论文部分内容阅读
目的建立拉萨市0~6岁藏族儿童体格发育的正常参考值。方法以横断面调查的方法,选取西藏自治区人民医院妇产科生后24~48 h的健康新生儿、西藏自治区人民医院妇幼保健院儿保科1~6岁和拉萨市5所幼儿园3~6岁的健康藏族儿童为调查对象。所有研究对象均为藏族常驻居民且无先天畸形。依据年龄分为新生儿、1、2、3、4、5和6岁组。估计每个年龄组男女至少各需300名。统一配置测量工具,参考《儿童保健学》提供的方法直接测量体重、身高(长)、头围(顶臀长)、坐高、胸围、上臂围和皮脂厚度7项体格发育指标,并间接计算BMI。对纳入分析的体格发育指标数据剔除极值数据。应用LMS软件构建不同性别年龄组的8个体格发育指标的百分位数及百分位数曲线图。按照2005年中国九城市城区儿童推荐的标准和2006年WHO推荐标准,采用标准统计量检定法(Z值法),分别计算各个体格发育指标的Z值。结果 2012年1月至2013年6月符合本文纳入标准的4 330名0~6岁藏族儿童30 310个体格发育指标数据进入分析,其中男童2 114名,女童2 216名。删除对模型干扰的极值数据84(0.28%)个。LMS法构建的百分位数曲线光滑,表明每组样本量基本满足拟合曲线要求。建立了拉萨市0~6岁藏族男、女童的8个体格发育指标的x珋±s及百分位数(P3~P97)。各年龄组男童有18个体格发育指标显著大于女童,女童有6个体格发育指标显著大于男童,总体上藏族男童的体格发育指标高于藏族女童。拉萨市藏族儿童的8个体格发育指标总体上落后于2006年WHO推荐标准,更落后于中国九城市城区儿童的体格发育水平。随年龄增长,藏族2~5岁儿童的BMI值逐渐走低。结论建立的0~6岁藏族儿童体格发育指标的x珋±s及百分位数将为藏族儿童临床科研实际应用和不同民族儿童体格发育指标之间的比较提供科学依据。
Objective To establish a normal reference value of physical development of Tibetan children aged 0-6 in Lhasa. Methods According to the method of cross-sectional survey, healthy neonates aged 24- 48 h after gynecology and obstetrics of People’s Hospital of Tibet Autonomous Region were selected. The children’s health care center of 1 ~ 6 years old in MCH and 5 kindergartens in Lhasa were 3 ~ 6 years old Healthy Tibetan children as survey subjects. All subjects were Tibetan resident without congenital malformations. Divided into newborns according to age, 1, 2, 3, 4, 5 and 6 years old. It is estimated that at least 300 men and women for each age group are required. Unified measurement tools, with reference to “child health” provides a direct measurement of weight, height (length), head circumference (top hip length), sitting height, chest circumference, upper arm circumference and sebum thickness of 7 physical development indicators, and indirect calculation BMI. Extremum data were excluded from the data of the physical development index included in the analysis. LMS software was used to construct the figures of percentiles and percentiles of 8 physical development indexes of different gender age groups. According to the recommended standards of children in urban areas of China in 2005 and the WHO recommended standards in 2006, the Z value of each physical development index was calculated by the standard statistical test (Z value method). Results From January 2012 to June 2013, 30 310 physical development index data of 4 330 Tibetan children aged 0-6 years who met the inclusion criteria were included in the analysis, including 2 114 boys and 2 216 girls. Remove the extreme value data 84 (0.28%) that interfere with the model. The percentile curve constructed by LMS method is smooth, which shows that the sample size of each group basically meets the fitting curve requirements. We established x 珋 ± s and percentiles (P3 ~ P97) of 8 physical development indexes of Tibetan boys and girls 0 ~ 6 years old in Lhasa. There were 18 physical development indexes of boys in all age groups were significantly greater than girls, 6 girls physical development index was significantly greater than boys, Tibetan boys in general physical development indicators higher than Tibetan girls. Eight physical development indicators of Tibetan children in Lhasa generally lag behind the WHO recommendation in 2006 and lag behind the physical development of children in urban areas of nine cities in China. With age, the BMI of Tibetan children aged 2 to 5 gradually decreased. Conclusion The x 珋 ± s and percentiles of Tibetan children aged 0-6 years old who have physical development indicators will provide a scientific basis for the comparison between Tibetan children’s clinical scientific research and physical development indexes of different ethnic children.