先天性心脏病危险因素的病例对照初步研究  

The preliminary case-control study of risk factors of congenital heart disease

作　　者：郭彦孜[1] 张国成[2] 苏海砾[3] 李军[3] 许东亮[2] 杨晓蕾[4] 

机构地区：[1]陕西中医学院第二附属医院新生儿科,陕西咸阳712000 [2]第四军医大学西京医院儿科 [3]第四军医大学西京医院超声科 [4]第四军医大学西京医院儿科超声科

出　　处：《中华临床医师杂志（电子版）》2011年第15期4406-4413,共8页Chinese Journal of Clinicians(Electronic Edition)

基　　金：科技部"863计划"课题(2007AA02Z442)

摘　　要：目的探讨西安地区先天性心脏病(CHD)的危险因素,为CHD的科学预防及其病因学研究提供参考依据。方法采用前瞻性、以医院为基础的病例对照研究。对在西京医院进行胎儿心脏超声检查的637名孕妇进行问卷式调查、统计CHD的危险因素;经胎儿尸检或婴儿生后复查心脏超声确诊CHD和非CHD(non-CHD);对98例病例组(CHD组)和196例对照组(non-CHD组)进行1:2病例对照研究,应用χ2检验、单因素和多因素Logistic回归分析CHD的危险因素。统计软件采用SPSS13.0软件包。结果按α=0.05水准,用χ2检验对59个研究因素进行分析,初步筛选出32个可疑危险因素,再经单因素Logistic回归分析从32个可疑危险因素中筛出13个CHD的危险因素,最后进行多因素Logistic回归分析,最终筛选出6个CHD的主要危险因素。(1)单因素Logistic回归分析结果表明13个CHD的危险因素:孕早期接触射线(OR=10.482)、孕早期饲养宠物(OR=8.668)、孕早期饮酒(OR=6.326)、发现怀孕周数晚(≥13周OR=11.158)、严重早孕呕吐(OR=2.369)、孕期12周前感冒发热(OR=6.334)、孕早期住地离最近交通主干道的距离(<50mOR=3.223,50～100mOR=7.877)、住地或单位附近污染企业(OR=7.617)、孕期负性生活事件(≥10个OR=3.628)是CHD的危险因素;孕妇孕期12周前补充复合维生素(OR=0.535)及叶酸(OR=0.519)、孕期经常食用蛋肉鱼水产品、牛奶及豆制品可降低CHD的患病风险。(2)多因素非条件Logistic回归分析结果表明6个CHD的主要危险因素:孕早期接触射线、孕早期饮酒、孕早期住地离最近交通主干道的距离、住地或单位附近污染企业是CHD发生的主要危险因素;孕期经常食用蛋肉鱼水产品、牛奶及豆制品可降低CHD的患病风险。结论孕早期是胎儿心脏发育的关键时期,孕早期接触射线、孕早期饮酒、孕早期住地离最近交通主干道的距离、住地或单位附近污染企业等4项是CHD发生的主要危险因素Objective To explore the risk factors of congenital heart disease(CHD)in xi'an area,and provide the reference for CHD scientific prevention and the study of etiology.Methods We adopted the method of questionnaire survey for the pregnant women antenatal examinationed in Xijing hospital,and filled in the questionnaire of CHD risk factors.We analyzed the risk factors of CHD by applicating χ2 test,the single factor and multiple factors logistic regression analysis.The statistical analysis software was SPSS 13.0 packages.Results(1)The result of χ2 test and single factor logistic regression showed that contacting rays during first trimester of pregnancy(OR=10.482),keeping pets(OR=8.668)and drinking(OR=6.326)during first trimester of pregnancy,finding pregnancy was late(≥13 W,OR=11.158),serious throwing up during first trimester of pregnancy(OR=2.369),having a cold and a fever in the first 12 weeks of pregnancy(OR=6.334),distance from apartment to recent traffic trunk during first trimester of pregnancy <50 m(OR=3.223),or between 50 m and 100 m(OR=7.877),polluting enterprises nearby residence during pregnancy or units during first trimester of pregnancy(OR=7.617),negative life events≥10(OR=3.628)were the risk factors of CHD;taking composite vitamin(OR=0.535)and folic acid(OR=0.519)in the first 12 weeks of pregnancy,often eat egg,meat,fish and aquatic product(OR=0.033)and drink milk and eat bean products(OR=0.045)during pregnancy can reduce the risk of perinatal CHD.(2)The result of multi-factor and unconditional logistic regression analysis showed that contacting rays(OR=11.180),drinking(OR=7.296),distance from apartment to recent traffic trunk <50 m(OR=3.969)or between 50 m and 100 m(OR=7.975),polluting enterprises nearby residence or units(OR=8.436)during first trimester of pregnancy were the major risk factors of CHD.Often eating eggs,meat,fish and aquatic products and drinking milk and eating bean products during pregnancy can reduce the risk of perinatal CHD.Conclusions Contacting rays,drinking and distance f

关 键 词：先天性心脏病 危险因素 病例对照研究 初步研究 

分 类 号：R725.4[医药卫生—儿科]