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1.
  目的  分析HIV阳性孕妇所生新生儿的低出生体重(low birth weight,LBW)情况及其相关的危险因素。  方法  选择2013年1月至2018年5月于昆明市第三人民医院住院分娩的194例HIV阳性孕妇为研究对象。孕妇信息包括人口特征、妇产科病史、抗逆转录病毒药物史、HIV传播途径以及HIV疾病状况(包括入组时的CD4计数、HIV RNA病毒载量和血红蛋白)。采用Logistic回归分析确定与LBW相关的危险因素。  结果  在194名婴儿中,38例(19.6%)为LBW(< 2500 g)。LBW婴儿与非LBW婴儿在入组体重、怀孕期间抗逆转录病毒药物治疗、入组CD4计数、入组HIV RNA病毒载量和分娩时孕龄差异均有统计学意义(P < 0.05)。多变量Logistic回归分析显示,入组时体重轻(OR = 2.14,95% CI = 0.84~4.05,P = 0.013)、入组时CD4计数(OR = 6.02,95% CI = 1.50~24.13,P < 0.001)、入组时HIV RNA病毒载量(OR = 3.34,95% CI = 1.70~6.55,P < 0.001)和分娩时孕龄(OR = 12.90,95% CI = 2.03~81.88,P < 0.001)是LBW的独立危险因素。  结论  孕妇HIV疾病状况与新生儿LBW相关。HIV的产前筛查和诊断,对于早期预防和治疗HIV母婴传播,减少不良妊娠结局至关重要。  相似文献   

2.
目的探讨低出生体重儿(LBW)发生的相关影响因素,为以后预防LBW的发生提供科学依据。方法选择出生体重〈2.5 kg的活产婴儿98例作为实验组,匹配同期出生、同性别、体重≥2.5 kg的正常新生儿98例作为对照组,回顾性分析孕产妇的围生期保健资料及产房分娩记录等,采用单因素和多因素Logistic回归分析法筛选发生LBW的相关因素。结果 (1)单因素分析结果显示:孕妇年龄、母亲身高、居住地、经济收入、孕检次、不良孕史、胎盘胎膜因素、双胎妊娠、孕周、妊娠期高血压疾病和慢性病病史与LBW的发生相关联(P〈0.05)。(2)多因素分析结果表明,妊娠期高血压疾病(OR=6.473)、胎盘胎膜因素(OR=2.834)、孕检次数(OR=0.161)和孕周(OR=0.402)入选以LBW为结果变量的回归模型(P〈0.05)。结论妊娠期高血压疾病、胎盘胎膜因素是LBW发生的独立危险因素,孕检次数和孕周是LBW的保护因素。增强孕期保健意识,对高危人群进行监护管理,发现问题及早治疗,是降低LBW发生的关键。  相似文献   

3.
目的探讨辅助生殖技术(ART)中影响出生婴儿性别比的相关因素。方法收集2008年1月~2014年3月于我院接受ART
治疗并成功分娩的4348个周期的患者的临床资料,包括男女双方年龄、不孕原因、授精方式、移植胚胎期别、移植胚胎类型、分
娩类型(单胎、双胎分娩)、既往ART流产次数、ART分娩次数和分娩的5607名新生儿的性别,分析不同因素对于分娩新生儿性
别的影响。结果共有3019名男婴和2588名女婴出生,性别比为116∶100;单胎分娩的3087名新生儿出生性别比为117∶100;双
胎分娩的2520名新生儿性别比为116:100;经ART治疗一胎分娩5542名新生儿出生性别比为117∶100;二胎分娩新生儿65名,
出生性别比为117∶100。在单胎妊娠活产婴儿中,若女方或男方高龄,出生男婴比例较对照组(年龄<35 岁)显著增高(分别为
58.4% vs 52.8%,P=0.012;56.4% vs 52.3%;P=0.026),同时观察到ICSI组出生男婴比例较IVF组明显较低(45.7% vs 55.6%,P<
0.001),其它因素则对出生婴儿性别比无显著影响;在双胎妊娠活产新生儿组中,上述不同因素对出生新生儿性别比均无显著
性差异。ART治疗后生育一胎新生儿中,女方高龄组出生男婴比例显著高于对照组(57.4% vs 53.0%, P=0.009),并可知ICSI组
中出生男婴比例显著低于IVF组(48.6% vs 55.4%, P=0.001);而ART治疗后生育二胎新生儿中,不同因素各组间出生婴儿性别
比均无显著性差异。单因素Logistic 回归分析提示,女方年龄(OR:0.836,95% CI 0.731~0.955,P<0.05)、授精方式(OR∶
1.151,95% CI 1.027~1.289,P<0.05)对出生婴儿性别比产生的影响有统计学意义,其它因素对出生婴儿性别比则无显著影响。
进一步行多因素Logistic回归分析提示,无独立的预测因素。结论经ART治疗后高龄女性生育男性婴儿比例更高,在单胎活
产婴儿中男方高龄与出生男婴比例增加相关,而ICSI授精方式较IVF女性婴儿比例更高。
  相似文献   

4.
目的:探讨妊娠期糖尿病(GDM)患者妊娠不同时期体质量增长与母体内脂素水平及新生儿体成分的相关性。方法:2013年7月-2015年7月分娩的妊娠足月孕妇,以年龄匹配原则,选取GDM孕妇及糖耐量正常(NGT)孕妇各130例,分为4组:NGT孕妇分娩适于胎龄儿(AGA)组 (NGT+AGA组,n =97 )、NGT孕妇分娩大于胎龄儿(LGA)组(NGT+LGA组,n =33)、GDM+AGA(n =69)和GDM+LGA(n =61)。收集临床资料,回顾性分析孕26周前、26~32周、32周至分娩3个阶段孕妇体质量增长情况;双抗体夹心酶标免疫(ELISA)分析法检测孕妇血清内脂素水平;新生儿出生后24~48 h内进行人体成分测量。分析不同组别孕妇妊娠不同时期体质量增长情况;比较组间内脂素水平及新生儿出生体质量(BW)、体脂百分含量(F %)的差异。结果:GDM患者孕前体质指数(BMI)明显高于NGT孕妇 (F = 13.247, P <0.001);4组孕期增重存在显著性差异(F =5.501,P <0.001), GDM+LGA组明显高于NGT+AGA组(P <0.001)。 GDM组孕妇妊娠孕26周之前体质量增速明显高于NGT组;GDM+LGA组孕妇妊娠32周至分娩前的体质量增速也显著增加。4组内脂素水平分别为(90.69±18.94)、(116.28±46.96)、(112.88±44.66)和(208.15±81.89)μg/L(F =72.602,P <0.001),GDM+LGA组显著高于其余3组(均P <0.001)。4组新生儿F %存在显著性差异,任意2组间的差异均有统计学意义(均P <0.05)。孕妇内脂素水平与新生儿出生体质量及体脂含量均呈显著正相关(r =0.539,0.629,均P <0.001),孕前BMI、孕26周前体质量增速、32周至分娩前的体质量增速是其重要相关因素。结论:孕前BMI以及孕26周前体质量增速是GDM的相关危险因素;32周至分娩前体质量增速则与新生儿出生体质量及体脂含量增加密切相关。孕妇内脂素水平可能是联系孕期体质量增长与新生儿体成分的中介因子。  相似文献   

5.
廖花 《中国现代医生》2023,61(28):33-35
目的 探讨拮抗剂方案不同来源胚胎对母婴结局的影响。方法 回顾性选取2020年1月至2021年12月于赣州市妇幼保健院使用拮抗剂方案助孕并分娩的产妇242例为研究对象。根据移植胚胎类型不同将其分成囊胚组(n=100)与卵裂胚组(n=142);根据胚胎移植方式分为新鲜周期组(n=102)与解冻周期组(n=140)。比较各组产妇的分娩方式、孕期并发症及新生儿结局。结果 囊胚组与卵裂胚组、新鲜周期组与解冻周期组产妇在妊娠糖尿病、妊娠高血压、子痫前期、前置胎盘、妊娠肝内胆汁淤积、产后出血和胎膜早破比较差异均无统计学意义(P>0.05);新鲜周期组产妇的卵巢过度刺激综合征发生率显著高于解冻周期组(P<0.05)。新鲜周期组的早产率高于解冻周期组,新生儿出生体质量低于解冻周期组(P<0.05);囊胚组的早产率显著高于卵裂胚组,男女性别比例高于卵裂胚组(P<0.05)。结论 拮抗剂方案来源的囊胚或卵裂期胚胎无论采用新鲜周期或解冻周期均是安全的助孕方式。  相似文献   

6.
目的比较体外受精-胚胎移植术后双胎之一孕早期自然减至单胎与初始单胎妊娠的产科结局。方法2010~2012年在广
州市妇女儿童医疗中心生殖医学中心行体外受精胚胎移植后获得单胎分娩患者409例,其中44例患者孕6周B超诊断为2个妊
娠囊,孕12周前其中一胎自然死亡;365例患者孕6周B超诊断为1个妊娠囊。比较两组患者分娩孕周、早产率、新生儿出生体
重、低体质量儿比例。结果在单胎分娩的患者中,10.8%(44/409)在孕6周B超时诊断为双胎,双胎自然减为单胎组与单胎组孕
妇平均分娩孕周为38.29±1.76和38.45±1.40周,两组比较差异无统计学意义(P=0.495);早产率分别为15.9%(7/44)和10.13%
(37/365),两组比较差异无统计学意义(P=0.298);新生儿出生体质量分别为3086.8±527.01和3261.8±437.85 g,双胎自然减为
单胎组新生儿出生体质量低于初始单胎组(P<0.05)。低体质量儿(<2500 g)比例双胎自然减为单胎组为6.82%(3/44),是初始
单胎组的2.74%(10/365)的2倍,但两组比较差异无统计学意义(P=0.316)。结论孕早期双胎自然减为单胎会导致剩余一胎新
生儿出生体质量低于单胎对照组。
  相似文献   

7.
目的探讨低出生体重儿(LBW)的发生情况及相关因素,为减少LBW的发生提供科学依据。方法调查驻马店市妇幼保健院2980例产妇分娩的128例LBW的流行病学资料,并按1∶2的比例选择同性别、同期出生的正常儿进行对照。采用单因素和多因素Logistic回归法,分析产妇孕前及孕期因素与LBW发生的相关关系。结果我市LBW的发生率为4.28%。单因素分析结果显示:母亲年龄、文化程度、居住地、经济收入、胎次、孕次、产检次数、孕周、孕期食欲差、胎盘前置植入粘连和妊娠期高血压疾病与LBW的发生有关;多因素分析表明,年龄(OR=1.604)、孕期食欲差(OR=2.295)、孕次(OR=2.596)、妊娠期高血压疾病(OR=3.493)是LBW发生的危险因素,而孕检次数(OR=0.285)、分娩孕周(OR=0.430,OR=0.390)是LBW的保护因素。结论 LBW的发生与多种因素有关。加强孕妇的健康教育,提倡最佳生育年龄、规范孕期保健是减少LBW的关键。  相似文献   

8.
目的 探讨影响前次剖宫产术后再次妊娠经阴道分娩成功的相关因素。方法 回顾性分析2014年1月—2017年12月在上海交通大学医学院附属国际和平妇幼保健院产科进行分娩的325例前次剖宫产再次分娩孕妇的资料(妊娠≥28周),比较剖宫产术后阴道试产(trial of labor after cesarean section, TOLAC)成功组和TOLAC失败组年龄、孕前BMI、孕期体质量增长、孕周、新生儿体质量、阴道分娩史、剖宫产次数、距前次剖宫产时间间隔、新生儿Apgar评分等情况。结果 325例孕妇全面评估后进行阴道试产,其中阴道分娩成功210例(TOLAC成功组64.62%),中转剖宫产115例(TOLAC失败组35.38%)。单因素分析两组孕妇孕前BMI、孕期体质量增长、孕周、新生儿体质量、阴道分娩史差异均有统计学意义(P<0.05),而两组的剖宫产次数、距前次剖宫产时间间隔、孕妇年龄、新生儿Apgar评分比较,差异均无统计学意义(P>0.05)。多元Logistic回归分析,孕妇孕期体质量增长、孕周、新生儿体质量是前次剖宫产后影响阴道试产成功的独立因素(P<0.05)。结论 孕妇孕期体质量增长、孕周、新生儿体质量是前次剖宫产后影响阴道试产成功的独立因素。  相似文献   

9.
248例辅助生殖技术后双胎妊娠结局   总被引:2,自引:0,他引:2  
目的探讨辅助生殖技术后多胎妊娠的临床结局。方法回顾性对照分析42例辅助生殖技术后双胎(A组)与143例辅助生殖技术后单胎(B组)、54例自然受孕双胎(C组)的孕期并发症、分娩方式及围产儿结局。结果辅助生殖双胎组卵巢过度刺激综合征、早产、胎膜早破、低体重儿发生率高于单胎组,而妊娠高血压疾病、妊娠期糖尿病等合并症的发生率与单胎组差异无显著性;辅助生殖双胎组与自然受孕双胎组母体合并症发生率差异无显著性,且新生儿预后良好。结论辅助生殖治疗多胎妊娠率高,为高危孕妇,故要予以高度重视,加强监护。  相似文献   

10.
  目的  了解西南地区孕妇孕期奶类摄入现况,探讨孕期奶类摄入量与新生儿出生体质量的关系。  方法  采用前瞻性研究,选取成都市某三甲妇幼医疗机构产前门诊孕8~14周单胎健康妇女为研究对象。通过3 d 24小时膳食回顾法分别于孕8~14周、孕24~28周及孕32~36周收集孕早、中、晚期奶及奶制品的摄入信息,计算总奶类摄入量和饮奶率;参照《中国孕期妇女膳食指南(2016)》的奶类推荐量(300 g/d)为标准计算达标率,同时将研究对象分为不饮奶组、饮奶不足组和饮奶适宜组。利用医院信息系统收集分娩孕周、新生儿出生体质量等资料。应用多因素非条件logistic回归模型分析孕期奶类摄入量与新生儿出生体质量的关系。  结果  最终纳入962例有效样本。孕早、中、晚期平均奶类摄入量〔中位数(P25,P75)〕分别为125.0(0,236.1) g/d、208.3(0,284.7) g/d、250.0(150.0,416.7) g/d,达标率分别为12.6%、33.2%和48.4%。平均新生儿出生体质量为(3 225.0±399.8) g,小于胎龄儿发生率为8.3%,大于胎龄儿发生率为3.9%。孕中期饮奶适宜组发生小于胎龄儿的风险较不饮奶组降低〔相对危险度(odds ratio, OR)=0.786,95%置信区间(confidence interval, CI):0.385~0.976〕。孕晚期饮奶不足组和饮奶适宜组发生小于胎龄儿的风险较不饮奶组降低(分别为OR=0.672,95%CI:0.477~0.821和OR=0.497,95%CI:0.116~0.807)。未观察到孕早期奶类摄入量与新生儿出生体质量和孕中、晚期奶类摄入量与大于胎龄儿发生风险有关。  结论  西南地区孕妇各孕期奶类摄入不足问题突出,亟待改善。孕期奶类摄入与新生儿出生体质量有关,孕中、晚期奶类摄入量增加可能降低小于胎龄儿发生的风险。  相似文献   

11.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

12.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

13.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

14.
Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P<0.01);the MAP decreased(P<0.01)and the HR increased drastically(P<0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.  相似文献   

15.
Objective:To investigate the gene expression of osteoprotegerin(OPG) and osteoclast differentiation factor(ODF) in the bone tissue of patients with hip fracture due to osteoporosis. Methods:OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers(over 50 years old) with hip fracture(Observer Group) and 30 cases of hip facture sufferers with no osteoporosis(Control group) were analyzed with the Semi-Quantitative RT-PCR method. Results:The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion:Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.  相似文献   

16.
Objective:To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas(SPTP). Methods:Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin(HE) staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results:Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin(9/9 cases), AAT(9/9 cases), NSE(9/9 cases), ACT(7/9 cases), CK20(2/9 cases), CgA(1/9 cases), S-100(3/gcases), PR(4/gcases), Syn(3/9 cases) and CD56(5/9cases), negative in CEA and ER. Conclusion:SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.  相似文献   

17.
In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.  相似文献   

18.
Objective: To explore the role of matrix metalloproteinase-1,2 (MMP-1, MMP-2) and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) in endometriosis. Methods: The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects (excluding endometriosis) were collected and examined by in situ hybridization technology and western blot assay. Results: Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant (P 〈 0.01 ). Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion: The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.  相似文献   

19.
Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.  相似文献   

20.
《中国结合医学杂志》2008,14(2):159-159
The 6th National General Congress of Chinese Association of Integrative Medicine (CALM) was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.  相似文献   

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