【作者】 王奇；

【导师】 韩萍；

【作者基本信息】 郑州大学 ， 营养与食品卫生学， 2012， 硕士

【摘要】 目的本研究通过了解HIV阳性孕妇分娩的婴幼儿的生长发育情况,进行婴幼儿营养状况评估,为制订提高婴幼儿健康水平及改善其营养状况的相关措施提供依据。方法在河南省艾滋病病例报告数较多地区,对2006年1月～2009年12月间HIV阳性孕妇分娩的180名婴幼儿进行随访调查,分别在婴幼儿满1、3、6、9、12、18月龄时,记录婴幼儿身长、体质量、头围,计算年龄别体质量、年龄别身高、身高别体质量Z值评分。在孕期检测HIV阳性孕妇的血红蛋白、CD4+T淋巴细胞,在婴幼儿12月龄、18月龄时进行HIV抗体检测。应用Spss17.0统计软件,采用t检验及Wilcoxon秩和检验,以国内及WHO婴幼儿生长发育情况为参考,对研究地区婴幼儿身长、体质量、头围及WAZ、 HAZ、 WHZ指标进行统计分析,评价婴幼儿的营养状况,采用单因素及多因素logistic回归分析对影响婴幼儿营养状况的相关因素进行统计分析。结果1.HIV阳性婴幼儿的身长在3-6月龄前低于HIV阴性婴幼儿(P<0.05),HIV阳性和阴性男婴除9月龄外,其它月龄男婴身长均低于国内婴幼儿参考值(P<0.05)。HIV阳性男婴体质量在1-3月龄低于国内参考值；阳性女婴在多个月龄低于国内参考值,阴性女婴体质量较好。2.跟国内参考值相比多个月龄婴幼儿头围值小于国内婴幼儿参考值(P<0.05)；与WHO男婴参考值相比,HIV阴性男婴头围值在1、6月龄时低于WHO参考值；HIV阳性女婴头围3月龄低于WHO参考值(P<0.05),HIV阴性女婴头围在3、9月龄低于WHO参考值(P<0.05)。3.HIV阴性婴幼儿在6月龄消瘦的发病率最高,为8.5%,在3月龄时低体质量发病率最高,为17.1%,在1月龄时生长发育迟缓率最高,为30.5%；HIV阳性婴幼儿在1月龄时消瘦和低体质量的发病率较高分别为15%、30%,6月龄时生长发育迟缓率最高,为41.7%；两组婴幼儿消瘦发病率差异各月龄均无统计学(P>0.05),多数时期HIV阴性婴幼儿低体质量的发病率低于HIV阳性婴幼儿,HIV阴性婴幼儿生长迟缓率在6、12、18月龄时候低于HIV阳性婴幼儿(P<0.05),其他月龄差异无统计学意义(P>0.05)。4.61%的HIV阳性孕妇孕期合并有贫血症状,82.2%的婴幼儿辅食添加时间在4月龄后；死亡婴幼儿中73.3%小于12月龄,死亡原因66.7%为肺炎。结论1.本研究中研究地区的HIV阳性产妇的婴幼儿的营养状况较差,其中HIV阳性婴幼儿身长、体质量、头围发育水平较低。2.本研究中研究地区HIV阳性产妇分娩的婴幼儿均采取人工喂养,但婴幼儿营养不良率较高,其中HIV阳性婴幼儿较HIV阴性更高。3.孕期孕妇是否贫血、婴幼儿是否服用抗病毒药物、婴幼儿辅食的添加月龄是影响婴幼儿营养不良的因素。更多还原

【Abstract】 ObjectiveThe nutrition status was evaluated by survey the growth and development of the infants born to the pregnant women with HIV positive, the goal of the evaluation was to formulate the measures in order to improve the health and nutrition level of the infant.MethodsThe study was conducted in the areas where the number of case of HIV/AIDS was more than other areas from January2006to December2009, Infants born to HIV-infected mothers were followed up from their birth to18-months old. Record height, weight, head circumference etc, The index of Z scores of weight for age, height for age, weight for height, were calculated using WHO Anthro2010at birth1,3,6,9,12, and18months of age, The total lymph-cell counts, hemoglobin, CD4+T lymphocytes of the pregnant were test, HIV antibody test of the infant was test in12and18months, The t test and Wilcoxon test were used to evaluate growth and development of the infant, Infant Nutritional status impact factors were analyzed through univariate analysis and multiple logistic regression models, applying SPSS17.0Statistical software.Results1. The height of HIV positive infant was less than HIV negative infant during3～6months (P<0.05) except the9months baby,other months the height are lower than the standard of country (P<0.05) The weight of boy with HIV infection was lower than the national standard during1～3months; the weight of girl was lower the the national standard in several months; the weight of girls with HIV negative was better.2. Compared with the national standard the head circumference value was less than standard in most months; the head circumference value of HIV negative boys in 1,6months were less than WHO standard; The head circumference of HIV positive baby girl in3months was less than WHO standards(P<0.05), The head circumference of HIV negative baby girl in3,9months were less than WHO standards(P<0.05).3. the emaciation of HIV negative infants was the highest in6th months, about8.5%, the low weight incidence is the highest in the3th months, about17.1%, the growth retardation is the highest in lth months, about30.5%; the incidence of emaciation and low weight is more higher in the lth were15%,30%, the incidence of growth retardation is the highest, about41.7%; the incidence of emaciation between two groups had no statistically significant(P>0.05), the low weight of HIV negative is less than the infants of the HIV positive, the growth retardation of HIV negative is less than the infant of HIV positive in the6th,12th, and18th months(P <0.05), the difference other months had no statistically significant (P>0.05).4.61%of HIV positive pregnant have symptoms of anemia,82.2%of the months of add assist food was later than4months;73.3%of the infant dead in less than12months;66.7%of the cause of death was pneumonia.Conclusion1. The nutrition of the infants born to HIV positive women was more worse, the length, weight, head circumference of HIV positive infant was poorer.2. The artificial feeding was adopted to the HIV positive women, but the malnutrition of the infant is more higher, especially the HIV positive infant.3. Whether anemia,HARRT to infants, the months of add assist food were the factors can influence the malnutrition of the infant.更多还原