南京地区学龄前儿童先天性心脏病的流行病学调查分析  

Epidemiological investigation of congenital heart disease in preschool children in Nanjing

作　　者：闵卫红 陈梅[1] 殷杰[1] MIN Weihong;CHEN Mei;YIN Jie(Children’s Hospital Affiliated to Nanjing Medical University,Jiangsu Nanjing 210000,China)

机构地区：[1]南京医科大学附属儿童医院,江苏南京210000

出　　处：《中国妇幼健康研究》2022年第3期23-27,共5页Chinese Journal of Woman and Child Health Research

基　　金：国家自然科学基金资助项目(8210079)。

摘　　要：目的了解南京地区学龄前儿童先天性心脏病(CHD)的现况并分析相关影响因素。方法向南京市11个市辖区幼儿园和托儿所的学龄前儿童家长发放调查问卷,调查儿童性别、民族、CHD和高血压家族史、母亲孕期情况等资料,筛选出CHD患儿疾病分类,并分析其相关影响因素。结果123505例儿童中发现CHD患儿453例,总患病率为3.67‰;其中房间隔缺损(ASD)比例最高,占37.55%,其次分别为室间隔缺损(VSD,占28.70%)、动脉导管未闭(PDA,占15.89%)、肺动脉瓣狭窄(PS,占5.08%)、法洛四联症(TOF,占3.97%)和主动脉瓣狭窄(AS,占0.88%),合并2种心脏缺陷和3种心脏缺陷的比例分别为6.62%和1.10%。多因素Logistic回归分析表明CHD家族史(OR=4.941,95%CI:2.344~9.921)、母亲孕早期病毒感染史(OR=4.148,95%CI:2.232~8.310)和孕早期用药史(OR=3.007,95%CI:2.473~4.304)是CHD的独立危险因素(P<0.05)。结论CHD家族史、母亲孕早期病毒感染史和孕早期用药史都是CHD的独立危险因素,应做好CHD的预防措施,提高孕期保健的质量,对CHD患儿做到早发现并及时干预治疗。Objective To understand the occurrence of congenital heart disease(CHD)in preschool children in Nanjing and analyze related influencing factors.Methods Questionnaires were distributed to parents of preschool children in kindergartens and nurseries in 11municipal districts of Nanjing.The general clinical data such as sex,nationality,family history of CHD and hypertension and mother’s condition during pregnancy were collected.The disease types of children with CHD were selected,and the related factors were analyzed.Results A total of 453 children with CHD were found in 123505 subjects,with a total prevalence rate of 3.67‰.The proportion of atrial septal defect(ASD)was the highest,accounting for 37.55%,followed by ventricular septal defect(VSD,accounting for28.70%),patent ductus arteriosus(PDA,accounting for 15.89%),pulmonary valve stenosis(PS,accounting for 5.08%),tetralogy of Fallot(TOF,accounting for 3.97%)and aortic valve stenosis(AS,accounting for 0.88%),The proportions of heart defects combined with 2 types and 3 kinds of heart defects were 6.62%and 1.10%,respectively.Multivariate logistic regression analysis showed that family history of CHD(OR=4.941,95%CI:2.344-9.921),maternal history of virus infection in early pregnancy(OR=4.148,95%CI:2.232-8.310)and drug history in early pregnancy(OR=3.007,95%CI:2.473-4.304)were independent risk factors for CHD(P<0.05).Conclusion Family history of CHD,history of maternal viral infection in early pregnancy and drug history in early pregnancy are independent risk factors for CHD.Preventive measures for CHD should be taken,the quality of health care during pregnancy should be improved,and children with CHD should be detected early and treated in time.

关 键 词：学龄前儿童 先天性心脏病 出生缺陷 流行病学调查 影响因素 

分 类 号：R17[医药卫生—妇幼卫生保健]