2017—2021年北京市先天性心脏病流行病学资料分析  

Epidemiological analysis of congenital heart disease in Beijing from 2017 to 2021

作　　者：张雯[1] 徐宏燕[1] 张彦春[1] 刘凯波[1] Wen Zhang;Hongyan Xu;Yanchun Zhang;Kaibo Liu(Department of Perinatal Health Care,Beijing Obstetrics and Gynecology Hospital,Capital Medical University·Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院围产保健科,北京100026

出　　处：《中华妇幼临床医学杂志（电子版）》2023年第1期61-68,共8页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的探讨近年北京市胎儿/新生儿群体的先天性心脏病(CHD)流行病学特征及分析。方法选择2017年1月至2021年12月北京市出生缺陷监测系统内纳入监测的985603例围产儿中,被诊断为CHD的11356例胎儿/新生儿,包括宫内死胎、治疗性引产胎儿与活产、死产及7 d内死亡新生儿中的CHD患儿为研究对象。2017—2021年,各年被诊断为CHD的胎儿/新生儿与纳入监测的围产儿依次为:2113与243438、2276与214333、2426与218922、2192与161605及2349与147305例。采取流行病学描述性分析方法,对北京市出生缺陷监测系统胎龄为13周至生后7 d内(观察期)与胎龄为28周至生后7 d内(围产期)的胎儿/新生儿群体的CHD总体发生率与CHD不同分型发生率进行分析。本研究遵循的程序符合2013年新修订的《世界医学协会赫尔辛基宣言》要求。结果①2017—2021年,北京市出生缺陷监测系统观察期内的胎儿/新生儿群体的CHD总体发生率为1.15%(11356/985603),2017—2021年各年的CHD发生率依次为0.87%(2113/243438)、1.06%(2276/214333)、1.11%(2426/218922)、1.36%(2192/161605)、1.59%(2349/147305),并且呈逐年增高趋势。被确诊的11356例CHD胎儿/新生儿的染色体异常率为3.90%(444例),位居前3位的依次为18-三体(127例,28.60%),21-三体(104例,23.42%)与22q11.2缺失综合征(19例,4.28%);合并心外畸形的发生率为11.91%(1351/11356),心血管及循环系统之外各系统畸形占比从高到低依次为肌肉骨骼系统(326例,24.13%),泌尿系统(248例,18.36%)和神经系统(202例,14.95%);危重先天性心脏病(CCHD)发生率为0.20%(1938/985603)。②被确诊的11356例CHD胎儿/新生儿中,围产期确诊者为8882例,围产期CHD总体发生率为0.90%(8882/985603)。2017—2021年各年的围产期CHD发生率依次为0.62%(1520/243438)、0.82%(1868/214333)、0.86%(1892/218922)、1.12%(1808/161605)、1.30%(1910/147305),亦呈逐年增高趋势。2021年围产期CHD胎儿/新生儿单纯房间隔缺损�Objective To explore the epidemiological characteristics of fetal and neonatal congenital heart disease(CHD)in Beijing by analyzing the surveillance data of CHD in recent years.Methods From January 2017 to December 2021,a total of 985603 perinatal infants were monitored in the Beijing Birth Defects Surveillance System,among which 11356 fetuses/newborns were diagnosed with CHD,including intrauterine stillbirth,therapeutic induction of labor fetus and live birth,stillbirth and neonatal death within 7 d after birth.These 11356 CHD fetuses/newborns were selected in study.From 2017 to 2021,the number of diagnosed CHD fetuses/newborns and monitored perinatal infants were 2113 cases vs 243438 cases,2276 cases vs 214333 cases,2426 cases vs 218922 cases,2192 cases vs 161605 cases,and 2349 cases vs 147305 cases,respectively.By means of descriptive epidemiological analysis method,the overall incidence of CHD and the incidence of different types of CHD were analyzed in fetal/newborn population with gestational age of 13 weeks to 7 d after birth(observation period)and gestational age of 28 weeks to 7 d after birth(perinatal period)in Beijing Birth Defects Surveillance System.The procedures followed in this study were in line with World Medical Association Declaration of Helsinki revised in 2013.Results①From 2017 to 2021,the overall incidence of CHD in fetal/neonatal population was 1.15%(11356/985603)during observation period of Beijing Birth Defects Surveillance System.And the incidence of CHD during observation period from 2017 to 2021 was 0.87%(2113/243438),1.06%(2276/214333),1.11%(2426/218922),1.36%(2192/161605)and 1.59%(2349/147305)respectively,which showed an increasing trend.The chromosomal abnormality rate of 11356 CHD fetuses/newborns was 3.90%(444 cases),and the top three chromosomal abnormality were trisomy 18(127 cases,28.60%),trisomy 21(104 cases,23.42%)and 22q11.2 deletion syndrome(19 cases,4.28%).The incidence of extracardiac malformations of 11356 CHD fetuses/newborns was 11.91%(1351/11356),and the proportion

关 键 词：先天性心脏病 危重先天性心脏病 发病率 流行病学研究 房间隔缺损 室间隔缺损 动脉导管未闭 卵圆孔 未闭 围产期 胎儿 婴儿 新生 

分 类 号：R541.1[医药卫生—心血管疾病] R181.3[医药卫生—内科学]