福建省2020—2022年新生儿先天性心脏病的流行病学特征  

Epidemiological Characteristics of Newborn Congenital Heart Disease in Fujian Province from 2020 to 2022

作　　者：许莹[1] 唐旭威 龚丽君 周策 陈良万[3] 胡志坚 廖东山[3] XU Ying;TANG Xuwei;GONG Lijun;ZHOU Ce;CHEN Liangwan;HU Zhijian;LIAO Dongshan(Department of Nutrition,Fujian Medical University Union Hospital,Fuzhou 350001,China;Department of Epidemiology and Health Statistics,School of Public Health,Fujian Medical University,Fuzhou 350122,China;Department of Cardiac Surgery,Fujian Medical University Union Hospital,Fuzhou 350001,China;Department of Maternal and Child Health,Fujian Provincial Health Commission,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院营养科,福州350001 [2]福建医科大学公共卫生学院流行病与卫生统计学系,福州350122 [3]福建医科大学附属协和医院心脏外科,福州350001 [4]福建省卫生健康委妇幼处,福州350001

出　　处：《福建医科大学学报》2023年第4期272-279,284,共9页Journal of Fujian Medical University

基　　金：福建省财政厅妇幼健康综合管理项目(21280020);福建省科技厅社会发展引导性项目(2023Y0023)。

摘　　要：目的分析福建省新生儿先天性心脏病(CHD)发病和筛查工作的时空分布特征,为地区开展防控工作提供建议。方法基于福建省新生儿CHD筛查工作信息管理系统数据,对筛查指标进行描述和SaTScan时空扫描分析,识别有统计学差异的时空异常聚集区,并计算识别区域的相对危险度(RR)。结果2020—2022年福建省CHD总筛查率、总筛查阳性率、总筛查阳性心脏超声检查率、总阳性确诊率和总发病率分别为89.66%、2.18%、58.29%、32.26%和6.30‰。其中,筛查率从2020年的70.58%增加至2022年的96.67%,发病率从2020年的5.02‰增加至2022年的7.16‰,筛查阳性心脏超声检查率从2020年的58.78%增加至2022年的64.52%,阳性确诊率从2020年的24.15%增加至2022年的42.78%,以上指标均呈增加趋势(P均<0.001)。筛查阳性率从2020年的2.95%下降至2022年的1.73%,指标呈下降的趋势(P<0.001)。时空扫描统计结果显示,晋江市(RR=2.53)、东山县(RR=3.73)、长汀县(RR=2.62)、仓山区(RR=2.06)和大田县(RR=1.97)为高发病率聚集中心(P<0.001)。晋安区(RR=0.18)、仙游县(RR=0.64)、永安市(RR=0.15)、南安市(RR=0.60)、漳浦县(RR=0.49)和惠安县(RR=0.57)为低筛查阳性心脏超声检查率聚集中心(P<0.001)。福州市城区、大田县和东山县同时处于高发病率和低筛查阳性心脏超声检查率聚集范围内(P<0.001)。结论福建省新生儿CHD筛查已经基本覆盖,筛查阳性心脏超声检查率分布不均衡,提示部分地区可能为CHD的高发区域,建议在福州市城区、大田县和东山县开展CHD病因学调查,同时进一步加强省内薄弱地区的筛查工作,强化核心技术环节。Objective To analyze the spatiotemporal distribution characteristics of congenital heart disease(CHD)among newborns in Fujian Province,and provide suggestions for the prevention of CHD.Methods The chi-square test and spatiotemporal scan analysis using SaTScan were employed to analyze data from the Fujian Province Newborn Congenital Heart Disease Screening Information Management System from 2020 to 2022.SaTScan identified clusters of spatiotemporal anomalies with statistical differences and calculates the relative risk(RR)of the identified regions.Results The total screening rate,screening positivity rate,rate of screening-positive patients who received echocardiography,positive diagnosis rate,and incidence rate of CHD were 89.66%,2.18%,58.29%,32.26%,and 6.30‰,respectively.The screening rate increased from 70.58%in 2020 to 96.67%in 2022,the incidence rate increased from 5.02‰in 2020 to 7.16‰in 2022,and the screening positive cardiac ultrasound rate increased from 58.78%in 2020 to 64.52%in 2022.The positive diagnosis rate increased from 24.15%in 2020 to 42.78%in 2022,and the above indicators showed an increasing trend(P<0.001).Meanwhile,the positive rate of screening decreased from 2.95%in 2020 to 1.73%in 2022,indicating a downward trend(P<0.001).Jinjiang(RR=2.53),Dongshan(RR=3.73),Changting(RR=2.62),Cangshan(RR=2.06),and Datian(RR=1.97)were the high\|incidence clustering centers(All P<0.001).Jinan District(RR=0.18),Xianyou County(RR=0.64),Yongan City(RR=0.15),Nan an City(RR=0.60),Zhangpu County(RR=0.49),and Hui an County(RR=0.57)were the low clustering centers of the rate of screening\|positive patients who underwent echocardiography(P<0.001).Fuzhou City District,Datian County,and Dongshan County were simultaneously located within the high\|incidence rate of CHD clustering range and the clustering range for low rate of screening\|positive patients who received echocardiography(P<0.001).Conclusion The screening for CHD in newborns in Fujian Province has achieved basic coverage;however,the rate of screening-po

关 键 词：先天性心脏病 福建省 筛查 时空分析 

分 类 号：R722.1[医药卫生—儿科] R181.3[医药卫生—临床医学]