CAJ | 학술논문

目的调查青海省不同海拔高度4～18岁藏族少年儿童先天性心脏病(CHD)流行病学特征.方法对海拔2535 m、3600 m和4200 m的32 578名藏族少年儿童按初筛、复筛、彩色多普勒超声心动图确定三个阶段进行调查;分析CHD不同海拔高度的患病率、病种分布、性别及各年龄组间变化.结果 3个地区(海东、黄南、果洛)查出CHD 235例,患病率为7.21‰.随着海拔的升高CHD患病率有所增加,分别为5.45‰、6.80‰和9.79‰.但海拔2535 m与3600 m之间CHD患病率差异无统计学意义(χ2=1.594,P＞0.05);海拔2535 m与4200 m、3600 m与4200 m之间CHD患病率的差异有统计学意义(χ2=7.002,P＜0.01;χ2=5.540,P＜0.05).在海拔2535 m地区各年龄组间CHD患病率差异无统计学意义,海拔3600 m、4200 m地区随着年龄增加CHD检出率也增加.各年龄组间比较,16～18岁组患病率最高,与4～7岁和8～12岁年龄组比较,差异有统计学意义(χ2=10.79,P＜0.005;χ2=5.60,P＜0.05).CHD的病种构成以房间隔缺损(ASD)为主(39.1%),室间隔缺损(VSD)其次(32.8%),动脉导管未闭(PDA)列第三(24.7%).但不同地区其构成比不同,海拔2535 m以VSD为首位,3600 m以ASD患病率最高42.8%,4200 m地区PDA占50.8%.结论藏族少年儿童CHD患病率、病种分布、性别及各年龄组间变化与海拔高度有关.
목적 조사청해성불동해발고도4～18세장족소년인동선천성심장병(CHD)류행병학특정.방법 대해발2535 m、3600 m화4200 m적32 578명장족소년인동안초사、복사、채색다보륵초성심동도학정삼개계단진행조사;분석CHD불동해발고도적환병솔、병충분포、성별급각년령조간변화.결과 3개지구(해동、황남、과락)사출CHD 235례,환병솔위7.21‰.수착해발적승고CHD환병솔유소증가,분별위5.45‰、6.80‰화9.79‰.단해발2535 m여3600 m지간CHD환병솔차이무통계학의의(χ2=1.594,P＞0.05);해발2535 m여4200 m、3600 m여4200 m지간CHD환병솔적차이유통계학의의(χ2=7.002,P＜0.01;χ2=5.540,P＜0.05).재해발2535 m지구각년령조간CHD환병솔차이무통계학의의,해발3600 m、4200 m지구수착년령증가CHD검출솔야증가.각년령조간비교,16～18세조환병솔최고,여4～7세화8～12세년령조비교,차이유통계학의의(χ2=10.79,P＜0.005;χ2=5.60,P＜0.05).CHD적병충구성이방간격결손(ASD)위주(39.1%),실간격결손(VSD)기차(32.8%),동맥도관미폐(PDA)렬제삼(24.7%).단불동지구기구성비불동,해발2535 m이VSD위수위,3600 m이ASD환병솔최고42.8%,4200 m지구PDA점50.8%.결론 장족소년인동CHD환병솔、병충분포、성별급각년령조간변화여해발고도유관.
Objective The epidemiological characteristics of congenital heart disease(CHD)among Tibetan children whose age ranged from 4 to 18 at different altitude were investigated in Qinghai province.Methods 32 578 Tibetan children living at 2535 m,3600 m and 4200 m were surveyed with the following 3 steps:prescreened,counterchecked and diagnosed with color Doppler.The entity distribution was then analysed and the age and gender were compared respectively.Resuits 235 CHD cases were identified.The total morbidity was 7.21‰.CHD morbidity was rising with the increase of altitude with 5.45‰ at 2535 m,6.80‰ at 3600 m and 9.79‰ at 4200 m respectively.There were significant static differences between 4200 m and the others with χ2=7.002(P＜0.01)to 2535 m and χ2=5.540(P＜0.05)to 3600 m.However,there was no statistical difference between 2535 m altitude and 3600 m altitude.The morbidity in different age had no statistical difference at 2535 m altitude but statistically increased with the increase of age at 3600 m and 4200 m.The total ratio of 16-18 age was significantly higher than other age periods with χ2=10.79(P＜0.005)to 4-7 age period and with χ2=5.60(P＜0.05)to 8-12 age period.The atrial septal defect(ASD)morbidity rates in three places was 39.1%followed by ventricular septal defect(VSD)with 32.8%and patent duetus arteriosus(PDA)with 24.7%.However,the constitute of CHD was different in different altitudes that VSD with 43.5%at 2535 m.ASD with 42.8%at 3600 m and PDA with 50.8%at 4200 m which was the highest morbidity.Conclusion Morbidity.constitutes and difference in gender and age were related to altitude.