唐氏综合征发生相关职业、环境影响因素研究

发布时间：2018-03-16 19:00

本文选题：唐氏综合征　切入点：影响因素　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究欲通过对广东省唐氏综合征发生的时间、空间、人间分布情况进行描述分析,并且通过比较分析胎儿为唐氏综合征和非唐氏综合征孕妇孕前职业、环境等因素的接触情况,以探索职业、环境因素对唐氏综合征发生的影响,为优生优育的宣传及预防干预措施的制定提供科学依据,从而降低唐氏综合征的发生率,达到一级预防的目的。方法:通过对某妇幼保健院2015年1月1日至2015年12月31日产前诊断科介入性穿刺抽取绒毛、羊水或脐血进行染色体G显带核型分析的2342名孕妇进行现况分析,统计分析该院2015年唐氏综合征检出情况及三间分布情况;通过系统抽样法随机抽取2015年1月1日至2016年12月31日期间于该院就诊经绒毛、羊水或脐血染色体G显带核型分析诊断胎儿为唐氏综合征的孕妇97名作为病例组,绒毛、羊水或脐血染色体G显带核型分析诊断胎儿为非唐氏综合征的孕妇373名作为对照组,采用成组设计的病例对照研究,通过逐步多因素logistic回归法比较分析病例组和对照组孕妇孕前职业、环境等因素暴露情况,探索唐氏综合征发生相关的影响因素。结果:1.抽取2015年1月1日-2015年12月31日期间孕妇进行调查,共收集到研究对象2342例,胎儿为唐氏综合征者63例,检出率为2.69%,其中三体型62例(98.4%),嵌合型1例(1.6%);非唐氏综合症2279例;2.唐氏综合征的发生有三个高峰即1月(3.9%)、7月(4.3%)、12月(4.1%)和两个低峰即3月(0.9%)、9月(1.7%);3.常住地在城市的孕妇唐氏综合症检出率为1.95%,常住地在农村的检出率为3.57%,唐氏综合征检出率城乡间的差异有统计学意义(χ2=7.88,P0.01);4.唐氏综合征发生的影响因素按照OR值由大到小依次为:孕前或孕早期服用雌激素类药物(χ2=0.807,OR=6.860)、孕前曾居住新装修房屋(χ2=10.664,OR=3.080)、孕妇年龄≥35岁(χ2=16.600,OR=2.755)、孕妇职业接触含苯有机溶剂(χ2=5.789,OR=2.589)、孕前补充叶酸(χ2=0.814,OR=0.107)。结论:唐氏综合征的发生可能受到气候、城乡差异的影响,其中,1月、7月、12月为发病高峰,3月、9月为发病低峰;农村发病率高于城市。经分析孕妇孕前职业接触含苯有机溶剂、孕妇年龄≥35岁、孕前或孕早期服用雌激素类药物、孕前曾居住新装修房屋均为唐氏综合征发生相关的危险因素。孕前补充叶酸可降低唐氏综合征的发生风险,为唐氏综合征的保护因素。严格监督各企业、工厂做好女性从业者的职业防护及育龄女性优生优育知识的宣传教育和孕前遗传咨询对降低唐氏综合征的发生极其重要。
[Abstract]:Objective: to describe and analyze the time, space and human distribution of Down's syndrome in Guangdong Province, and to compare the fetal status of pregnant women with Down's syndrome and non-Down 's syndrome before pregnancy. In order to explore the influence of occupational and environmental factors on the occurrence of Down's syndrome, to provide scientific basis for the propaganda of eugenics and eugenics and the formulation of preventive intervention measures, so as to reduce the incidence of Down's syndrome. Methods: from January 1st 2015 to December 31st 2015, the villi were extracted by interventional puncture in a department of prenatal diagnosis in a MCH hospital. The status of 2342 pregnant women with amniotic fluid or umbilical cord blood chromosome G-banding karyotype was analyzed. The detection and distribution of Down's syndrome in the hospital in 2015 were statistically analyzed. From January 1st 2015 to December 31st 2016, 97 pregnant women whose fetuses were diagnosed as Down's syndrome were randomly selected as the case group by G-banding karyotype analysis of chromosomes in amniotic fluid or umbilical cord blood from January 1st 2015 to December 31st 2016. The G-banding karyotype analysis of amniotic fluid or umbilical cord blood chromosomes was performed in 373 pregnant women with non-Down syndrome as control group. Stepwise multivariate logistic regression was used to compare and analyze the pre-pregnancy occupation and environment of pregnant women in the case group and the control group. Results: a total of 2342 pregnant women were selected from January 1st 2015 to December 31st 2015 to investigate the incidence of Down's syndrome. 63 fetuses were born with Down's syndrome. The detection rate was 2.69. 62 cases of trisomia were involved with 98.4G and 1 case with chimeric type. 2279 cases of non-Down syndrome were diagnosed. There were three peaks in the occurrence of Down's syndrome, that is, on January, 3.9, July and December, respectively.) and two low peaks, namely, December, 0.934, #dateatis, 1.70.There are three peaks in the occurrence of Down's syndrome: Tang Jiao, a pregnant woman who lives in the city, usually lives in the city. The detection rate of Down's syndrome was 1.95 and 3.57 in rural areas. The difference between urban and rural areas was statistically significant (蠂 ~ 2 / 7.88 / P 0.01p ~ (0.01)). The influencing factors of Down's syndrome were as follows: prepregnancy or pregnancy according to OR value. Early use of estrogen drugs (蠂 2 + 0.807) (蠂 2 + 0.807), living in newly decorated houses before pregnancy (蠂 2 / 10.664), pregnant women aged more than 35 years (蠂 ~ 216.600), occupational exposure of pregnant women to benzene-containing organic solvents (蠂 ~ (2) 5.789OR2.589N), supplementation of folic acid before pregnancy (蠂 ~ (2 +) 0.814) OR0.1077.Conclusion: the occurrence of Down's syndrome may be affected by climate, The influence of urban and rural differences, including January, July, December as the peak incidence, December, December as the low peak, the incidence in rural areas is higher than in urban. After analysis of pregnant women before pregnancy occupational exposure to benzene-containing organic solvents, pregnant women aged more than 35 years old, Taking estrogen drugs before pregnancy or early pregnancy, and living in newly decorated houses before pregnancy are all risk factors associated with Down's syndrome. Folic acid supplementation before pregnancy can reduce the risk of Down's syndrome. In order to protect Down's syndrome, it is very important to strictly supervise the occupational protection of female practitioners, to publicize and educate women's knowledge of eugenics and to consult before pregnancy in order to reduce the incidence of Down's syndrome.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.5

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