营养与双生子散光眼形成、演变的关系

发布时间：2018-04-04 00:28

  本文选题：双生子　切入点：婴儿　出处：《南京医科大学》2010年硕士论文

【摘要】：目的0-3岁是视觉发育的关键期,任何影响视觉形成的内在或外在因素都会导致视觉发育的异常。散光眼是引起婴幼儿视觉发育异常的常见眼病胎儿眼球在宫内发育过程中,在遗传与环境相互作用下,可形成不同的屈光状态,使婴儿在出生时就可能发生散光。散光的形成受遗传因素与环境因素的共同影响,遗传因素在散光形成中的作用已被证实,环境因素在散光形成中的作用研究甚少。环境因素范围较广,包括母胎健康状况、母胎营养因素、出生时情况等,其中营养素水平对散光的影响目前国内外尚未见相关前瞻性研究。故本文旨在通过对孕期母婴营养状况与双生子生后散光眼发病情况的研究,来探讨孕期营养与双生子散光眼形成的关系。 方法以2008年3月31日～2009年3月31日分娩于江苏省人民医院的28对双生子为研究对象,其中单卵双胎11对(男性5对,女性6对)、双卵双胎17对(男性8对,女性6对,异性3对)。分别于孕4-6月时、分娩前抽取母亲空腹静脉血及分娩后即刻采集胎盘脐带残端中的脐静脉血进行血清营养素检测,其中酶联免疫法检测血清25-羟维生素D3,高效液相色谱法检测血清维生素A,原子吸收光谱法测定血清钙、铁、镁、锌。对28对双生子于生后3月、6月、9月、12月、18月进行屈光检查,将双生子的眼散光状况与孕母孕期及双生子在出生前、后等相关因素进行分析。同期随机抽取56例单胎儿作为对照。 结果双生子生后3月、12月时柱镜≥2D散光眼检出率分别为53.57%、43.75%,均显著高于单胎婴儿(χ2=21.35、18.52,P均0.05)。双生子散光家族史的有无,两组间散光值比较(F=6.33,P=0.01)差异有统计学意义双生子组与单胎儿组散光的遗传相关性分别为58.33%、57.14%。母亲有早孕反应(OR=1.40,95%CI 1.10-5.13)、母亲孕中期骨密度(OR=1.44,95%CI1.30～6.19)、血色素(OR=1.69,95%CI 1.03-2.78)、分娩时血清镁(OR=1.39,95%CI 1.03-1.89)、维生素A(OR=1.03,95%CI 1.01-1.06)、双生子脐血维生素D(OR=1.02,95%CI 1.00-1.04)和出生体重(OR=1.02,95%CI 1.00-1.03)与双生子散光眼的关联有统计学意义(P0.05)。 结论双生子散光眼检出率明显高于单胎儿；母孕期营养状况影响双生子散光眼的形成,应在整个孕期针对性地对孕母进行营养指导,以降低婴儿散光眼的发生率
[Abstract]:Objective 0-3 years old is the key period of visual development. Any internal or external factors affecting visual formation will lead to abnormal visual development.Astigmatism is a common ophthalmopathy that causes the visual dysplasia of infants. During the development of fetal eyeball in the uterus, under the interaction of heredity and environment, different refractive states can be formed, which may lead to astigmatism at birth.The formation of astigmatism is influenced by both genetic and environmental factors. The role of genetic factors in the formation of astigmatism has been confirmed.There are a wide range of environmental factors, including maternal and fetal health status, maternal and fetal nutrition factors, at birth, and so on. The effect of nutrient level on astigmatism has not been studied in China and abroad.The aim of this paper is to explore the relationship between maternal nutrition and the formation of twin astigmatism by studying the nutritional status of mother and child during pregnancy and the incidence of astigmatism after twin birth.Methods from March 31, 2008 to March 31, 2009, 28 pairs of twins in Jiangsu Provincial people's Hospital were studied. Among them, 11 pairs of monozygote twins (5 pairs of males, 6 pairs of females, 17 pairs of dizygotic twins (8 pairs of males and 6 pairs of females) were studied.The opposite sex is 3 pairs.Maternal fasting venous blood was collected before delivery and umbilical vein blood from umbilical cord stump of placenta was collected immediately after delivery to detect serum nutrients.Enzyme-linked immunosorbent assay (Elisa) was used to detect serum 25 hydroxyvitamin D 3, high performance liquid chromatography (HPLC) to detect serum vitamin A, and atomic absorption spectrometry (AAS) to determine serum calcium, iron, magnesium and zinc.Diopter examination was performed on 28 pairs of twins in March, June, September, December and 18 months after birth. The astigmatism of twins and the related factors before and after pregnancy were analyzed.At the same time, 56 cases of single fetus were randomly selected as control.Results the detectable rate of column lens 鈮，

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