【摘要】 目的:了解石河子地区神经管畸形(NTDs)的发病情况,探讨导致NTDs发生的相关危险因素,为预防NTDs的发生提供理论依据。方法:对2001年1月～2008年12月石河子地区23所医院分娩的孕28周～产后7天内的围产儿进行监测,调查NTDs儿的发病情况及孕母方面的原因;同时对2008年1月～2009年9月在石河子大学第一附属医院门诊B超诊断为NTDs的孕妇进行调查,并监测其血清叶酸和VitB12水平。结果:①8年间共监测到围产儿24417例,其中NTDs患儿40例,围产儿中NTDs的平均发生率为16.38/万,团场地区NTDs的发生率为26.26/万,远高于市区6.54/万;②门诊调查的孕中期NTDs妇女血清中叶酸和VitB12水平均低于同期正常对照妇女,差异有统计学意义;③NTDs儿多发生于文化程度低、经济状况差和孕期接触不同有害物质的妇女。结论:①应积极推动围产期保健,增强育龄妇女的预防意识;②B超是NTDs诊断的主要依据,应提高B超在孕早期的诊断作用;③孕期增补叶酸的同时应当补充VitB12,并尽量减少相关危险因素的接触,以减少神经管畸形儿的发生。更多还原

【Abstract】 Objective:To understand the prevalence of neural tube defects (NTDs) in Shihezi,explore the related risk factors of NTDs and provide a scientific basis for prevention of NTDs.Methods:Perinatal infants aged from 28 gestational weeks to 7 days born in 23 hospitals in Shihezi from January 2001 to December 2008 were monitored,and the prevalence of NTDs and maternal effect factors were surveyed; simultaneously,pregnant women whose fetuses were diagnosed as NTDs by B type ultrasound in the hospital from January 2008 to September 2009 were surveyed,and the serum levels of folic acid and vitamin B12 were detected.Results:24 417 perinatal infants were surveyed,the incidence of NTDs was 16.38/10 000 (40 cases),the incidence of NTDs in rural areas (26.26/10 000) was significantly higher than that in urban areas (6.54/10 000); the serum levels of folic acid and vitamin B12 in NTDs women of second trimester were significantly lower than those in healthy women; the incidence of NTDs was high in women with low education level,poor income and exposure history to different poisons in pregnancy.Conclusion:Perinatal health care and preventive consciousness should be enhanced; B type ultrasound is a main diagnostic criteria,which should be applied in early pregnancy; supplement of folic acid and vitamin B12 should be promoted,avoiding exposure to related risk factors may reduce the incidence of NTDs.更多还原