CAJ | 학술논문

目的调查青海省6个州和海东地区3个县4～18岁少年儿童先天性心脏病(CHD)流行病学特征.方法共计对288 066名少年儿童按初筛、复筛、彩色多普勒超声心动图确定三级筛选方法.分析不同海拔、不同民族CHD患病率及病种分布,探讨性别间及各年龄段间CHD变化及与海拔高度的关系.结果查出CHD 1633例,总患病率为5.66‰.不同海拔(2000m～、3000m～、4000m～)患病率分别为4.89‰、5.71‰、8.74‰.不同海拔之间患病率差异有统计学意义(χ~2=54.696,P＜0.001),趋势分析表明随着海拔高度的上升总患病率明显增加(χ~2=41.826,P＜0.001).女性总患病率(6.95‰)明显高于男性(4.54‰),χ~2=73.79,P＜0.001.海拔2000m～地区男女性患病率差异无统计学意义(χ~2=0.807,P＞0.05).随海拔升高女性CHD的患病率高于男性,3000 m～(χ~2=84.733,P＜0.001)、4000 m～(χ~2=16.313,P＜0.001).海拔2000m～地区各年龄段间CHD患病率差异有统计学意义(χ~2=18.138,P＜0.001),但患病率不随年龄的增加而变化(χ~2=3.424,P＞0.05).海拔3000m～、4000m～地区CHD患病率随年龄增长而增加,差异有统计学意义(χ~2=19.230,P＜0.001;χ~2=26.894,P＜0.001).各民族间患病率的差异有统计学意义(χ~2=24.456,P＜0.001),其中蒙古族7.55‰、藏族6.40‰、汉族5.32‰、土族5.23‰、回族4.89‰、撒拉族2.22‰.CHD构成比以房间隔缺损(ASD)为主(37.42%),其次为动脉导管未闭(PDA)(28.47%)和室间隔缺损(VSD)(26.01%).但海拔不同其构成比又有不同,海拔2000 m～、3000 m～以ASD为首位,分别占37.80%、37.67%,4000 m～PDA占首位(46.36%).结论青海省4～7岁少年儿童CHD患病率、病种分布、性别间及各年龄段间变化与海拔高度有关.
목적 조사청해성6개주화해동지구3개현4～18세소년인동선천성심장병(CHD)류행병학특정.방법 공계대288 066명소년인동안초사、복사、채색다보륵초성심동도학정삼급사선방법.분석불동해발、불동민족CHD환병솔급병충분포,탐토성별간급각년령단간CHD변화급여해발고도적관계.결과 사출CHD 1633례,총환병솔위5.66‰.불동해발(2000m～、3000m～、4000m～)환병솔분별위4.89‰、5.71‰、8.74‰.불동해발지간환병솔차이유통계학의의(χ~2=54.696,P＜0.001),추세분석표명수착해발고도적상승총환병솔명현증가(χ~2=41.826,P＜0.001).녀성총환병솔(6.95‰)명현고우남성(4.54‰),χ~2=73.79,P＜0.001.해발2000m～지구남녀성환병솔차이무통계학의의(χ~2=0.807,P＞0.05).수해발승고녀성CHD적환병솔고우남성,3000 m～(χ~2=84.733,P＜0.001)、4000 m～(χ~2=16.313,P＜0.001).해발2000m～지구각년령단간CHD환병솔차이유통계학의의(χ~2=18.138,P＜0.001),단환병솔불수년령적증가이변화(χ~2=3.424,P＞0.05).해발3000m～、4000m～지구CHD환병솔수년령증장이증가,차이유통계학의의(χ~2=19.230,P＜0.001;χ~2=26.894,P＜0.001).각민족간환병솔적차이유통계학의의(χ~2=24.456,P＜0.001),기중몽고족7.55‰、장족6.40‰、한족5.32‰、토족5.23‰、회족4.89‰、살랍족2.22‰.CHD구성비이방간격결손(ASD)위주(37.42%),기차위동맥도관미폐(PDA)(28.47%)화실간격결손(VSD)(26.01%).단해발불동기구성비우유불동,해발2000 m～、3000 m～이ASD위수위,분별점37.80%、37.67%,4000 m～PDA점수위(46.36%).결론 청해성4～7세소년인동CHD환병솔、병충분포、성별간급각년령단간변화여해발고도유관.
Objective The epidemiological characteristics of congenital heart disease(CHD)in children aged from 4 to 18 years were investigated in Qinghai province.Methods Altogether 288 066 children inhabiting at 6 prefectures and 3 counties were examined by the following three steps:pre-screening,re-examination and diagnosis with color Doppler.And the entity distribution was analyzed while the differences were compared by age,gender,altitudes and nationalities respectively.Results Altogether 1633 cases of CHD were discovered.The total prevalence of CHD was 5.71‰.The prevalence of CHD was found to increase with the increase of altitude by 4.89‰ at the altitude of 2535 m,5.71‰ at 3600 m,and 8.74‰ at 4200 m respectively.There were significant differences among different altitude(χ~2=54.696,P＜0.001).χ~2 trend analysis showed the increase with χ~2=41.826(P＜0.001).The total incidence of CHD in females was 6.95‰,which was significantly higher than that in males with 4.54‰(χ~2=73.79,P＜0.001).There were significant differences between males and females at the altitude of 3000 m(χ~2=84.733,P＜0.001)and 4000 m (χ~2=16.313,P＜0.001)except at the altitude of 2000 m(χ~2=0.807,P＞0.05).The prevalence of CHD in different age groups was statistically significant at the every altitude of 2000 m(χ~2=18.138,P＜0.001),3000 m(χ~2=18.544,P＜0.001)and 4000 m(χ~2=27.535 P＜0.001).The prevalence of CHD was increasing with the increase of age groups at the altitude of 3000 m(χ~2=19.230,P＜0.001)and 4000 m(χ~2=26.894,P＜0.001)except at the altitude of 2000 m.Within the prevalence of CHD of different nationalities,there was a significant difference with χ~2=24.456(P＜0.001).Within the constituent rate of CHD,the prevalence of atrial septal defect(ASD)was as high as 37.42%,followed by the prevalence of patent ductus arteriosus(PDA)as 28.47% and ventricular septal defect(VSD)as 26.01%.Regarding the four categories of CHD,the constituent rate varied at different altitudes.For example,the prevalence rate of ASD constituted 37% at the altitude of 2000 m and 3000 m,and that of PDA accounted for 46.36% at the altitude of 4200 m.Conclusion The epidemiological characteristics of CHD in Qinghai children were possibly associated with altitude levels.