母亲HBsAg／抗－HBs状态与新生儿先天畸形关系的前瞻性研究

关于乙肝病毒感染与先天畸形关系的研究多着眼于病毒本身及其抗原。作者在回顾性研究中发现抗－ＨＢｓ可能与先天畸形发生有关。本文前瞻性队列研究结果表明，抗－ＨＢｓ阳性母亲的新生儿畸形发生率（３．１６％）显著高于抗－ＨＢｓ阴性母亲（１．３５％），Ｐ＝０．０１４１，再次证实抗－ＨＢｓ可能有致畸作用。随乙肝疫苗广泛接种，育龄妇女抗－ＨＢｓ阳性率越来越高，因此进一步探讨抗－ＨＢｓ致畸作用十分重要。     

THE EFFECT OF HBsAg ANTIGENEMIA IN PREGNANT WOMEN ON FETUSES AND INFANTS

ＴＨＥＥＦＦＥＣＴＯＦＨＢｓＡｇＡＮＴＩＧＥＮＥＭＩＡＩＮＰＲＥＧＮＡＮＴＷＯＭＥＮＯＮＦＥＴＵＳＥＳＡＮＤＩＮＦＡＮＴＳＹｕｅＹａｆｅｉ（岳亚飞）；ＺｈａｎｇＳｈｕｌｉｎ（张树林）；ＷｕＬｉｎｇ（吴玲）；ＬｉＧｕｉｌｉｎ（李桂林）；ＤｉＰｅｎｇｃｈ...     

Family lifestyle factors related to children's congenital heart defects in China: a case-control study

Objective To explore the multiple risk factors for family lifestyle of children with congenital heart defects (CHDs) in Shaanxi Province, China. children and their parents. The univariate and multivariable logistic regression models were used to analyze the influence of risk factors related to parents' lifestyle on CHDs. Results Several possible risk factors were found for CHDs, including fever (OR=4.465, P=0.017), pesticides contact (OR=2.234, P=0.083), passive smoking during pregnancy (OR=20.529, P=0.007) and father's smoking (OR=3.342, P=0.005); fever (OR=2.428, P=0.012) and passive smoking during pregnancy (OR=1.201, P=0.037) were also correlated with ventricular sepal defect (VSD). Conclusion Fever, pesticides contact and passive smoking are associated with CHDs during pregnancy. We should focus our attention on health care during pregnancy to avoid the above-mentioned risk factors and call on parents to hold on to a good healthy lifestyle.     

THE EFFECT OF HBsAg ANTIGENEMIA ON PREGNANCY

ＴＨＥＥＦＦＥＣＴＯＦＨＢｓＡｇＡＮＴＩＧＥＮＥＭＩＡＯＮＰＲＥＧＮＡＮＣＹＹｕｅＹａｆｅｉ；ＺｈａｎｇＳｈｕｌｉｎ；ＬＩＧｕｉｌｉｎ；（ＤｅｐａｒｔｍｅｎｔｏｆＯｂｓｔｅｔｒｉｃｓａｎｄＣｙｎｅｃｏｌｏｇｙ，ＦｉｒｓｔｃｆｆｉｌｉａｔｅｄＨｏｓｐｉ...     

胎儿生长发育与孕母动物蛋白摄入量关系的探讨

１１８４例初生儿体格生长发育与其孕母动物蛋白摄入量的调查显示，孕母平均蛋白入量（ｇ／月）城市为７８８ｇ，郊区为３３９ｇ，城区明显高于郊区；随孕母蛋白质入量的增加，初生儿的体重、身长、头围、胸围、上臂围及小腿围值也有所增长，两者呈低度到中度正相关，且城区高于郊区。说明胎儿的生长发育与孕母动物蛋白入量有密切关系。要提高儿童健康水平，必须从孕期做起，尽可能为孕母提供更多的动物蛋白，并使食品多样化。     

孕妇眼压变化的初步观察

本文选择60名(120只眼)孕妇作受检者,30名(60只眼)相同年龄未孕妇女作对照组。用Schiotz眼压计测眼压,证实了中期和晚期妊娠妇女的眼压显著低于对照组(P<0.01),晚期妊娠妇女的眼压显著低于中期妊娠妇女(P<0.01),为诊断和治疗孕妇青光眼和探讨用性激素治疗青光眼提供了依据。     

血小板细胞内游离钙离子浓度与孕晚期妊高征的关系

采用荧光法测定６１ 例孕晚期妊高征患者,２０ 例同期正常孕妇产前、产后２４ ｈ 外周血血小板细胞内游离钙离子浓度、血清钙浓度及尿蛋白含量,同时以１５ 例健康非孕妇女作对照。结果发现,妊高征患者血小板细胞内游离钙离子浓度明显高于正常孕妇及非孕妇女（ Ｐ＜ ０．０１）;产后２４ｈ 妊高征患者血小板细胞内游离钙离子浓度明显低于产前,高于正常孕妇及对照组（ Ｐ＜ ０．０５）;中、重度妊高征患者血小板细胞内游离钙离子浓度与其血压及尿蛋白呈正相关（ｒ 分别为０５、０６、０９３、０９２, Ｐ＜ ００１）;妊高征患者血清钙浓度明显低于正常孕妇及健康非孕妇女（ Ｐ＜ ０．０１）。提示细胞内游离钙离子浓度与妊高征的发生与发展密切相关,可能是导致妊高征血压升高、蛋白尿形成的重要因素     

Genetic polymorphism of T6235C mutation in 3' non-coding region of CYP1A1 and GSTM1 genes and lung cancer susceptibility in the Mongolian population

Objective To estimate the relative risk for lung cancer associated with genetic polymorphism of T6235C mutation in 3' non-coding region (Msp Ⅰ) of cytochrome P450 1A1 (CYP1A1) and glntathione S-transferase M1 (GSTM1) in the Mongolian population in Inner Mongolian Region of China. Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and multiplex PCR methods were used to analyze blood samples obtained from 263 case subjects and 263 control subjects to determine their genotypes for CYP1A1 and GSTM1.Control subjects were matched with case subjects by ethnic background, age and gender. Results The frequencies of the variant CYP1A1 genotypes (CYP1A1C) and GSTM1-null in lung cancer groups were higher than those in control groups (38.4% vs. 28. 5% and 57.8% vs. 48.0%). The individuals who corried with CYP1A1C genotype had a significantly higher risk of lung cancer (OR=1.56, 95% CI=1.08 to 2.25, P=0.016) than those who carried with non-variation CYP1A1 genotype. The ones who carried with GSTM1-null genotype also had a significantly higher risk of lung cancer (OR=1.49, 95% CI=1.06 to 2.10, P=0.023) than these who carried with GSTM1-present genotype.When combination of polymorphisms of CYP1A1 and GSTM1 genotypes was analyzed, the risk of lung cancer for combination of CYP1A1C and GSTM1-null genotypes was increased significantly (OR=2.084, 95e CI=1.27 to 3.42, P=0.003). Susceptibility to lung cancer was related to smoking (OR=2.10, 95% CI=1.48 to 2.98, P=0.000). Considering smoking status, the risk of lung cancer for combination of smoking and CYP1A1C genotype was remarkably increased (OR=2.76, 950/0 CI=1.74 to 4. 37, P=0.000). It was the same case with combination of smoking and GSTM1-null genotype (OR=4. 38, 95% CI=2.35 to 8.15, P=0.000). Conclusion The polymorphisms of CYP1A1C genotype and GSTM1-null are the risk factors of lung cancer in the Mongolian population in Inner Mongolia Region of China. Smoking is also related to susceptibility to lung cancer. There may be a synergetic interaction between CYP1A1C and GSTM1-null in the elevated susceptibility of lung cancer. Smoking may have a synergetic interaction with CYP1A1C and GSTM1-null in the elevated susceptibility of lung cancer.     

THE ANALYSIS OF HUMAN CYTOMEGALOVIRUS INFECTION DURING PREGNANCY IN QINBA MOUNTAINOUS AREA

Humancytomegalovirus (HCMV )isoneofthemostcommoncongenitalvirusinfectioninhu manandalsousuallythecauseofmentalretardationandhearinglossofchildreninthedevelopedworld .TheactiveinfectionpercentageofHCMVisabout0 .3% - 12 .0 %there ,butwithregardtothedevel opingcountries ,especiallythepovertymountainousareas,the percentageofCMVinfectionisun known .QinbamountainousareainShaanxiisapoverty strikingarea ,wheretheeconomicconditionandtheculturearebackwardandtheincidenceofMRishigh .TostudyCMVinfec…     

贫困山区孕期CMV感染与IL-6的关系

目的　研究贫困山区孕期巨细胞病毒 (Cytomegalovirus,CMV)感染状况 ,探讨孕期CMV感染与白细胞介素 6(Interleukin 6,IL 6)的关系。方法　用ELISA和PCR方法检测贫困山区30 5例正常孕妇外周血特异性CMVIgM抗体及CMVDNA ,对其中 48例孕期CMV感染者及68例孕期未感染CMV者进行随访 ,检测产后两周内乳汁及新生儿尿液CMVDNA ;并采用双抗体夹心ELISA法检测孕妇及乳母外周血中IL 6水平。结果　孕妇CMV活动性感染率 1 9.0 2 % ,孕期CMV活动性感染及乳汁排泄CMV者其外周血IL 6水平显著高于未感染者 (P <0 .0 5 )。结论　贫困山区孕期CMV感染率较国内外报道的高 ;IL 6在孕期活动性CMV感染中可能起着重要作用     

超声心动图产前诊断胎儿心血管畸形的临床分析

为了在产前能够诊断胎儿心血管发育异常，评估其超声诊断价值，我们联合应用Ｍ型及二维超声心动图对孕１６周以上的孕妇３１０例进行产前检查，其检出先天性心脏病胎儿１１例，经引产尸解及生后随访证实。并发现从有高危因素的孕妇中检出率（５．５％）明显高于无高危因素的孕妇（０．７％），两组检出率有显著差异（Ｐ＜０．０５）。本文认为对具有高危因素的孕妇产前应用超声心动图检查胎儿心脏，诊断胎儿心血管发育异常有重要的实用价值。     

孕妇血清铜值与胎盘功能的关系

用火焰原子吸收法测定了孕28～40周正常孕妇83例,孕37～40周重度妊娠高血压综合征及41周以上妊娠妇女42例的血清铜值,并与同期尿E/C比值及新生儿Apgar评分相比较,结果提示:孕妇血清铜值在40周前随孕周的增长而增高。41周以上妊娠,重度妊高征血清铜值偏低。当尿E/C比值<10及Apgar评分≤7分时,孕妇血清铜值低,提示孕晚期母亲血清铜值可作为判断胎盘功能的辅助指标。     

补钙预防妊高征及对血小板细胞内游离钙浓度的影响

目的　研究补钙对妊高征的预防作用。方法　对 88例有妊高征倾向的孕妇 (随机分为 3组 )自妊娠 2 0～ 2 4周起采用口服不同剂量的钙尔奇 - D(6 0 0 mg、12 0 0 mg)及对照的前瞻性研究 ,用荧光分光光度计测定口服钙前后的血小板游离钙离子浓度 ,并观察妊高征的发生率。结果　经补钙 6 0 0 mg后妊高征发生率 (17.2 4 % )较对照组降低 ,补钙 12 0 0 mg后 ,其妊高征发生率 (6 .90 % )明显低于对照组(2 6 .6 7% ) (P <0 .0 5) ;补钙两组血小板游离钙离子浓度与对照组相比明显降低 (P <0 .0 5)。结论　补充一定量的钙剂可降低血小板游离钙离子浓度 ,对有妊高征倾向的高危孕妇可预防妊高征的发生。     

超声心动图产前诊断胎儿先天性心脏病的临床价值

目的探讨超声心动图对胎儿先天性心脏病的产前诊断和临床价值。方法选择妊娠大于18周、有高危倾向的孕妇及会诊病例共193例行胎儿超声心动图检查。采用胎儿四腔心切面、左右室流出道切面、主动脉弓切面、动脉导管弓切面、三血管切面及上下腔静脉长轴切面,观察心脏大小、结构、大血管的位置、走行等;应用彩色多普勒血流显像观察各瓣口及间隔、大血管内血流情况。结果发现胎儿先天性心脏病19例。其中单心室、单心房并共同动脉干1例;单心室1例;右室双出口1例;完全性心内膜垫缺损2例;左心发育不良2例;三尖瓣闭锁2例;法乐四联征3例;主动脉瓣狭窄1例;单纯室间隔缺损6例。合并心外畸形2例,其中内脏膨出并重度脑积水1例、脊柱裂1例。漏诊Ⅱ型房间隔缺损2例。显示产前诊断胎儿先天性心脏病的敏感性为90%,特异性为100%。结论超声心动图是早期诊断胎儿严重先天性心脏病的最主要、无创性诊断技术,对围产期临床正确处理有重要的指导作用。     

低剂量米索前列醇用于足月妊娠引产的临床观察

目的　观察比较低剂量米索前列醇及蓖麻油餐用于足月妊娠引产的临床效果。方法　选择有引产指征、无引产及米索前列醇使用禁忌症的单胎、头位、胎膜完整的足月妊娠妇女 63例 ,随机分为A组 (2 0例 ,米索前列醇 2 5μg) ,B组 (2 0例 ,米索前列醇 50 μg)和C组 (2 3例 ,蓖麻油餐 )。2 4h阴道后穹窿置药一次。结果　A、B、C三组引产成功率分别为 85 0 %、80 0 %、86 95% ,用药后临产的时间分别为 (2 96± 1 46)min、(30 8± 2 31 )min、(2 0 6± 1 0 1 )min。分娩方式、新生儿体重、宫颈评分 ,三组比较差异均无显著性 (P >0 0 5)。B组第一产程和总产程较C组缩短 (P <0 .0 5) ,A组产时出血量较C组少 (P <0 0 5) ;宫缩过强羊水污染的发生率A组及C组较B组低。结论　低剂量米索前列醇用于足月妊娠引产是有效的。     

INTRAUTERINE GROWTH RETARDATION AT FULL TERM PREGNANCIES WITH ENDOCRINE FACTORS

Intrauterinegrowthretardation(IUGR)isoneofthecriticalcomplicationsduringpregnancyandremainsthemajorcauseofperinatalmorbidityandmorta1ity.Despiteadvancesintheresearchofeti-ology,pathogenesis,diagnosis,andmanagementforIUGR,doctorscouldneitherdiagnoseitcor-rectlynormanageitefficiently.ThedataprovidedbynationalresearchinggroupforbirthdefectsshowedthattheincidencerateofIUGRwas6.38%inChina.Amongthetotalperinataldeathofneonates,themortalityofIUGRaccountsfor42.3%.Moreover,evenaftertheirbirth,th…     

2342例孕妇Rh血型及免疫抗体测定与新生儿溶血病

作者对２３４２例孕妇进行了Ｒｈ血型检查，其中３７５例疑有血型抗原免疫者进行了血清免疫抗体测定。结果，检出Ｒｈ阴性孕妇１３例，其中２例血清中存在ＩｇＧ抗Ｄ抗体。对孕妇进行Ｒｈ血型及免疫抗体测定，可为Ｒｈ新生儿溶血病的产前诊断和治疗提供诊断依据，并对孕妇围产期及以后的输血有指导意义。     

IGF-Ⅱ在早期胚胎发育终止蜕膜组织中的表达

目的　研究胰岛素样生长因子 Ⅱ (IGF Ⅱ )在早期胚胎发育终止中的表达以及母体血中IGF Ⅱ水平的改变与胚胎发育终止的关系。方法　采用免疫组织化学SP法检测早期胚胎发育终止蜕膜中IGF Ⅱ蛋白的表达 ;采用原位杂交法检测早期胚胎发育终止蜕膜中IGF ⅡmRNA的表达 ;采用酶联免疫吸附试验 (ELISA)检测正常妊娠及早期胚胎发育终止孕妇血中IGF Ⅱ水平的变化。结果　正常妊娠的蜕膜组织中IGF Ⅱ的表达明显高于胚胎发育终止组 (P<0 .0 1) ;正常妊娠组蜕膜中IGF ⅡmRNA的表达明显高于胚胎发育终止组 (P <0 .0 1) ;正常妊娠组母血中IGF Ⅱ水平也明显高于胚胎发育终止组 (P <0 .0 1)。结论　IGF Ⅱ在蜕膜组织中的表达水平与胚胎发育密切相关 ,其含量的减少可能是导致胚胎死亡的原因之一。     

NFκBIA HaeⅢ、EC-SOD基因多态性和饮酒与溃疡性结肠炎的相关性

目的探讨核转录因子-κB抑制因子HaeⅢ(NFκBIA HaeⅢ)、细胞外超氧化物岐化酶(EC-SOD)基因多态性和饮酒与溃疡性结肠炎(UC)发病之间的关系。方法采用病例-对照研究的方法,以400例UC患者及400例健康对照者的外周血白细胞为样本,利用聚合酶链反应(polymerase chain reaction,PCR)技术分析了NFκBIA HaeⅢ和EC-SOD基因多态性。结果 NFκBIA HaeⅢ(Non-A/A)基因型和EC-SOD(C/G)基因型频率分布分别为39.50%、71.50%(病例组)和21.25%、43.00%(对照组),二者经χ2检验差异有统计学意义(P<0.01;P<0.01)。NFκBIAHaeⅢ(Non-A/A)患UC的风险显著增加(OR=2.419 5,95%CI=1.827 1～4.065 4)。EC-SOD(C/G)基因型者患UC的风险也显著增加(OR=3.325 6,95%CI=1.908 5～4.538 7)。基因突变的协同分析发现,NFκBIA HaeⅢ(Non-A/A)/EC-SOD(C/G)基因型者在UC组和对照组中的分布频率分别为32.50%和6.25%,二者经χ2检验有显著性差异(P<0.01)。NFκBIA HaeⅢ(Non-A/A)/EC-SOD(C/G)基因型者患UC的风险显著增加(OR=10.158 1,95%CI=4.192 4～12.309 4)。病例组的饮酒率显著高于对照组(OR=2.583 7,95%CI=1.408 1～4.932 6,P<0.01),NFκBIA HaeⅢ(Non-A/A)/EC-SOD(C/G)基因型与饮酒有协同作用(OR=35.209 9,95%CI=19.975 1～62.592 2)。结论 NFκBIA HaeⅢ(Non-A/A)/EC-SOD(C/G)基因型和饮酒是UC的易患因素,三者在UC发生中起协同作用。     

周至县1992年妇女围产保健情况调查

对周至县1992年分娩孕产妇进行了抽样调查。结果表明:在直接反映孕产妇围产期保健情况的几项主要指标中,除产前检查率、孕3月初检率、新法接生率达到全国农村围产期保健质量乙级标准和要求外,产后出血发生率、住院分娩率和产后访视率均未达到乙级标准;高危住院分娩率仅占22.22％;而且当出现严重合并症和并发症时,及时就诊率只占65.51％。但与该县1989年保健情况调查资料相比,产前检查率、产前检查≥3次率、新法接生率已有明显改善;但产后访视率、住院分娩率未有提高。本次定性调查还显示妇女自我保健意识差,封建思想仍很严重。