云南省58262名3~14岁儿童的先天性心脏病流行病学特征和危险因素分析  

Prevalence and related risk factors of congenital heart disease among 58262 Chinese children aged 3-14 years in Yunnan

作　　者：刘勇 张雅永[2] 韩燊[2] 张蕊 肖本山 曹宇 蒋立虹[3] LIU Yong;ZHANG Ya-yong;HAN Shen;ZHANG Rui;XIAO Ben-shan;CAO Yu;JIANG Li-hong(Affiliated Hospital of North Sichuan Medical College,Department of Cardiovascular Surgery,Nanchong 637000,China;Yan’an Affiliated Hospital of Kunming Medical University,Department of Cardiovascular Surgery,Kunming 650051,China;The First People’s Hospital of Yunnan Province,Department of Cardiovascular Surgery,Kunming 650032,China)

机构地区：[1]川北医学院附属医院心脏大血管外科,四川省南充市637000 [2]昆明医科大学附属延安医院心血管外科 [3]云南省第一人民医院心血管外科

出　　处：《中国心血管病研究》2023年第2期166-171,共6页Chinese Journal of Cardiovascular Research

基　　金：中国科学院“西部之光”人才培养引进计划[(2020)82]。

摘　　要：目的分析云南省儿童先天性心脏病的流行病学特征及危险因素。方法对云南省不同民族和不同海拔地区儿童进行横断面研究。对2016年3月至12月参与昆明医科大学附属延安医院流行病学调查的云南省58262名3~14岁儿童进行分析。包括11个民族,海拔高度70~3200 m。采用体格检查和心脏彩色多普勒超声心动图进行诊断。结果总共诊断先天性心脏病患儿404例,总患病率为6.96‰,其中房间隔缺损(ASD)是3~14岁年龄段最常见的先天性心脏病,患病率为4.38‰。患病率在不同海拔高度的差异有统计学意义(χ^(2)=30.81,P<0.001)。高海拔地区(OR=1.802,95%CI 1.517~2.141)、出生时低体重(OR=1.527,95%CI 1.062~2.194)、早产(OR=2.001,95%CI 1.108~3.936)、高龄产妇(OR=1.505,95%CI 1.104~2.052)、孕期感染(OR=1.251,95%CI 1.139~1.374)和先天性心脏病家族史(OR=1.269,95%CI 1.157~1.391)是先天性心脏病的危险因素。结论高海拔地区儿童先天性心脏病患病率明显高于低海拔地区,ASD是云南3~14岁年龄段最常见的先天性心脏病类型。在高海拔地区出生、出生低体重儿、早产、高龄产妇、孕期感染、CHD家族史等因素增加CHD患病风险。Objective To investigate the prevalence and major risk factors of congenital heart disease(CHD)in children in Yunnan,China.Methods The multiple-ethnic,multiple-altitude and cross-sectional study was performed in Yan’an Affiliated Hospital of Kunming Medical University.A total of 58262 children(3-14years)were recruited from March to December 2016.Eleven ethnics were covered with altitudes ranged from 70 to3200 meters.Physical examination and echocardiography were used as screening methods for CHD diagnosis.Results A total of 404 children were diagnosed with CHD.The overall prevalence of CHD was 6.96 per 1000live births among 58262 children.Atrial septal defect(ASD)was the most common CHD and the prevalence was4.38 per 1000 live births.The prevalence of CHD showed differently in diverse altitudes(ranged from 2.81 to10.83 per 1000 live births)and regions(ranged from 2.61 to 18.47 per 1000 live births).Some factors,such as high-altitude regions,low birth weight,premature,advanced maternal age,pregnant infections and familial history of CHD were the risk factors for CHD.Conclusion The higher prevalence of CHD was found among individuals who were born in the high-altitude regions.ASD was the most common CHD in children aged 3-14 years in Yunnan,China.Born in high-altitude regions,mountain area regions,lower birth weight,premature,advanced maternal age,pregnant infections,familial history of CHD contributed to the incidence of CHD.

关 键 词：先天性心脏病 房间隔缺损 室间隔缺损 流行病学 筛查 

分 类 号：R714.5[医药卫生—妇产科学]