云南省出生缺陷、先天性心脏病流行趋势与全国的比较分析  

Comparative analysis on prevalent trends of birth defects and congenital heart diseases in Yunnan Province and nationwide

作　　者：沈建华 张笑男[2] 仇赛云[2] 刘锦桃[2] SHEN Jian-hua;ZHANG Xiao-nan;QIU Sai-yun;LIU Jin-tao(Yunnan Health Development Research Center,Kunming Yunnan 650100,China;Yunnan Maternal and Child Care Service Center,Kunming Yunnan 650051,China)

机构地区：[1]云南省健康发展研究中心,云南昆明650100 [2]云南省妇幼保健院,云南昆明650051

出　　处：《卫生软科学》2019年第10期87-91,共5页Soft Science of Health

摘　　要：[目的]对云南省和全国的出生缺陷、先天性心脏病流行趋势进行比较分析,为出生缺陷、先天性心脏病的防控干预提供依据。[方法]通过全国妇幼卫生监测网、云南“三网监测”和年报数据、围产保健监测系统与出生缺陷监测系统收集相关数据,并进行比较分析。[结果]①出生缺陷总体趋势:全国出生缺陷发生率最低为1996年的87.34/万、最高为2010年的149.1/万,出生缺陷发生率呈逐年上升趋势(P<0.01),1996-2004年,农村出生缺陷发生率高于城市,2005年后农村开始低于城市;云南省1989-2002年出生缺陷发生率呈波浪式下降,2003-2004年有所上升,2005-2007年逐年下降,2008-2010年又直线上升,总体随时间的推移而上升(趋势χ^2=6.054,P=0.014);②出生缺陷病种及顺位:全国出生缺陷主要病种是:先天性心脏病、多指/趾、总唇裂、外耳其他畸形、N管缺陷、脑积水等。全国2005-2014年先天性心脏病(先心病)上升为第一病种,2010-2014年先天性心脏病发生率为42.66/万;云南省在1992年及以前,出生缺陷以唇腭裂、多指趾、马蹄内翻等为主。1996年先天性心脏病首次进入出生缺陷前五位病种,2007年上升为第四位,2008年上升为第三位;2009年之后已稳居第一位。③先心病发生率:全国来看,浙江、广东、陕西、湖南和云南等5省先心病发生率最高,除贵州、江苏和青海3个省外、其他27个省市区出生缺陷发生类型先心病均为第一位病种。以先心病的发生率为因变量,经逐步回归分析发现,只有纬度进入方程,其复相关系数r=0.392,决定系数R 2=0.154,P=0.032。[结论]全国和云南省出生缺陷总体呈上升趋势,先天性心脏病在出生缺陷中处于上升趋势,云南省先天性心脏病发生率高于全国水平,纬度是影响先心病发生率的主要因素。Objective To compare and analyze prevalent trend of birth defects and congenital heart disease in Yunnan Province and nationwide so as to provide basis for prevention and intervention of birth defects and congenital heart disease.Methods Data were collected through the national maternal and child health monitoring network,Yunnan“three networks monitoring”and annual report data,perinatal health care monitoring system and birth defects monitoring system to compare and analyze.Results 1.Overall trend of birth defects was that the lowest incidence of birth defects in China was in 1996 with 87.34/10,000,the highest was in 2010 with 149.1/10,000,incidence of birth defects was increasing year by year(P<0.01).Incidence of birth defects in rural areas was higher than that in urban areas from 1996 to 2004,and it began lower in rural than that in urban after 2005.Incidence of birth defects presented wave mode decline in Yunnan province from 1989 to 2002,It had went up somewhat from 2003 to 2004 and declined somewhat year by year from 2005 to 2007,rose perpendicularly from 2008 to 2010.The overall trend was upward with the passage of time(trend χ^2=6.054,P=0.014).2.The types and sequence of birth defects were that congenital heart disease,polydactyly,total harelip,auricle else malformation,N-tube defects,hydrocephalus and so on,congenital heart disease(CHD)rose to the first disease in China from 2005 to 2014,and the incidence of CHD was 42.66/10,000 from 2010 to 2014.In Yunnan Province,main birth defects were cleft lip and palate,polydactyly,horseshoe varus and so on in 1992 and before.Congenital heart disease entered the top five diseases of birth defects for the first time in 1996,went up the fourth place in 2007 and the third place in 2008,and ranked the first steadily after 2009.3.The incidence of congenital heart disease(CHD)was the highest in Zhejiang,Guangdong,Shaanxi,Hunan and Yunnan provinces,with the exception of Guizhou,Jiangsu and Qinghai provinces,it was the first birth defects disease in other 27 provinces

关 键 词：出生缺陷 先天性心脏病 流行趋势 云南省 

分 类 号：R541.1[医药卫生—心血管疾病]