CAJ | 학술논문

背景:采用多项有序反应变量的Logistic分析方法,可以从另一个侧面,探讨在子宫内低水平铅暴露状态下,新生儿胎粪铅含量与新生儿神经行为发育之间的关系.目的:探讨影响新生儿神经行为发育的多种因素及敏感性.设计:以新生儿神经行为总评分作为因变量,以问卷中的影响因素及脐血铅、胎粪铅等24项指标作为自变量,采用多项有序分类反应型变量的Logistic逐步回归分析方法,在P=0.10水平筛选出相应的影响因素.单位:武汉科技大学,华中科技大学同济医学院职业病流行病学实验室,中国第一冶金建筑总公司职工医院.对象:随机选择武汉市新型工业区的青山区一冶职工医院妇产科1999-0l/10出生的足月、健康新生儿103例作为观察对象,家属同意参加课题研究并填写问卷调查,提供新生儿胎粪,按时进行新生儿测试.方法:①在新生儿断脐前采取脐血5 mL,于-4℃的冰箱中冷藏保存.收集出生24 h内的胎便,用石墨炉原子吸收光谱法测定脐血铅与胎粪铅的含量.②新生儿神经行为的检查:采用新生儿20项神经行为检查法于分娩第3天进行检查.同时采用自行设计的问卷对产妇进行调查.问卷涉及可能影响新生儿神经发育的其他因素,共22项.③对新生儿神经系统发育有影响的家庭、社会、环境、健康状况以及脐血铅含量、胎粪铅含量共24个变量(其中含2个亚变量)作自变量,以新生儿神经行为评分作为反应变量,筛选出相应的影响因素.主要观察指标:筛选出影响新生儿神经行为发育的因素.结果:103例新生儿进入结果分析.孕周、孕期服药月份、血红蛋白、孕期情绪、胎粪铅、孕期服药6项因素选入模型.结论:新生儿神经行为发育受多项因素的影响.孕期营养状况好、孕周长、孕期情绪好有利于新生儿神经行为的发育.孕期服药不利于新生儿神经行为的发育,尤其是妊娠早期用药.胎粪铅含量增高将不利于新生儿神经行为的发育. 揹景:採用多項有序反應變量的Logistic分析方法,可以從另一箇側麵,探討在子宮內低水平鉛暴露狀態下,新生兒胎糞鉛含量與新生兒神經行為髮育之間的關繫.目的:探討影響新生兒神經行為髮育的多種因素及敏感性.設計:以新生兒神經行為總評分作為因變量,以問捲中的影響因素及臍血鉛、胎糞鉛等24項指標作為自變量,採用多項有序分類反應型變量的Logistic逐步迴歸分析方法,在P=0.10水平篩選齣相應的影響因素.單位:武漢科技大學,華中科技大學同濟醫學院職業病流行病學實驗室,中國第一冶金建築總公司職工醫院.對象:隨機選擇武漢市新型工業區的青山區一冶職工醫院婦產科1999-0l/10齣生的足月、健康新生兒103例作為觀察對象,傢屬同意參加課題研究併填寫問捲調查,提供新生兒胎糞,按時進行新生兒測試.方法:①在新生兒斷臍前採取臍血5 mL,于-4℃的冰箱中冷藏保存.收集齣生24 h內的胎便,用石墨爐原子吸收光譜法測定臍血鉛與胎糞鉛的含量.②新生兒神經行為的檢查:採用新生兒20項神經行為檢查法于分娩第3天進行檢查.同時採用自行設計的問捲對產婦進行調查.問捲涉及可能影響新生兒神經髮育的其他因素,共22項.③對新生兒神經繫統髮育有影響的傢庭、社會、環境、健康狀況以及臍血鉛含量、胎糞鉛含量共24箇變量(其中含2箇亞變量)作自變量,以新生兒神經行為評分作為反應變量,篩選齣相應的影響因素.主要觀察指標:篩選齣影響新生兒神經行為髮育的因素.結果:103例新生兒進入結果分析.孕週、孕期服藥月份、血紅蛋白、孕期情緒、胎糞鉛、孕期服藥6項因素選入模型.結論:新生兒神經行為髮育受多項因素的影響.孕期營養狀況好、孕週長、孕期情緒好有利于新生兒神經行為的髮育.孕期服藥不利于新生兒神經行為的髮育,尤其是妊娠早期用藥.胎糞鉛含量增高將不利于新生兒神經行為的髮育.
배경:채용다항유서반응변량적Logistic분석방법,가이종령일개측면,탐토재자궁내저수평연폭로상태하,신생인태분연함량여신생인신경행위발육지간적관계.목적:탐토영향신생인신경행위발육적다충인소급민감성.설계:이신생인신경행위총평분작위인변량,이문권중적영향인소급제혈연、태분연등24항지표작위자변량,채용다항유서분류반응형변량적Logistic축보회귀분석방법,재P=0.10수평사선출상응적영향인소.단위:무한과기대학,화중과기대학동제의학원직업병류행병학실험실,중국제일야금건축총공사직공의원.대상:수궤선택무한시신형공업구적청산구일야직공의원부산과1999-0l/10출생적족월、건강신생인103례작위관찰대상,가속동의삼가과제연구병전사문권조사,제공신생인태분,안시진행신생인측시.방법:①재신생인단제전채취제혈5 mL,우-4℃적빙상중랭장보존.수집출생24 h내적태편,용석묵로원자흡수광보법측정제혈연여태분연적함량.②신생인신경행위적검사:채용신생인20항신경행위검사법우분면제3천진행검사.동시채용자행설계적문권대산부진행조사.문권섭급가능영향신생인신경발육적기타인소,공22항.③대신생인신경계통발육유영향적가정、사회、배경、건강상황이급제혈연함량、태분연함량공24개변량(기중함2개아변량)작자변량,이신생인신경행위평분작위반응변량,사선출상응적영향인소.주요관찰지표:사선출영향신생인신경행위발육적인소.결과:103례신생인진입결과분석.잉주、잉기복약월빈、혈홍단백、잉기정서、태분연、잉기복약6항인소선입모형.결론:신생인신경행위발육수다항인소적영향.잉기영양상황호、잉주장、잉기정서호유리우신생인신경행위적발육.잉기복약불리우신생인신경행위적발육,우기시임신조기용약.태분연함량증고장불리우신생인신경행위적발육.
BACKGROUND: Logistic analysis of multi-ordered response-variable is used to probe into from another view the interrelationship between lead content in fetus faeces and neurobehavioral development under exposure to low-level lead in uterus.OBJECTIVE: To probe into multi-factors of neurobehavioral development in neonates and the sensibility.DESIGN: The total score of neurobehavior in neonates was taken as dependent variable and 24 indexes were as independent variables, such as induced factors, lead in umbilicus blood and lead in fetus faeces in questionnaire. Logistic progressive regression of multi-ordered response-variables was used in analysis and corresponding factors were screened at level of P=0.10.SETTING: Wuhan University of Science and Technology, Laboratory Room of Occupation Disease and Epidemic disease in Tongji Medical College of Huazhong University of Science and Technology and Occupation Hospital of China First Metallurgical Construction General Company.PARTICIPANTS: Totally 103 full-month borne and healthy neonates were randomized in Department of Gynecology of one occupation hospital in Qingshan District of New-type Industry Area of Huanhan City from January to October 1999 as the objects. The relatives agreed with topic research and questionnaire investigation and they provided neonatal faeces and received neonatal tests on time.off the umbilicus and preserved in freezing in refrigerator at -4 ℃. The faeces in 24 hours after birth was collected and the lead contents of umbilicus blood and faeces were assayed with graphite furnace atomic absorpBehavioral Neurological Assessment (NBNA) was used in examination on the 3rd day after delivery. Simultaneously, the self-designed questionnaire was adopted in the investigation for parturients. The questionnaire involved other possible factors of neonatal neurobehavioral development, including dependent variables, concerning to states of family, society, environment and health that affected neurological development in neonates and lead contents in umbilicus blood and faeces. Scores of neonatal neurobehavior were taken as response variables. Finally, the corresponding factors were screened.MAIN OUTCOME MEASURES: To screen the factors of neurobehavioral development of neonates.RESULTS: Totally 103 cases entered result analysis. Six factors were selected in the model, named pregnant weeks, the month of drug administration in pregnancy, hemoglobin, emotions in pregnancy, lead level in fetus faeces and drug administration.CONCLUSION: Neonatal neurobehavioral development was related to multiple factors. Good nutrient in pregnancy, long pregnant weeks and good emotions in pregnancy benefit neurobehavioral development of neonates. Drug administration during pregnancy is disadvantageous in neonatal neurobehavioral development, especially the medication at the early phase of pregnancy. The increased lead content in neonatal faeces does not benefit neonatal neurobehavioral development.