先天性脊柱侧凸患儿心脏异常发生情况及影响因素  

Incidence and risk factors of cardiac anomalies in children with congenital scoliosis

作　　者：杨炎睿 张立 王迎松[1] 赵智[1] 钱赓浩 李韬[1] 施志约 宋智博 YANG Yanrui;ZHANG Li;WANG Yingsong;ZHAO Zhi;QIAN Genghao;LI Tao;SHI Zhiyue;SONG Zhibo(Department of Orthopedics,The Second Affiliated Hospital of Kunming Medical University,Kunming 650000,China;不详)

机构地区：[1]昆明医科大学第二附属医院骨科,云南昆明650000

出　　处：《山东医药》2025年第4期42-47,共6页Shandong Medical Journal

基　　金：云南省基础研究计划昆医联合专项面上项目(202401AY070001-223);云南省重点研发计划社会发展专项(202403AC100008);云南省中青年后备人才项目;昆明医科大学一流学科团队项目(2024XKTDYS05)。

摘　　要：目的观察先天性脊柱侧凸(CS)患儿心脏异常的发生情况并分析其影响因素,为临床筛查和干预提供参考。方法回顾性收集CS患儿149例,依据经胸超声心动图检查结果判定患儿是否存在心脏异常,根据心脏异常的具体特征分为先天性心脏病(CHD)及其他心脏异常(OCA)。收集患儿的基本信息及与CS相关的临床特征,比较合并与未合并CHD的CS患儿以及合并与未合并OCA的CS患儿的临床资料,采用二元Logistic回归分析筛选CS患儿合并心脏异常的影响因素。结果149例CS患儿中,共48例发生心脏异常,其中10例发生CHD(房间隔缺损1例、卵圆孔未闭4例、动脉导管未闭2例、左上腔静脉永存1例、右位心1例、CHD术后1例)、38例发生OCA[二尖瓣反流(轻度)14例、三尖瓣反流(轻度)34例、主动脉瓣反流4例、二尖瓣前叶增厚1例];心脏异常总发生率为32.21%,其中CHD发生率为6.71%、OCA发生率为25.50%。合并与未合并CHD的CS患儿以及合并与未合并OCA的CS患儿性别、年龄、民族、BMI分级、居住地海拔、主弯部位、主弯严重程度、主弯方向、胸廓纵横径比值比较差异均无统计学意义(P均>0.05)。二元Logistic回归分析结果显示,性别、年龄、民族、BMI分级、居住地海拔、主弯部位、主弯严重程度、主弯方向、胸廓纵横径比值均不是CS患儿发生心脏异常的影响因素(P均>0.05)。结论CS患儿中CHD的发生率为6.71%,最常见的类型为卵圆孔未闭;OCA的发生率为25.50%,以三尖瓣反流最为常见。未发现性别、年龄、民族、BMI、居住地海拔、主弯部位、主弯严重程度、主弯方向及胸廓纵横径比值等因素与CS患儿心脏异常的发生存在显著关联。Objective To observe the occurrence of cardiac anomalies in children with congenital scoliosis(CS)and to analyse their influencing factors,so as to provide reference for clinical screening and intervention.Methods A to-tal of 149 children with CS were retrospectively collected,and the presence of cardiac anomalies was determined based on the results of transthoracic echocardiography,and the cardiac anomalies were classified into congenital heart disease(CHD)and other cardiac anomalies(OCA)according to the specific features of the anomalies.Basic information and clini-cal characteristics related to CS were collected,and the clinical data of CS patients with and without CHD and CS patients with and without OCA were compared,and binary Logistic regression analysis was used to screen the influencing factors of CS patients with cardiac anomalies.Results Among 149 CS children,a total of 48 cases developed cardiac abnormali-ties,including 10 cases of CHD(atrial septal defect 1,patent foramen ovale 4,patent ductus arteriosus 2,left superior ve-na cava perpetuum 1,dextrocardia 1,and postoperative CHD 1),and 38 cases of OCA[14 cases of mitral regurgitation(mild),34 cases of tricuspid regurgitation(mild),and 4 cases of aortic regurgitation,and 1 case of mitral valve anterior leaflet thickening];the overall incidence of cardiac abnormalities was 32.21%,of which the incidence of CHD was 6.71%and the incidence of OCA was 25.50%.The differences in gender,age,ethnicity,BMI classification,altitude of residence,site of primary curvature,severity of primary curvature,direction of primary curvature,and the ratio of the lon-gitudinal diameter to the transverse diameter of the thoracic cavity were not statistically significant between CS patients with and without CHD,and CS patients with and without OCA(all P>0.05).The results of binary Logistic regression analysis showed that gender,age,ethnicity,BMI classification,altitude of place of residence,site of major curvature,severity of major curvature,direction of major curvature,and the

关 键 词：先天性脊柱侧凸 心脏异常 先天性心脏病 影响因素 

分 类 号：R682.13[医药卫生—骨科学]