兰州市先天性心脏病的影响因素分析

详细信息    查看全文 | 推荐本文 |

英文篇名：Analysis of influence factors of congenital heart disease in Lanzhou City, China 作者：周立 ; 杨龙刚 ; 周秀芳 ; 李玲 ; 王洁 ; 白亚娜 ; 程宁 ; 王敏珍 ; 马莉 ; 王瑞娟 英文作者：Zhou Li;Yang Long-gang;Zhou Xiu-fang;Li Ling;Wang Jie;Bai Ya-na;Cheng Ning;Wang Min-zhen;Ma Li;Wang Rui-juan;Department of Neonatology, Lanzhou City Maternity and Child-care Hospital;School of Public Health, Lanzhou University;Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences,Lanzhou University; 关键词：先天性心脏病 ; 检出率 ; 影响因素 ; Logistic回归 ; 兰州市 英文关键词：congenital heart disease;;incidence rate;;influence factor;;Logistic regression;;Lanzhou City 中文刊名：LZYX 英文刊名：Journal of Lanzhou University(Medical Sciences) 机构：兰州市妇幼保健院新生儿科;兰州大学公共卫生学院;兰州大学基础医学院甘肃省新药临床前研究重点实验室; 出版日期：2019-02-08 出版单位：兰州大学学报(医学版) 年：2019 期：v.45;No.175 基金：兰州市人才创新创业项目(2015-RC-33,2016-RC-25) 语种：中文; 页：LZYX201901005 页数：5 CN：01 ISSN：62-1194/R 分类号：22-26

摘要

目的掌握兰州市新生儿先天性心脏病(CHD)的发生情况及流行特征,初步探讨其发生的影响因素。方法采用1∶2病例对照研究方法,选择兰州市妇幼保健院2015—2018年所有新生儿中明确诊断为CHD患儿112例为病例组,根据出生日期相近原则选择224例正常新生儿为对照组,采用条件Logistic回归揭示CHD的潜在影响因素。结果本研究共调查新生儿5 644名,CHD患儿112例,占1.98%,其中男性53例,女性59例。对CHD患儿的亚型分析显示,动脉导管未闭和房室间隔缺损占比最大,分别为30例(26.8%)、29例(25.9%)。多因素分析结果显示影响CHD患儿发生的主要危险因素有:产前感染(OR=1.324,95%CI:[1.180,1.480])和新生儿体重异常(OR=7.197,95%CI:[3.009,17.211])。结论兰州市近几年新生儿CHD发生率较高,产前感染及新生儿体重异常是新生儿发生CHD的潜在风险因素。
        Objective To master the occurrence and epidemiological characteristic of congenital heart disease(CHD) in Lanzhou City, preliminarily discuss the influence factors of them. Methods We used 1∶2 casecontrol study design, 112 cases of newborns with CHD who were definitely diagnosed in Lanzhou City Maternity and Child-care Hospital from 2015 to 2018 were selected as the case group, based on the principle of proximity of birth dates, 224 normal newborns were selected as the control group, the potential influence factors of CHD were revealed by conditional Logistic regression. Results The study included 5 644 new-borns, there were 112 cases of CHD and the incidence rate of CHD was 1.98%. Among 112 cases of CHD,there were 53 males and 59 females. The subtypes of CHD included patent ductus arteriosus(PDA) and ventricular septal defect(VSD), which were accounting for the largest proportion 30(26.8%), 29(25.9%),respectively. The results of multivariate analysis showed that the major risk factors for CHD were maternal infection during pregnancy(OR = 1.324,95% CI: [1.180, 1.480])and abnormal weight of newborns(OR =7.197, 95% CI: [3.009, 17.211]). Conclusion The incidence rate of CHD in newborns is above normal in Lanzhou. Maternal infection during pregnancy and abnormal weight of newborn are potential risk factors for CHD in newborns.

引文

[1] Mahle WT, Newburger JW, Matherne GP, et al. Role of pulse oximetry in examining newborns for congenital heart disease:a scientific statement from the AHA and AAP[J]. Pediatrics, 2009, 124(2):823—836
    [2]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2016》概要[J].中国循环杂志, 2017, 32(6):521—530
    [3]刘珍.先天性心脏病的环境与遗传高危因素研究进展[J].实用妇产科杂志, 2011. 4(27):260—264
    [4]梁芳. 2005—2010年兰州市国家级监测点出生缺陷情况分析[J].中国妇幼保健, 2012, 27(23):3546—3548
    [5]潘丽,梁芳,常锐霞,等.兰州市2010—2014年围产儿出生缺陷现况分析[J].中国初级卫生保健, 2016, 30(1):36—38
    [6] Liu Xiao-cheng, Liu Gong-shu, Wang Ping, et al. Prevalence of congenital heart disease and its related risk indicators among 90 796 Chinese infants aged less than 6months in Tianjin[J]. International Journal of Epidemiology, 2015, 44(3):884—893
    [7] Wu Mei-huan, Chen Hui-chi, Lu Chan-wei, et al. Prevalence of congenital heart disease at live birth in Taiwan[J]. Journal of Pediatrics, 2010, 156(5):782—785
    [8]袁雪,王惠珊,闫淑娟,等. 10 665名儿童先天性心脏病发病状况监测结果和环境危险因素分析[J].中国妇幼保健, 2006, 21(6):781—783
    [9]李文成,申强,谭瑞明,等.怀化地区0~14岁儿童先心病流行病学调查[J].包头医学院学报, 2016, 32(4):10—11
    [10]聂志强,欧艳秋,陈寄梅,等. 2004—2011年广东省胎婴儿先天性心脏病危险因素分析[J].中华心血管病杂志,2013, 41(8):704—708
    [11]曲艳吉,刘小清,麦劲壮,等.不同先天性心脏病类型的环境危险因素分析[J].北京大学学报:医学版,2015, 47(3):420—430