昆山市0～5岁儿童先天性心脏病的调查  

An epidemiological investigation of congenital heart disease among children aged 0-5 years in Kunshan City

作　　者：杨文红[1] 罗晓明[1] 韩霞[1] 严菊花[1] 周春琴[1] 陈伟达[1] 黄国英[2] 

机构地区：[1]江苏省昆山市妇幼保健所,江苏昆山215300 [2]复旦大学附属儿科医院,上海210004

出　　处：《中国妇幼健康研究》2010年第6期727-729,共3页Chinese Journal of Woman and Child Health Research

基　　金：昆山市科技局社会发展计划资助项目（ks0923）

摘　　要：目的 了解昆山地区0～5岁儿童先天性心脏病的患病情况及其流行特征,及早发现先天性心脏病患者,为制定预防控制策略提供依据.方法 利用昆山市儿童保健三级网络,开展0～5岁儿童先天性心脏病的普查,所有儿童先进行问诊和体格检查,体检发现疑似先天性心脏病儿童进行彩色多普勒超声心动图检查确诊.结果 0～5岁儿童先天性心脏病检出率为6.29‰,无性别、户籍差异（均P〉0.05）;先天性心脏病检出率婴儿组最高（10.00‰）,随年龄的增长而下降,除3～岁组和4～5岁组之间比较无显著性差异外,其余各年龄组间两两比较均有显著性差异（均P〈0.05）;居住在工业集中区的儿童先天性心脏病检出率显著高于城市生活区和农业旅游区（χ^2分别为6.33、6.07,均P〈0.05）;先天性心脏病检出类型中,居前5位的分别为：房间隔缺损、室间隔缺损、房间隔缺损合并动脉导管未闭、室间隔缺损合并动脉导管未闭、动脉导管未闭.结论 开展儿童先天性心脏病普查对早期发现、减少漏诊、获得先天性心脏病的真实流行病学资料具有极大价值;本地儿童先天性心脏病检出率位于全国平均水平,与同类地域地区的检出率接近,无异常升高现象,且先天性心脏病的构成比与同类文献报道相似;孕妇居住环境对先天性心脏病的发生有明显影响,应高度关注.Objective To investigate prevalence and epidemiological characteristics of congenital heart disease（CHD） among children aged 0-5 years in Kunshan city and to identify those children with CHD so as to provide basis for formulating preventive and controlling strategies. Methods All children（49 901 ） aged 0-5 year in kunshan city were screened by tertiary child health webs of Kunshan city. All children received inquiry and physical examination and those who were suspected as CHD received doppler ultrasonic cardiography further to confirm the diagnosis of CHD. Results 314 CHD patients were identified and the prevalence rate was 6.29‰, The prevalence rate among children in 0-1 year age group （ 10.00‰ ） was higher than that in other age groups and it dropped with increase in age of the children. Except between the 3 years - age group and 4-5 years age group, there were significant differences in prevalence of CHD between other two-two groups （all P 〈 0.05 ）. The prevalence rate of CHD among children in industrially centralized areas than urban household areas and rural tourism areas （χ^2 = 6.33, 6.07respectively,both P 〈 0.05）. Most common CHD found（27.07% ）was simple atrial septal defect（ASD）, the next was ventricular septal defect （VSD）（23. 89% ）. The prevalence rate of ASD associated with patent ductus arteriosus（PDA） ,VSD associated with PDA and simple PDA were ranked in the third to fifth places. Conclusion Developing CHD screening among children is of very important significance for early identifying, reducing missed diagnosis rate, getting real epidemiologica] data of CHD. The prevalence rate of local children＇ s CHD is at the national average level, which approaches to same geographical areas and no abnormal increasing tendency is found. Furthermore, the constituent ratioes of CHD are similar than comparable literature reported, and living environment of pregnant women influences prevalence rate of CHD significantly.

关 键 词：先天性心脏病 普查 流行病学 检出率 儿童 

分 类 号：R725.4[医药卫生—儿科]