关(P0.01)。(3)孕晚期母血及脐血TG与婴儿42 d年龄别体质量Z分值(weight-for-age Zscore,WAZ)、体质量指数Z分值(body mass index Z-score,zBMI)、年龄别身长Z分值(length-for-age Z-score,LAZ)呈负相关,与婴儿3、6、9、12月龄WAZ、身长别体质量Z分值(weight-for-length Z-score,WLZ)、zBMI呈负相关;LDL-C与婴儿42 d LAZ、WAZ及3月龄LAZ呈负相关;C-P含量与婴儿42 d LAZ及6月龄LAZ呈正相关。结论:母血及脐血高LDL-C、TG易致新生儿LBW,而高C-P则可导致新生儿HBW;母血及脐血高TG、LDL-C、C-P水平是新生儿体格生长的不利因素。     

脐血IgE对食物过敏高危儿童预测作用的研究

目的:探讨脐血IgE用于早期预测食物过敏(food allergy,FA)高危儿童的可行性.方法:随机选取2009年5月2011年1月于复旦大学附属金山医院儿科出生的96例婴儿,随访至出生后24个月.随访中根据临床表现、标准问卷调查、排除性饮食试验及血清特异性sIgE检测进行分组,采用纸片放射免疫吸附法测定脐血IgE值.结果:随访24个月时,FA组患儿的脐血IgE值高于未发生食物过敏的婴儿组(non-food allergy组,NFA组),差异有统计学意义(P＜0.05);IgE值越高,过敏程度越重,持续时间越长.结论:高脐血IgE值对食物过敏高危儿童有预测作用.     

低水平铅暴露对婴儿的影响

目的 :探讨低水平铅暴露对一岁以内的婴儿体格发育、神经行为发育和铅、锌、铁、动态变化的影响。方法 :从我院 2 0 0 1年 3月～ 12月间出生的新生儿中选取 35例 ,以临主时孕妇血铅、婴儿血铅水平作为铅暴露指标。以身长、体重、头围作为体格发育指标 ;以锌、铁作为体内锌、铁变化的指标。在 3月± 1周、6月± 1周、9月± 1周、12月± 1周进行随访。结果 :孕妇血铅与婴儿血铅整呈正相关 ,孕妇血铅与 3、9个月婴儿血锌呈负相关。 3个月婴儿血锌和血铁有相关性。线性相关分析描示在临产孕妇血铅和 3、6、9个月婴儿血铅中有统计学意义。结论 :低水平铅暴露时婴儿神经行为发育造成不利影响 ;宫内铅和环境铅是影响出生后血铅水平的主要因素。提高血锌、铁水平可降低血铅水平。减少铅暴露的危害     

孕妇及新生儿潜在影响新生儿第1个24 h血糖水平相关因素

[目的]分析孕妇及新生儿潜在影响新生儿第1个24 h血糖水平相关因素。[方法]回顾性分析2016年3月—2017年3月在本院接受分娩孕妇1 863例及其所娩出的新生儿,分析孕妇不同分娩方式对新生儿娩出后微量血糖的影响,脐血血糖含量和新生儿微量血糖含量相关性及孕妇和新生儿因素对新生儿娩出微量血糖的影响。[结果]急症性剖宫产、选择性剖宫产与经阴分娩娩出新生儿在0.5 h、2 h及6 h其血糖含量比较差异有统计学意义(P0.05),娩出12 h及24 h其血糖含量比较差异无统计学意义(P0.05);在娩出新生儿时收集其脐血,检测得出脐血血糖是(4.42±0.68)mmol/L,和新生儿微量血糖行相关性分析,新生儿在娩出0.5 h、2 h其血糖和出生以后脐血血糖含量呈正相关(r值分别为0.638、0.463,P0.05);新生儿娩出2 h内低血糖发生率在孕妇年龄、体重增加量及分娩即刻血糖含量比较差异有统计学意义(P0.05);新生儿娩出2 h内低血糖发生率在其出生体重和脐带、羊水状况方面比较差异有统计学意义(P0.05)。[结论]对新生儿出生后6 h内血糖含量及时监测,可及时发现低血糖状况,便于前期进行干预,预防脑损伤等情况发生。     

携带乙型肝炎表面抗原的母亲对婴儿出生后的传染性

母亲携带的乙肝表面抗原(HBsAg)常可传染其婴儿,方式有二:一为出生期感染——宫缩开始至分娩结束(母-胎微输血和/或胎儿接触产道分泌物)发生的感染;一为出生后感染。本文是(在台北)用随机双盲安慰剂法观察105名母亲是HBsAg阳性的婴儿,出生后感染乙肝病毒(HBV)的情况。婴儿出生后立即注射乙肝免疫球蛋白(HBIG)1次(其中有些还在出生后3和6个月再注射1次),以预防出生期的感染。于3-4个月后用放射免疫法检测此被动抗体已阴转,并于出生后12个月时检测HBV标记物仍为阴性,而随后出现HBV感染(检测出     

自然分娩和剖宫产足月新生儿生后早期血糖变化

目的探讨自然分娩和剖宫产足月新生儿生后早期血糖变化。方法选取2013年11月至2014年11月分娩的足月新生儿120例,根据分娩方式的不同,将其分为自然分娩组和剖宫产组。其中自然产组60例,剖宫产组60例(应急剖宫产22例,择期剖宫产38例),监测新生儿脐血血糖、分娩即刻孕母末梢血糖及新生儿出生后0.5 h、2 h、6h、12 h、24 h动态血糖。结果自然产组新生儿生后24 h内各时间点的血糖值、脐血及孕妇分娩即刻指端末梢血糖值明显高于剖宫产组(P0.01)。应急剖宫产新生儿生后2 h、6 h的血糖值、脐血及孕妇分娩即刻指端末梢血糖值明显高于择期剖宫产新生儿(P0.01)。而应急剖宫产新生儿出生后0.5 h的血糖值明显低于择期剖宫产新生儿(P0.05)。应急与择期剖宫产新生儿出生后12 h和24 h的血糖值相比,无显著差异(P0.05)。低血糖母亲自然产组新生儿生后24 h内各时间点的血糖值、脐血及孕妇分娩即刻指端末梢血糖值明显高于低血糖母亲剖宫产组(P0.05)。结论部分足月新生儿存在生后早期发生低血糖的可能,自然分娩儿发生低血糖的可能性小于剖宫产儿,应急剖宫产儿低血糖多发生在出生后0.5 h左右,而择期剖宫产儿和自然分娩儿多发生在出生后2 h左右,孕母分娩前空腹低血糖与自然分娩相比,对剖宫产儿的血糖影响更大。     

除湿止痒洗液与0．05％地奈德乳膏联合治疗婴儿湿疹疗效观察

婴儿湿疹,俗称“奶癣”。是常见的一种过敏性皮肤病,通常在出生后第2或第3个月开始发病,亦有报告出生后第2—3周发生者,皮疹特点可分为渗出型和干燥型。无论哪一型均有阵发剧烈瘙痒,引起婴儿睡眠不安、厌食,并继发感染,有碍婴幼儿正常的生长、发育及健康。由于婴儿服药不便,故外用药物的应用尤为重要。本科自2009年5月至12月,应用中药外用制剂除湿止痒洗液联合0．05％地奈德乳膏治疗婴儿湿疹66例,取得了满意的疗效,现报告如下。     

罗哌卡因联合舒芬太尼分娩镇痛对婴儿生长发育的影响

目的:探讨罗哌卡因联合舒芬太尼用于产妇自控分娩镇痛对婴儿生长发育的影响。方法:选择要求阴道分娩的初产妇200例,随机分为观察组(分娩镇痛组)和对照组(非镇痛组),每组100例。观察新生儿的Apgar评分,出生后3、6和12个月时回院随访,进行婴儿体格发育状况评估;而在6和12个月时点采用贝利婴幼儿发展量表的智力发展指数(MDI)和运动发展指数(PDI),对婴儿智力和运动情况进行评估。结果:新生儿Apgar评分两组间比较,差异无统计学意义(P>0.05);婴儿在3、6和12个月时的身长、体重、头围和胸围等情况两组比较,差异无统计学意义(P>0.05)。两组6和12个月时的MDI和PDI比较,差异均无统计学意义(P>0.05)。结论:罗哌卡因联合舒芬太尼行分娩镇痛安全、有效,对婴儿身长、体重、头围、胸围和智力、运动能力等发育情况均无明显影响。     

初产妇孕晚期睡眠质量对婴儿睡眠模式的影响研究

目的 探究初产妇孕晚期睡眠质量对婴儿睡眠模式的影响。方法 选择2020年1月-2021年12月我院收治的初产妇及其分娩婴儿150例为研究对象,分析初产妇门诊就诊资料,以获取孕晚期睡眠数据,并分别于婴儿出生后2周、1个月、2个月、3个月测定其睡眠数据,采用Pearson相关性分析初产妇孕晚期睡眠质量与婴儿睡眠的相关性,明确初产妇孕晚期睡眠质量对婴儿睡眠模式的影响。结果 初产妇孕晚期睡眠质量呈下降趋势,睡眠质量核心指标随孕周增大变差;婴儿早期随月龄增大日睡眠时间及夜间睡眠时间延长、睡眠效率增高、睡眠潜伏期缩短、夜间醒次数减少;Pearson相关性分析结果显示,PSQI评分与婴儿日睡眠时间、夜间睡眠时间、睡眠效率呈负相关(P<0.05),与婴儿睡眠潜伏期、夜间醒次数呈正相关(P<0.05);日睡眠时间与婴儿日睡眠时间、夜间睡眠时间呈正相关(P<0.01);睡眠潜伏期与婴儿睡眠潜伏期呈正相关(P<0.01);夜间睡眠时间与婴儿日睡眠时间、夜间睡眠时间、睡眠效率呈正相关(P<0.01,P<0.05);睡眠效率与婴儿日睡眠时间、夜间睡眠时间、睡眠效率呈正相关(P...     

Fecal tumor necrosis factor alpha, eosinophil cationic protein and IgE levels in infants with cow's milk allergy and gastrointestinal manifestations.

Infants with atopic eczema exhibit a specific fecal protein pattern after oral challenge with cow's milk, characterized by an increase in both eosinophil cationic protein (ECP) and tumor necrosis factor (TNF)alpha. The aim of our study was to determine the pattern of these proteins in allergic infants with intestinal manifestations. TNFalpha, ECP and immunoglobulin E (IgE) were measured in stools from 13 infants with intestinal symptoms and 10 healthy infants. The allergic infants underwent two stool collections, one before a cow's milk challenge and the other after the challenge, either at the onset of clinical manifestations (n=6) or 15 days after the challenge if no clinical manifestations occurred (n=7). Baseline TNFalpha, ECP and IgE levels were low in all infants. The concentration of TNFalpha increased after the challenge in infants positive to challenge (p<0.05) but not in those negative to challenge. ECP and IgE levels remained low after the challenge in all the allergic infants. These data confirm that fecal TNFalpha and ECP levels indicate various reaction types of food allergy and that different immunologic disturbances lead to atopic eczema or intestinal symptoms during food allergy. Fecal protein pattern can thus be a useful tool in diagnosing food allergy in infants with intestinal manifestations.     

Cord blood lipids in infants born to HIV-1-infected women treated with combination antiretroviral therapy

BACKGROUND: To investigate the effect of exposure to protease inhibitor (PI) therapy in utero on cord blood lipids in infants born to mothers enrolled in AIDS Clinical Trials Group protocol 5084, a prospective, multicentre, observational study of antiretroviral therapy (ART) during pregnancy. METHODS: Clinical outcome was determined in 80 infants born to women treated with PIs and 73 infants born to women treated with other antiretrovirals during pregnancy. Cord blood serum from 117 of these infants was assayed for total, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, triglyceride, apolipoprotein A1 (apoA1), apolipoprotein B100 (apoB) and lipoprotein (a). Covariates considered in the analysis included race/ethnicity, gestational age, infant gender, infant birth weight, mode of delivery, maternal tobacco and alcohol use, post-partum body mass index, and ART duration. RESULTS: Cord blood total and HDL cholesterol, triglyceride, apoA1, apoB, lipoprotein (a) and apoB/apoA1 ratio were not different between the two groups. Cord blood lipid levels in these HIV-exposed infants were similar to those reported in other neonatal cohorts. Controlling for race/ethnicity, infants born to women treated with PIs had higher LDL cholesterol than those born to women not treated with PIs (29 mg/dl versus 27 mg/dl, P = 0.006). CONCLUSION: Only LDL cholesterol was significantly higher in the cord blood of PI-exposed infants versus those not exposed to PIs in utero. As the difference between the two groups was small, the clinical relevance of the effect of maternal PI treatment on infant LDL cholesterol levels at birth is not clear.     

一例重度婴幼儿湿疹使用压缩面膜给予黄连素湿敷的个案护理

探讨使用压缩面膜给予黄连素湿敷在治疗婴幼儿中（重）度湿疹的效果观察。本文对本院收治的1例婴幼儿重度湿疹的临床资料进行回顾性分析。结论 ：使用压缩面膜给予黄连素冷湿敷为临床治疗婴幼儿湿疹提供了一种安全有效、可供参考的治疗方法，值得进一步加以推广使用     

早产儿婴儿期智能发育的早期干预

背景:近年来,早产儿的存活率逐年上升,但由于早产儿大脑发育不成熟,智能发育往往较正常儿落后。目的:探讨以家庭为中心,以物质营养、信息刺激和爱抚为主要干预内容的早期干预对早产儿婴儿期智能发育水平的影响。设计:随机抽样对照观察。单位:山东大学临床医学院·济南市中心医院儿科。对象:选择2000-05/2002-07在济南市中心医院出生的孕31～36周早产儿35例(男18例,女17例)作为早期干预对象,同时设立同期出生的孕31～36周早产儿33例(男18例,女15例)和足月新生儿49例(男26例,女23例)为对照组。方法:以家庭为中心,以营养、信息刺激和爱抚为主要干预内容进行早产儿早期干预,建立健康档案,进行抚触和穴位按摩,1个月内家访2次;两对照组只在3,6,10月龄常规体检一次。在10月龄时采用Gesell发育诊断量表和日本S～M社会生活能力量表对各组婴儿的智能发育水平进行评定。主要观察指标:各组婴儿智能发育水平评定结果。结果:在实验过程中,早产儿干预组死亡1例,失访2例,合格病例32例,合格率91%。早产儿对照组33例,失访3例,合格病例30例,合格率91%。足月儿对照组49例,失访3例,合格病例46例,合格率94%。①早产儿干预组10月龄时Gesell各能区的发育商DQ及日本S～M社会生活能力评定值均显著高于早产儿对照组,其中适应性、精细动作、语言、个人社会行为4项发育商差异具有高度显著性意义。②早产儿干预组10月龄时Gesell各能区的发育商DQ及日本S～M社会生活能力评定值均低于足月儿对照组,差异有显著性意义。③干预组中胎龄大于35周的早产儿各评定值均低于足月儿对照组,但差异无显著性意义(P>0.05)。结论:早期干预对早产儿婴儿期智能发育有明显的促进作用,部分早产儿经干预可达到足月儿水平。     

中药淀粉浴辅助治疗婴儿湿疹效果观察

目的探讨自配中药淀粉浴治疗婴儿湿疹的效果与护理方法。方法采用本院自制的止痒洗剂加医用淀粉进行泡浴,并同时实施药浴的护理、家长的健康指导、饮食及皮肤护理。结果 52例患儿经过治疗及护理后,总有效率达80.7%。结论中药淀粉浴辅助治疗婴儿湿疹,对湿疹瘙痒、渗液、皮肤干燥等症状的改善效果明显,得到了患儿家长的认可。     

Polycythaemia in infants of diabetic mothers: β-hydroxybutyrate stimulates erythropoietic activity

This study tested whether elevated maternal β-hydroxybutyrate (β-OHB) levels contribute to polycythaemia in infants of diabetic mothers. Pregnant diabetic women (n = 27) and non-diabetic controls (n = 20) and their singleton infants were included. Maternal glycosylated haemoglobin and β-OHB levels were studied at 34-36 weeks' gestation; levels were significantly higher in mothers with diabetes than in controls. Birth weights and cord blood levels of insulin and fetal haemoglobin were significantly higher in infants from diabetic mothers compared with control infants, as were haematocrit levels in venous blood samples taken from each infant at 4 h following delivery. Cord blood erythropoietin levels were similar in both groups. There was a positive strong correlation between maternal β-OHB levels and polycythaemia in newborn infants, indicating that β-OHB could activate erythropoiesis independently from intrauterine hyperinsulinaemia and/or erythropoietin levels, and may be important in the pathogenesis of polycythaemia in infants born to diabetic mothers.     

Developmental outcomes of infants with bronchopulmonary dysplasia: comparison with other medically fragile infants

The purpose of this study was to compare the developmental outcomes and mother-infant interactions of infants with bronchopulmonary dysplasia (BPD) and those of other medically fragile infants. One-hour behavioral observations were made of the interactions of mothers with two groups of infants (23 with BPD, 39 medically fragile without BPD or neurological problems) at enrollment, every 2 months during hospitalization, 1 month after discharge, and at 6 months' and 12 months' corrected age. Assessment of the home environment also was done at 6 and 12 months. Multiple regressions were calculated separately for child mental, adaptive, language, and motor outcomes. Predictors were: home environment assessment, measures of maternal interactive behaviors (positive attention, expression of negative affect, medicalized caregiving), infant group membership, and presence of intraventricular hemorrhage (IVH) in the infant. There were no significant differences between the two groups in any of the developmental outcomes or interactive variables, and the presence of IVH had no effect on these variables. Maternal positive attention and the home environment were correlated with mental development, and mother negative affect was related to adaptive behavior for both groups. Differences in developmental and interactive behaviors between infants with BPD and other prematurely born infants found in other studies appear to be a result of chronic health problems and, thus, are not unique to infants with BPD.     

大于胎龄儿脐血抵抗素水平测定及意义

目的 探讨血抵抗素水平与大于胎龄儿的关系。方法选取大于胎龄儿（LGA）60例和适于胎龄儿（AGA）30例。应用酶联免疫吸附法测定脐血和母血抵抗浓度，用免疫比浊法测定血脂水平；并分析脐血抵抗素水平与母血抵抗素、新生儿性别、出生体质量、体质指数（BMI）、胎盘重量和血脂水平的相关性。结果大于胎龄儿脐血抵抗素水平高于适于胎龄儿，差异有统计学意义（P〈0．01）；2组新生儿血脂水平差异无统计学意义（P〉0．05）。大于胎龄儿血抵抗素水平与新生儿出生体质量、BMI、胎盘重量、脐血三酰甘油水平均呈显著正相关（r分别为0．85，0．79，0．62，P〈0．01）。大于胎龄儿男婴和女婴脐血抵抗素，血脂各成分水平比较，差异均无统计学意义（P〉0．05）。结论血抵抗素水平的变化与大于胎龄儿的发生有关，测定脐血抵抗素水平有助于判断大于胎龄儿的发展趋势。     

小儿脑瘫脑血流多普勒超声检测的研究

目的： 研究小儿脑瘫脑血流的变化规律。方法： 应用彩色多普勒超声对５６ 例患儿与６０ 例正常健康儿脑血流参数进行对照检测。结果： 小儿脑瘫组的三个年龄段的大脑中动脉、大脑前动脉的舒张末期及平均血流较同年龄段的正常小儿显著下降,而脑血管阻力指数则显著增高。同时年龄较大组的脑瘫患儿的大脑中动脉的平均流速及脑血管阻力指数较同年龄组的正常儿差异更显著。结论： 通过检测脑血流有助于对脑瘫患儿的诊断与早期治疗。