天津市津南区3~6岁学龄前儿童生长发育Z评分及营养状况评价

目的 了解天津市津南区学龄前儿童的生长发育水平及营养状况,为本地区的儿童保健和营养指导工作提供参考。方法 调取2017年津南区所有国办幼儿园内3~6岁儿童的春季体检数据,采用分层随机抽样的方法,将调查对象按照年龄分为3~、4~、5~、6~7岁4组,并在各年龄组中按照性别比1∶1的比例随机选取调查对象,共得到2 172名儿童的体检数据。采用世界卫生组织(WHO)推荐使用的Z评分法进行评价。结果 各年龄组中,男童的身高、体重均高于同年龄段女童;男童和女童的身高别体重(WHZ)和年龄别身高(HAZ)值在各年龄组间比较差异有统计学意义(男童F_WHZ=11.966,女童F_WHZ=28.291,男童F_HAZ=40.474,女童F_HAZ=22.520,P<0.05),男童组的年龄别体重(WAZ)值在各年龄组间比较差异有统计学意义(男童F_WAZ=3.258,P<0.05);男童WAZ和HAZ值高于女童,差异有统计学意义(t_WAZ=6.426,t_HAZ=8.913,P<0.05)。男童消瘦的发生率随着年龄的增加而下降,差异具有统计学意义(χ²_趋势=22.550,P<0.05)。男女童的超重发生率均随着年龄的增加呈上升趋势,差异具有统计学意义(男童χ²_趋势=119.876,女童χ²_趋势=87.316,P<0.05)。此外,男女童肥胖的发生率也随着年龄的增加而增加,差异具有统计学意义(男童χ²_趋势=22.550,女童χ²_趋势=68.397,P<0.05)。结论 天津市津南区学龄前儿童超重和肥胖问题较为突出,营养不良问题也不容忽视,应引起重视。     

中国9地区3～12岁儿童生长发育Z评分分析

目的了解并分析中国9地区3~12岁儿童生长发育和营养状况,为促进儿童保健和营养管理提供依据。方法对9地区(7城市,2农村)1 722名儿童进行身高、体重等体格测量和问卷调查,计算相应Z评分,综合评价被调查儿童的生长发育和营养状况。结果 9地区被调查儿童的身高和体重均值及超重率较高,而低体重率、生长发育迟缓率、消瘦率较低,年龄别体重(weight for age Z-score,WAZ)、年龄别身高(height for age Z-score,HAZ)和年龄别BMI(BMI for age Z-score,BAZ)达中等以上发育水平者分别为89.04%、89.19%和83.22%,城市儿童和农村儿童消瘦率、超重率以及WAZ、BAZ发育较差者所占比例的差异有统计学意义(P0.05)。结论 9地区被调查儿童生长发育总体状况较好,但仍然存在低体重和超重、肥胖的情况,应重视儿童的健康教育和营养管理工作。     

构建正常胎儿心胸比Z评分模型

目的 构建正常胎儿心胸比（CTR）Z评分模型,包括横径比（CTR1）、周长比（CTR2）和面积比（CTR3）。方法 对954胎孕11~40⁺⁶周正常胎儿行产前超声检查,于标准切面测量CTR作为因变量,以胎体大小参数,包括孕周（GA）、双顶径（BPD）及股骨长度（FL）为自变量,行回归分析,获得CTR均数回归方程;并分析CTR残差,以确定CTR标准差的最佳回归方程;根据公式计算CTR Z评分。结果 正常胎儿CTR与GA、BPD及FL均呈正相关（r=0.74~0.86,P均<0.05）;胎儿CTR参数与胎体大小参数的最佳拟合方程均为直线回归方程。成功构建了基于胎体大小参数CTR均数的拟合回归方程;CTR残差分析结果提示CTR标准差不随胎体大小变化而改变,均为恒定值标准差;根据方程可计算正常胎儿CTR Z评分。结论 基于GA、BPD及FL建立的正常胎儿CTR Z评分模型可为产前评估胎儿发育提供参考。     

构建正常胎儿超声心动图动脉导管Z评分模型

目的 构建针对正常胎儿动脉导管（DA）内径及血流参数的Z评分模型。方法 纳入1 042胎孕20~40周单胎胎儿,以超声心动图所测胎儿DA内径及血流参数为因变量,胎儿生物学参数双顶径（BPD）、股骨长（FL）及孕周（GA）为自变量,采用回归分析获得DA内径及血流参数预测值及标准差的最佳拟合方程,并根据公式计算Z评分。结果 胎儿DA内径及血流参数均与胎儿生物学参数呈显著正相关（P均<0.05）。胎儿DA相关参数与生物学参数的最佳拟合方程均为直线回归方程。成功构建了胎儿DA内径及血流参数预测值及其标准差预测值的回归方程,并可根据方程计算胎儿DA内径及血流参数的Z评分。结论 基于胎儿生物学参数BPD、FL及GA构建的胎儿DA内径及血流参数Z评分模型可为定量评估胎儿DA内径及血流参数提供更有价值的参考。     

Metacarpophalangeal pattern profile analysis in Sotos and Marfan syndrome

Patients with Sotos and Marfan syndrome have unusually long metacarpals and phalanges which may make the differential diagnosis difficult in younger children. Using Q-scores, we compared metacarpophalangeal pattern profile (MCPP) analysis in these two syndromes and identified distinct and different pattern profiles. This illustrates that the MCPPs are specific in these syndromes, even at an early age, and not related solely to the unusually long metacarpals and phalanges. For this study we used data from 50 Sotos patients (34 from the United Kingdom and 16 from the Netherlands, with a total of 95 hand films) and 36 Marfan patients (from the Netherlands, with 98 hand films). Of all patients over age 3 years the bone length (including the epiphysis) was determined. The patients under 7½ years (29 Sotos and 12 Marfan) were also measured without inclusion of the epiphysis. The patients measured without epiphysis had a relative short metacarpal 1 (MC1) and long distal phalanx 1 (DPh1) in Sotos syndrome, and a relative long MC1 and short DPh1 in Marfan syndrome. Between age 3 and 7½ years more than 90% of the films could be classified correctly using these two variables. Of the roentgenograms measured with epiphyses, about 80% were classified correctly. © 1994 Wiley-Liss, Inc.     

Patterns of weight growth in Aboriginal children on Queensland communities

Abstract We have used data from existing health records to study the birthweights and percentage weights for age (%W/A) of children in five Aboriginal communities in Queensland. The data are from cohorts of children born in the 1950s-80s at Cherbourg, the 1960s-80s at Yarrabah and the 1970s-80s in Woorabinda, Palm Island and Doomadgee. Birthweights have not changed significantly in any of the communities and generally remain below the international level. The weights for 1 and 5 year old children have improved significantly at Cherbourg and Palm Island, but have dropped significantly at Doomadgee. The overall pattern is for children on remote communities to have a lower %W/A and less improvement in %W/A than those closer to population centres. Other workers have found the same pattern elsewhere. These patterns of growth are probably not directly related to the level of general health services, but rather to other facilities available and attitudes of mothers to child care. The results also show that Aboriginal children can reach international levels of %W/A, so the poor growth in many communities is potentially preventable.     

Z-Score Reference Values for Height in Turkish Children Aged 6 to 18 Years

Ob­jec­ti­ve: Standard deviation score or Z-score reference charts are used in some countries in preference to percentile charts and are considered as better tools in assessing children with measurements outside the accepted limits of normality. Growth data for Istanbul children have previously been reported as percentiles; hence, the aim of this study is to present these data in Z-score reference tables. Data on secular trend in height in Turkish children will also be presented.Methods: Height and weight data based on a total of 11 664 height and 11 655 weight measurements in 1100 boys and 1020 girls between 6 and 18 years of age obtained by biannual visits to schools were analyzed. All children came from well-to-do families and were all healthy. All measurements were made by two trained technicians. The LMS method was used in the analyses. The results were expressed as Z-score values for age.Results: Heights of the boys and girls in all age groups were close to the updated USA growth references and showed an upward trend from previous data on Turkish children.Conclusions: Height growth in Turkish school-age children of high socioeconomic level conforms to the updated growth data for USA children and also shows a secular trend. The data also point to the importance of updating local growth data periodically.     

QCT检测骨密度T值和Z值临床应用初探 附68例原发性骨质疏松症回顾性诊治分析

目的:探讨QCT检测骨密度之T值和Z值对骨质疏松症的干预价值。材料与方法:①利用SiemensCT机备有的Qsteo软件,对620例25—65岁健康人群进行骨密度检测,确定陕西咸阳地区男女之骨密度峰值。②根据检测后的T值和Z值,结合中国骨质疏松委员会制定的诊断标准确定干预标准。③对适合干预的人群进行预防性和治疗性干预,并对资料完整、观察两年以上的68位患者进行回顾性分析。结果:22例T值-2.5、Z值-0.5者进行预防性干预后,骨密度提高,疼痛症状缓解。28例T值-2.5、Z值-0.5者进行临床干预后,骨密度提高,疼痛减轻。18例T值-2.5、Z值-0.5合并骨折者经临床干预后,骨密度无变化,疼痛减轻,无再发骨折。结论:①QCT测定骨密度是一种简单易行的方法,但各地国人骨密度数据库尚需探讨。②T值和Z值结合判断对临床预防和治疗骨质疏松具有指导意义。     

Newborn length predicts early infant linear growth retardation and disproportionately high weight gain in a low-income population

Background

Stunting is prevalent by the age of 6 months in the indigenous population of the Western Highlands of Guatemala.

Aim

The objective of this study was to determine the time course and predictors of linear growth failure and weight-for-age in early infancy.

Study design and subjects

One hundred and forty eight term newborns had measurements of length and weight in their homes, repeated at 3 and 6 months. Maternal measurements were also obtained.

Results

Mean ± SD length-for-age Z-score (LAZ) declined from newborn − 1.0 ± 1.01 to − 2.20 ± 1.05 and − 2.26 ± 1.01 at 3 and 6 months respectively. Stunting rates for newborn, 3 and 6 months were 47%, 53% and 56% respectively. A multiple regression model (R² = 0.64) demonstrated that the major predictor of LAZ at 3 months was newborn LAZ with the other predictors being newborn weight-for-age Z-score (WAZ), gender and maternal education ∗ maternal age interaction. Because WAZ remained essentially constant and LAZ declined during the same period, weight-for-length Z-score (WLZ) increased from − 0.44 to + 1.28 from birth to 3 months. The more severe the linear growth failure, the greater WAZ was in proportion to the LAZ.

Conclusion

The primary conclusion is that impaired fetal linear growth is the major predictor of early infant linear growth failure indicating that prevention needs to start with maternal interventions.