铜陵市城区婴儿先天性心脏病流行病学调查  

EPIDMIOLOGCAL SURVEY ON CONGENTAL HEART DISEASE THE INFANT IN TONGLING CITY

作　　者：陈尚徽 龙翔[1] 胡冬香[1] 马宝霞[1] 陈京栋 方红英[1] 高红琼 

机构地区：[1]安徽省铜陵市妇幼保健院儿保科,铜陵244000

出　　处：《现代预防医学》2010年第4期658-661,共4页Modern Preventive Medicine

基　　金：安徽省铜陵市卫生局科研项目(200512)

摘　　要：[目的]了解铜陵市城区婴儿先天性心脏病发生率、类型构成，探讨生活、工作环境因素、孕期病原生物感染对婴儿先天性心脏病的病因学意义。[方法]利用心脏听诊和心脏超声心动图检查相结合的方法对2005-2006年产科分娩的活产儿至1岁时进行先天性心脏病发生率调查，同时设计调查因卷采用1：2病例对照研究对65例先心病组和对130例照组儿童的父母进行可疑高危因素的调查。采用单因素和多因素条件Logistic回归分析方法对17个变量进行分析，筛选出与先心病发生相关的危险因素。[结果]先天性心脏病的发生12．01‰,其中7d内发现占49．2％．30d内发现占58．46％，90d内发现占89．23％。男女童之间发生率无明显差异。先心病类型以室间隔和房间隔缺损为主占56．92％；先天性心脏病患儿死亡占相应年度婴儿死亡的30.3％。单因素条件Logistic回归分析初步筛选出6个可疑危险因素。再经多因素条件Logistic回归分析，孕期用药、孕期感冒、孕期营养欠佳是先天性心脏病的主要危险因素。[结论]通过儿科医生、妇幼保健系统的常规体检和B超检查可早期发现先天性心脏病。妇产科和妇幼保健医生指导孕妇预防病毒感染、合理用药和营养，以减少先天性心脏病发生的危险因素。[ Objective ] To realize the prevalence and types of congenital heart disease （CHD） in infants of Tongling, and explore the living and working environment factors, and the etiology of infants CHD by pathogenic microorganism during pregnancy. [Methods] Cardiac auscultation with ultrasound examination were used to screen and investigate the prevalence of CHD among 0-to-1-year-old children born from 2005 to 2006. A 1 ： 2 case-control study was designed to investigate the risk factors of CHD among the parents of 65 cases and 130 controls with questionnaires. Simple and multivariable conditional Logistic regression was used to analyze the 17 factors to select the related risk factors of CHD. [ Results] The prevalence of CHD was 12.01‰, The detection rate in 7 days, 30 days and 90 days were 49.2%, 58.46% and 89.23%, respectively. There was no significant difference between male and female. Ventricular septum defect and atrial septal defect （ASD or VSD） were the main type of CHD, and aceounted for 56.92%. Furthermore, the mortality of infants with CHD accounted for 30.3% of the infant mortality. Simple conditional Logistic regression analysis results showed that 6 suspicious risk factors. Multivariable conditional Logistic regression analysis was used to filter the risk factors. Maternal exposure to medicine, cold and lack of nourishment during pregnancy were the main risk factors for CHD. [ Conclusion] We can confirm the early congenital heart disease through general examination and ultrasound in maternal and children＇s health care center or pediatricians. In order to reduce risk factors of CHD, obstetrieians or doctors in maternal and children＇s health care center should instruct pregnant women to prevent virus infection, take reasonable medicine and nourishment.

关 键 词：先天性心脏病 发生率 危险因素 病例对照研究 

分 类 号：R541.1[医药卫生—心血管疾病]