儿童屈光不正性弱视与低视力分析

屈光不正性弱视是引起儿童弱视的最常见原因,对视功能损害严重,必须早期发现早期治疗。现将我院1992～1999年门诊检查治疗的240例儿童因屈光不正而致弱视总结分析如下。1 资料和方法1.1 一般资料 本组共240例弱视患者,男150例,女90例,就诊年龄为2～15岁。其中双眼弱视210例,单眼弱视30例。1.2 方法1.2.1 散瞳验光检查屈光度 用1％阿托品膏点双眼,每日3次,连用3d。检查由经验丰富的医师进行,嘱半月后复查。1.2.2 查远、近视力,矫正视力 凡矫正视力≤0.8者均列为弱视。双眼矫正视力<0.3者均列为低视力。1.2.3 检查屈光不正性弱视儿童斜视度及性质。     

屈光不正性弱视儿童戴镜后的屈光演变

目的:探讨屈光不正性弱视儿童戴镜后屈光状态随年龄的变化规律,为临床提供随访时间及配镜依据。方法:回顾性分析温州医学院附属眼视光医院288例(576只眼)屈光不正性弱视儿童连续多年屈光数据,按初诊时主导眼等效球镜度数分为8组进行屈光度与观察期的直线回归分析。结果:屈光度与月龄多数存在直线回归关系(P<0.05)。首先,M4组非主导眼、M3组的双眼、M1组的双眼和H1组的双眼屈光度数改变先朝远视方向进展,但进展的度数逐年降低,后向近视方向发展的趋势。M2、H2和H3组的双眼屈光度数改变一开始即向近视方向进展。其次,转变年龄各不相同,H1非主导眼最小(2.4岁),M3主导眼最大(7.4岁)。第三,改变速度各不相同。远视各组下降速度接近;在近视组,M1的双眼和M3的主导眼增加速度最快,M2非主导眼增加速度最慢。散光度数基本不变。结论:屈光不正性弱视儿童正视化过程可以分为两大类:①一开始即向近视方向进展。②先朝远视进展,再向近视进展。演变速度和转变年龄与屈光不正程度、眼别相关。随访时间和配镜处方的制订需要考虑上述规律。     

早期BMI较低对儿童青少年营养不良影响的队列研究

了解广东省中山市8~ 16岁儿童青少年营养不良的发病率,探讨早期体质量指数(body mass index,BMI)较低(BMI相似文献   

母亲孕前BMI和孕期增重对0～1岁儿童BMI生长轨迹影响作用的研究

目的 描述0～1岁儿童BMI生长轨迹,并探讨母亲孕前BMI及孕期增重对其影响。方法 研究对象源自马鞍山优生优育队列（MABC）,该队列于2013年5月—2014年9月建立。本研究将符合条件的3 079名对象纳入分析,收集孕妇相关信息和新生儿出生时资料。并在婴儿出生后42天、3月龄、6月龄、9月龄、12月龄随访时收集其身长、体重、喂养情况等数据信息。运用潜变量增长模型拟合0～1岁儿童BMI生长轨迹,将不同的生长轨迹命名为特定的生长模式。采用多项式logistic回归模型分析孕前BMI和孕期增重与不同生长轨迹的关联。结果 根据潜变量增长模型,可将3 079名儿童的发育轨迹划分为4类:较慢生长轨迹（n = 463）、适宜生长轨迹（n = 1 326）、较快生长轨迹（n = 1 027）和持续高生长轨迹（n = 263）。多因素logistic回归分析显示:母亲孕前肥胖/超重可预测儿童早期持续高生长模式的发生（OR = 1.67,95%CI:1.16～2.41）,母亲孕前肥胖/超重其子代呈现较慢生长模式的可能性更小（OR = 0.64,95%CI:0.42～0.97）,母亲孕前消瘦的儿童更易成为较慢生长模式（OR = 1.60,95%CI:1.24～2.06）;母亲孕期增重与儿童早期生长轨迹间关联均无显著性。结论 0～1岁婴儿BMI生长轨迹可分为较慢、适宜、较快和持续高值4种模式;母亲孕前BMI对0～1岁儿童生长模式有预测作用,孕期增重情况与0～1岁婴儿BMI生长模式无统计学关联。     

广州市6~9岁儿童骨骼肌含量指标正常参考值研究

建立广州市6~9岁儿童肌肉含量的参考值,为评价儿童肌肉发育情况提供依据.方法 在广州市小学及幼儿园招募456名6~9岁儿童,采用双能X线吸收法(DXA)测量儿童全身及四肢肌肉含量(ASM),并测量身高、体重,计算体质量指数(body mass index,BMI)及四肢肌肉含量指数(如ASM体重,ASM/身高2及ASM/BMI).应用LMS曲线法建立男女童各部位肌肉含量及四肢肌肉含量指数的百分位曲线.结果 随着年龄增加,不论男生还是女生各肌肉含量指标均增大;除6岁年龄段上下肢及四肢肌肉含量、ASM/体重、ASM/BMI,以及9岁年龄段的ASM/体重和ASM/BMI外,其余各年龄段指标男生均大于女生(P值均<0.05).结论 初步建立了6~9岁学龄儿童肌肉含量及肌肉指数的参考值,且随着年龄的增大,相应参考值也逐渐增大.可为评估儿童肌肉发育提供较为准确的参考.     

婴儿期BMI峰值与6岁儿童超重/肥胖关联的出生队列研究

目的 探讨婴儿期BMI峰值与6岁儿童超重/肥胖的关联。方法 基于2013年建立的“马鞍山优生优育队列（Ma’anshan Birth Cohort,MABC）”,对队列儿童连续追踪随访至6岁、定期体格测量收集相关信息,绘制BMI生长曲线。多因素logistic回归分析婴儿期BMI峰值与6岁儿童超重/肥胖之间的关联。结果 婴儿期BMI峰值时点时的BMI水平男童高于女童,差异有统计学意义（18.56kg/m² vs. 18.14kg/m²,t ＝ 5.155,P＜0.01）,峰值年龄性别之间无统计学差异（7.10月龄 vs. 7.19月龄,t ＝ Symbolm@@1.084,P＞0.05）。婴儿期峰值时的BMI水平高是6岁儿童超重/肥胖的危险因素（超重OR＝1.58, 95%CI: 1.37～1.83;肥胖OR＝1.38, 95%CI: 1.13～1.69）。峰值年龄与6岁儿童超重/肥胖之间无统计学关联。结论 峰值时的BMI水平越高,6岁儿童患超重和肥胖症的风险越高,对于学龄前儿童超重/肥胖的预防可从生命早期提供干预措施,以减轻学龄前儿童疾病负担。     

芜湖县学龄前儿童视觉屈光不正影响因素研究

目的了解芜湖县学龄前儿童视觉屈光不正的发生及其影响因素,为防治婴幼儿屈光不正提供依据。方法通过对托幼机构在园儿童屈光状态的筛查,掌握学龄前儿童视觉屈光不正发生情况,选取12所具有代表性的托幼机构开展问卷调查,研究影响学龄前儿童视觉屈光不正发生的危险因素。结果芜湖县2 776名学龄前儿童视觉屈光不正检出率15.59%。多因素分析结果显示,用眼时间、不良饮食习惯、家长文化程度、遗传因素、早产出生史等为学龄前儿童屈光不正的影响因素。结论芜湖县3~6岁儿童屈光不正发生率较高,影响因素是多方面的。     

屈光不正儿童屈光度变化的连续观察

目的探讨屈光不正性弱视儿童屈光度变化的规律。方法对197例(370眼)屈光不正性弱视儿童每年进行一次屈光检查,连续4年以上,将逐年屈光度的数据作比较,并进行屈光度与观察期的直线回归分析。结果远视屈光度逐年减少,其平均值与观察期存在回归关系;近视屈光度逐年增加,其平均值与观察期也存在回归关系;散光度数保持不变或略有增减。结论屈光不正性弱视儿童的屈光度随着年龄的增长,有远视度数逐年减少,近视度数逐年增加的趋势,而散光度数则基本保持不变。     

2006～2010年长春市5岁以下儿童屈光不正情况分析

目的:了解长春市5岁以下儿童屈光不正的情况,探讨儿童屈光不正的影响因素。方法:对2006～2010年来吉林大学第二医院就诊的5岁以下患者进行登记筛查,经散瞳验光,对确诊屈光不正的患儿进行统计分析。结果:2006～2010年60 318例5岁以下儿童中,检出屈光不正27 256眼,2006～2010年屈光不正构成比由37.02%上升至45.18%。109 926只眼中,远视性屈光不正98 490眼,占89.59%;近视性屈光不正5 664眼,占5.15%,5岁以下儿童主要以远视为主。结论:5岁以下儿童屈光不正发病率有逐年上升趋势,并且随着年龄的增加有逐渐减少的趋势,5岁以下儿童屈光不正与遗传、环境因素有关。     

学龄前儿童屈光不正相关因素研究进展

<正>眼是人体最精密的器官,也是主要的感光(屈光)器官。眼的屈光系统由角膜、房水、晶状体、玻璃体构成,通过这些光学密度不同且几何形态各异的透明组织和液体的相互匹配,形成一个成像的组合透镜系统。在无眼调节功能的情形下,从5 m以外远处物体上发出的平行光线,经这一透镜组的折射,在     

蒙古族人群IL-6、NO水平与脑卒中发病关系的队列研究

摘要:目的　前瞻性探讨人群基线IL-6、NO水平与脑卒中发病的关联。方法　对2 589名蒙古族居民进行基线调查,采集血清样本检测IL-6和NO,随访研究人群脑卒中发病和死亡情况。结果　男性IL-6平均水平（7.93 ng/L）显著低于女性（8.54 ng/L）,P＜0.05;而男性NO平均水平（42.34 μmol/L）显著高于女性（37.79 μmol/L）,P＜0.05。平均随访9.2年,共发生脑卒中事件124例,其中缺血性脑卒中76例,出血性脑卒中46例,卒中分型不清2例。总的发病密度为519.11/10万人年,男性的各类脑卒中发病率均显著高于女性（P值均＜0.05）。Cox比例风险模型分析结果显示,无论是否调整其他变量,IL-6和NO与各型脑卒中发病的风险比均无统计学意义。结论　该人群具有较高的脑卒中发病率,且男性显著高于女性,基线IL-6和NO水平与缺血性脑卒中和出血性脑卒中事件均无关联。     

Musculoskeletal complaints among 11-year-old children and associated factors: the PIAMA birth cohort study

Musculoskeletal complaints (MSC) are common among children, often persist into adolescence, and increase the risk of MSC in adulthood. Knowledge regarding determinants of MSC among children is limited. The aim of this study was to determine the prevalence of MSC at age 11 years and to examine associations with sociodemographic factors, growth and development factors, mental health, tiredness, and lifestyle. Data from a Netherlands birth cohort study, the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) Study (n = 2,638), were used (1996-2009). MSC were defined as complaints about the back, an upper extremity, a lower extremity, or any of these sites. Logistic regression analyses using a forward stepwise procedure were performed on multiply imputed data. The 1-year period prevalences of back, upper extremity, and lower extremity complaints that lasted at least 1 month were 2.8%, 4.8%, and 10.9%, respectively. Only poorer mental health was consistently associated with all 3 types of complaints. Poorer mental health, daytime tiredness, early pubertal development, being physically active at age 11 years, and weight-for-height z score were associated with having any MSC. This study showed that MSC, especially lower extremity complaints, are common among 11-year old-children and that only poorer mental health status is associated with MSC at all anatomic sites.     

Compliance with anti-tuberculosis preventive therapy among 6-year-old children

There are no published data regarding compliance with anti-tuberculosis preventive therapy among children in Australia and limited published data worldwide. This study aimed to determine the compliance rate among 6-year-old children prescribed preventive therapy for tuberculosis infection. A prospective cohort study was conducted on 78, 6-year-old children prescribed anti-tuberculosis preventive therapy. Compliance was measured by compliance with prescribed preventive therapy as reported by parents who were administered questionnaires on completion of the course. In a subsample of 44 children, the proportion of children who complied with scheduled visits to the hospital, and pharmacy records of isoniazid dispensed were used as measures of compliance. Questionnaire data indicated a reported compliance rate for completion of the 6-month course of preventive therapy of 70.5% (55 children). For those 55 who reported completing the full course, 91% reported missing less than 1 tablet per week. In the subsample of 44 children, only 59% attended all follow-up clinic visits, and 54% collected all 6 months of isoniazid prescribed. Compliance with anti-tuberculosis preventive therapy is suboptimal. Improved methods to measure compliance and strategies to optimise compliance with preventive therapy is required.     

Characteristic lifestyles in 6-year-old children with obese parents: Results of the toyama birth cohort study

Objective The aim of this study was to identify characteristic lifestyles in children with obese parents. Methods 8,030 children (4,072 males and 3,958 females) aged 6 to 7 years were investigated. A questionnaire relating to the lifestyles of children was distributed through elementary schools for completion by parents. The heights and weights of parents were self-reported. A parent with a body mass index (weight in kilograms divided by the square of height in meters) greater than the 90th percentile for gender (26.7 kg/m² for fathers and 24.3 kg/m² for mothers) was defined as an obese parent. A chi-square test for each trend was applied to evaluate an increasing trend in the frequency or level of each lifestyle in children with obese parents. Results Children with obese parents were significantly associated with increasing trends in the proportions categorized by irregular intake of breakfast, faster eating, longer TV watching, and shorter sleeping hours. Conclusions These lifestyles are considered to be possible risk factors for the development of obesity. These characteristic lifestyles observed in children with obese parents could strengthen the relationship between child and parental body compositions, in addition to the genetic predisposition to obesity in children with obese parents. These findings indicate that education with lifestyle modification for obese parents will be required to prevent further weight gain in children with obese parents.     

中老年人群中吸烟与血压关联的前瞻性队列研究

目的 吸烟是重要的心血管事件危险因素,但部分研究却发现吸烟与高血压无关,甚至吸烟者血压水平更低。吸烟与血压的关联还需要更多纵向研究证据。本研究基于中国健康与养老追踪调查（China Health and Retirement Longitudinal Survey,CHARLS）数据探索45～80岁中老年人群中吸烟对血压的影响。方法 研究对象来源于CHARLS研究中完成2011年基线和2013、2015年随访的人群。纳入完成3次调查的研究对象,采用多水平线性回归分析吸烟对血压的影响,采用含时依变量的Cox回归分析吸烟对高血压发生风险的影响,同时调整性别、年龄、文化程度、婚姻状况、BMI和饮酒。结果 本研究共纳入6 667名无心血管疾病的研究对象,平均年龄58.8岁,男性占46.3%。多水平线性回归分析显示,在调整协变量后,相对于不吸烟者,吸烟者的SBP高1.81 mmHg（95% CI：0.55～3.07 mmHg,P<0.05）,DBP高0.85 mmHg（95% CI：0.10～1.60 mmHg,P<0.05）。Cox回归分析显示,吸烟与高血压发生风险的关联无统计学意义（HR=1.11,95% CI：0.89～1.38,P>0.05）。结论 在中老年人群中,吸烟与血压水平升高相关联。吸烟与高血压发生风险的关系有待进一步研究证实。     

Trends in height and BMI of 6-year-old children during the nutrition transition in Chile

OBJECTIVE: We analyzed trends in height and BMI and their interaction in 6-year-old Chilean children over the last 15 years. RESEARCH METHODS AND PROCEDURES: We calculated height for age z-score (HAZ), BMI z-score, prevalence of obesity, underweight, and stunting from cross-sectional national school-based annual population surveys in 1987, 1990, 1993, 1996, 2000, and 2002. Using mixed model analysis, we determined the risk of obesity according to height over time as odds ratios (ORs) and 95% confidence interval and the potential influence of height and year of study on BMI z-score. RESULTS: Over the study period, height increased by 2.8 cm in boys and 2.6 cm in girls, whereas stunting declined from 5% to 2% in both. Tallness increased by approximately 2%, BMI z-score increased from +0.3 to +0.65 in boys and to +0.62 in girls, and HAZ increased from -0.47 in boys and -0.45 in girls to 0 in 2002. Underweight declined from 4% to 3%, whereas obesity rose from 5% to approximately 14%. The probability of obesity among tall children was significantly greater than that for normal height children (OR, 2.3 to 3.5). The lowest obesity risk was observed between -2 and -1 HAZ. The OR for obesity in the stunted relative to normal height children was variable, ranging from 1.23 to 0.65, whereas it was significant and consistently positive (1.1 to 1.7) for boys and girls when it was compared with the lowest obesity risk according to height. DISCUSSION: Tallness is significantly associated with increased obesity risk in children, while stunting is also associated, but to a lesser degree.     

The association between weight perception and BMI among high school students

OBJECTIVE: To assess the association between weight perception and BMI among a large, diverse sample of adolescents. This study used both measured and self-reported height and weight to calculate BMI. RESEARCH METHODS AND PROCEDURES: A convenience sample of students (n = 2032) in grades 9 through 12 completed a questionnaire assessing demographic characteristics, self-reported height and weight, and body weight perception. These students were then weighed and had their height measured using a standard protocol. RESULTS: Using BMI calculated from measured height and weight, 1.5% of students were classified as underweight or at risk for underweight, 51.2% of students were normal weight, and 47.4% were overweight or at risk for overweight. Among this same sample of students, however, 34.8% perceived themselves as underweight, 42.9% perceived themselves as about the right weight, and 22.3% perceived themselves as overweight. Even when using BMI calculated from self-reported height and weight, >20% of students who were overweight or at risk for overweight perceived themselves as underweight. DISCUSSION: Because perception of overweight is a key determinant of adolescent nutritional habits and weight management, many students who are overweight or at risk for overweight but who do not perceive themselves as such are unlikely to engage in weight control practices. Increasing awareness of medical definitions of overweight might improve accuracy of weight perceptions and lead to healthier eating and increased physical activity.     

家庭因素与儿童青春发动时相关系的前瞻性队列研究

目的探索不同家庭因素与儿童青春发动时相的关系,为进一步开展儿童青春期发育研究提供参考。方法采用目的性抽样方法,对重庆市九龙坡区1 237名儿童进行为期5年的前瞻性队列随访,采用Cox回归分析家庭因素与儿童青春发动时相的关系。结果单因素分析结果显示,基线年龄和体质量指数(BMI)是男女童青春发动时相提前的影响因素(P值均<0.01);顺产相较于剖宫产的女童更早观察到乳房发育(HR=1.27,95%CI=1.04～1.54);自觉家庭经济条件好是女童月经初潮(HR=0.81,95%CI=0.66～0.99)、阴毛发育(HR=0.80,95%CI=0.65～0.97)和男童青春发动时相提前(睾丸发育HR=0.69,95%CI=0.58～0.83;首次遗精HR=0.62,95%CI=0.49～0.78;外生殖器发育HR=0.70,95%CI=0.56～0.87;阴毛发育HR=0.66,95%CI=0.54～0.80)的保护因素;留守男童更晚观察到睾丸发育(HR=0.74,95%CI=0.57～0.96)、首次遗精(HR=0.71,95%CI=0.50～0.99)、阴毛发育(HR=0.68...