2011—2014年西安咸阳地区先天性心脏病危险因素分析  

Analysis of Risk Factors of Congenital Heart Disease in Xi'an and Xianyang Area from 2011 to 2014

作　　者：郭彦孜[1] 刘俊[1] 郑玲芳[2] 李晓燕[3] 袁宁霞[4] 薛静[5] 王越月[6] 

机构地区：[1]陕西中医药大学第二附属医院新生儿科,陕西咸阳712000 [2]西安医学院第二附属医院新生儿科,西安710000 [3]陕西中医药大学第一附属医院产科,陕西咸阳712000 [4]陕西中医药大学第二附属医院产科,陕西咸阳712000 [5]陕西中医药大学第二附属医院超声科,陕西咸阳712000 [6]陕西中医药大学第二附属医院病理科,陕西咸阳712000

出　　处：《临床误诊误治》2016年第1期80-83,共4页Clinical Misdiagnosis & Mistherapy

基　　金：陕西省教育厅课题(11JK0664)

摘　　要：目的探讨先天性心脏病(congenital heart disease,CHD)的危险因素,为CHD一级预防措施的制定提供依据。方法对2011年7月1日—2014年12月31日西安咸阳地区经产前胎儿心脏超声及生后小儿心脏超声或引产胎儿尸检结果证实的子代CHD孕妇228例及正常儿孕妇456例进行问卷调查,问卷内容包括孕妇一般情况、妊娠史、既往病史、家族史、遗传史,孕前和孕期情况(有无服药、发热、饮酒、精神刺激、接触放射线或化学制剂等、孕早期患病情况、接触有害物质情况、孕期宫内感染情况、孕期膳食情况、孕期负性生活事件等)。采用单因素和多因素logistic回归分析对CHD的危险因素进行分析。结果多因素logistic回归分析结果表明:孕早期接触放射线、孕早期饮酒、孕妇年龄≥35岁、孕前和孕早期糖尿病、居住地距交通主干道<100 m、居住地或单位附近有污染企业、孕期强烈精神刺激是CHD发生的主要危险因素;孕早期补充复合维生素及叶酸,孕期常食用蛋肉鱼类、牛奶及豆类制品可以降低胎儿CHD的患病风险。结论做好围产保健,减少孕期疾病,避免孕期接触有害物质和改变不良的行为习惯,孕期注意营养均衡,孕早期补充复合维生素及叶酸,孕期常食用蛋肉鱼类、牛奶及豆类制品等措施,有利于降低子代CHD的发生风险。Objective To investigate the risk factors of congenital heart disease （CHD） in Xihn and Xianyang area, and provide the reference for CHD of primary preventive measures. Methods We studied the questionnaires filled in survey of the CHD risk factors for 228 CHD cases of pregnant women and non-CHD 456 cases of pregnant women who underwent ante- natal and postnatal fetal heart ultrasound examinations in the Affiliated Hospital of Shaanxi Traditional Chinese Medical Univer- sity and other institutions during July 1 2011 and December 31, 2014. The questionnaire surveys included general cases, pregnancy cases, PMH, famiiy history, genetic history, cases before conception and during pregnancy （any medication, fe- ver, drinking, mental stimulation, exposure to radiation or chemicals, early pregnancy illness, contact with harmfui sub- stances, intrauterine infection, dieting and negative life events, etc）. The risk factors of CHD was analyzed using chi-square test, the single factor and multiple factors logistic regression analysis. Results The multi-factors logistic regression analysis results showed that： exposure to radiations during the early pregnancy, drinking alcohol, parturient women aged 〉/35, diabe- tes mellitus before pregnancy, less than 100 m of the distance between the residence area and any major traffic road, residence or working place near the polluting enterprises, the intensive mental stimulation during first trimester of pregnancy were the main risk factors of CHD; intake such as multi-vitamin and folie acid during the early pregnancy, eggs, meat, fish and aquatic products and milk and soy bean products during pregnancy can reduce the risks factors of perinatal CHD. Conclusion Health care, reducing pregnancy diseases, avoiding contact with harmful substances, changing bad habits, nutrition equilibrium dur- ing pregnancy, multi-vitamin and folic acid during the early pregnancy, eggs, meat, fish and aquatic products and milk and soy bean products during pregnancy can reduce the risk factors of

关 键 词：心脏病 胎儿 危险因素 问卷调查 

分 类 号：R714.5[医药卫生—妇产科学]