CAJ | 학술논문

目的调查2011年9月~2013年9月湖南省邵阳地区3~14岁儿童先天性心脏病流行病学特征。方法对邵阳地区158291名3~14岁幼儿园、小学一年级到初中二年级儿童按初筛、复筛、彩超多普勒确诊三个阶段进行调查。将该地区9县、3区先天性心脏病的患病率、病种分布、性别等各项指标进行了统计分析，并进行病因的调查研究。结果确诊先天性心脏病患者208例，总患病率为1.31‰，男性为1.12‰，女性为1.57‰（χ2=5.970，P<0.05）。9县3区中，新宁县、绥宁县、城步苗族自治区三县区先天性心脏病患病率分别为2.31‰、2.29‰、2.50‰，明显高于其他县区，不同县区之间发病率有统计学差异。病种构成以室间隔缺损占首位（54.32%），其次是房间隔缺损（19.71%）、动脉导管未闭（14.42%）。对母亲孕期相关暴露因素采用条件logistic回归模型多因素分析，得出本地先天性心脏病发生的危险因素为母孕3个月内病毒感染、先兆流产史及高龄妊娠。结论邵阳地区新宁县、绥宁县、城步苗族自治区三县区先天性心脏病患病率明显高于其他县区，女性患病率高于男性；当地的先天性心脏病构成以室间隔缺损和房间隔缺损为主。本地先天性心脏病发生的危险因素为母孕3个月内病毒感染、先兆流产史及高龄妊娠，因此应加强孕期保健，教育孕妇尽量避免暴露于危险因素中。
목적조사2011년9월~2013년9월호남성소양지구3~14세인동선천성심장병류행병학특정。방법대소양지구158291명3~14세유인완、소학일년급도초중이년급인동안초사、복사、채초다보륵학진삼개계단진행조사。장해지구9현、3구선천성심장병적환병솔、병충분포、성별등각항지표진행료통계분석，병진행병인적조사연구。결과학진선천성심장병환자208례，총환병솔위1.31‰，남성위1.12‰，녀성위1.57‰（χ2=5.970，P<0.05）。9현3구중，신저현、수저현、성보묘족자치구삼현구선천성심장병환병솔분별위2.31‰、2.29‰、2.50‰，명현고우기타현구，불동현구지간발병솔유통계학차이。병충구성이실간격결손점수위（54.32%），기차시방간격결손（19.71%）、동맥도관미폐（14.42%）。대모친잉기상관폭로인소채용조건logistic회귀모형다인소분석，득출본지선천성심장병발생적위험인소위모잉3개월내병독감염、선조유산사급고령임신。결론소양지구신저현、수저현、성보묘족자치구삼현구선천성심장병환병솔명현고우기타현구，녀성환병솔고우남성；당지적선천성심장병구성이실간격결손화방간격결손위주。본지선천성심장병발생적위험인소위모잉3개월내병독감염、선조유산사급고령임신，인차응가강잉기보건，교육잉부진량피면폭로우위험인소중。
Objective To make epidemiological investigation on the children of 3-14 years old with congenital heart disease from Sep. of 2011 to Sep. of 2013 in Shaoyang area. Methods Total 158 291 children of 3-14 years old from kindergardens,primary schools and GradeⅠtoⅡof Junior Middle School in Shaoyang area were selected through primary screening,secondary screening,and color Doppler examination for diagnosis,totally three stages for investigation. The indexes of prevalence rate of congenital heart disease, the distribution of the disease,and gender of the patients in nine counties and three districts in the area were statistically analyzed,and the cause of disease was investigated. Results 208 patients were diagnosed with congenital heart disease. The total prevalence rate was 1. 31‰,in which the male accounted for 1. 12‰ and the female accounted for 1. 57‰(χ2 =5. 970,P<0. 0s5). In the nine districts and three counties,the prevalence rates of congenital heart disease in Xinning County,Suining County,and Chengbu Miao Autonomous Region were 2. 31‰,2. 29‰,and 2. 50‰,respectively,significantly higher than those in other counties,and the incidence rates in different counties had statistically difference. In terms of the constituents of the disease,ventricular septal defect accounted for the first (54. 32%),followed by atrial septal defect(19. 71%)and patent ductus arteriosus(14. 42%). In terms of related disclosure factors of the mothers during pregnancy,multivariate conditional logistic regression model analysis was made and it was found that the major risk factors of congenital heart disease included virus infection within three months of the pregnancy,threatened abortion,and elderly pregnancy. Conclusion The prevalence rates of congenital heart disease in Xinning County,Suining County,and Chengbu Miao Autonomous Region in Shaoyang area were significantly higher than those in other counties,and the incidence rate of females is higher than males;the congenital heart disease in the area mainly includes ventricular septal defect and atrial septal defect. The major risk factors of congenital heart disease include virus infection within three months of the pregnancy,threatened abortion,and elderly pregnancy. Therefore,the education of health care during pregnancy should be strengthened,and pregnant women should avoid exposure to risk factors as possible.