CAJ | 학술논문

目的探讨围孕期多种危险因素暴露与先天性心脏病的发病之间的相关性.方法选择2012年3月1日至2013年10月1日在第四军医大学进行超声心动图检查确诊为先天性心脏病的435例(患病组)幼儿及574例(健康对照组)正常体检的儿童家庭作为观察对象,对其家庭一般情况及围孕期有毒环境因素暴露情况进行问卷调查.对采集的数据予以数量化和分级,输入SPSS 13.0数据库,经逻辑校对无误后应用x2检验,非条件Logistic回归分析方法进行资料分析.结果患病组幼儿体质量低于健康对照组(P＜0.01),但两组受检者在年龄、身高、心率及父母年龄方面差异均无统计学意义.父母的受教育程度在先天性心脏病患病组与健康对照组之间差异有统计学意义(P＜0.0t),且先天性心脏病组中父亲及母亲高中及以下受教育程度的比例明显高于健康对照组(父亲:86.7％比67.4％,母亲:83.4％比66.4％).圆锥干畸形和单纯室间隔缺损是发病率最高的先天性心脏病.药物、工作环境暴露和病毒性感染均与圆锥干畸形有很高的相关性(P＜0.01,OR值分别为6.74、3.73、2.82).药物、病毒感染、房屋装修、烫发染发及工作环境暴露均会增加单纯室间隔缺损的罹患风险(OR值分别为2.77、2.07、1.76、1.89、1.81).结论围孕期多种危险因素暴露与先天性心脏病发病存在显著的相关关系.
목적 탐토위잉기다충위험인소폭로여선천성심장병적발병지간적상관성.방법 선택2012년3월1일지2013년10월1일재제사군의대학진행초성심동도검사학진위선천성심장병적435례(환병조)유인급574례(건강대조조)정상체검적인동가정작위관찰대상,대기가정일반정황급위잉기유독배경인소폭로정황진행문권조사.대채집적수거여이수양화화분급,수입SPSS 13.0수거고,경라집교대무오후응용x2검험,비조건Logistic회귀분석방법진행자료분석.결과 환병조유인체질량저우건강대조조(P＜0.01),단량조수검자재년령、신고、심솔급부모년령방면차이균무통계학의의.부모적수교육정도재선천성심장병환병조여건강대조조지간차이유통계학의의(P＜0.0t),차선천성심장병조중부친급모친고중급이하수교육정도적비례명현고우건강대조조(부친:86.7％비67.4％,모친:83.4％비66.4％).원추간기형화단순실간격결손시발병솔최고적선천성심장병.약물、공작배경폭로화병독성감염균여원추간기형유흔고적상관성(P＜0.01,OR치분별위6.74、3.73、2.82).약물、병독감염、방옥장수、탕발염발급공작배경폭로균회증가단순실간격결손적리환풍험(OR치분별위2.77、2.07、1.76、1.89、1.81).결론 위잉기다충위험인소폭로여선천성심장병발병존재현저적상관관계.
Objective To evaluate the associations between the occurrence of congenital heart diseases (CHDs) in children and exposures to peri-conceptional multiple nongenetic risk factors.Methods For this age-matched case-control study,standardized data were collected from 435 families of children with CHD and 574 families of non-malformed children.The questionnaires were conducted on multiple nongenetic risk factors including paternal characteristics and conditions,maternal therapeutic drug exposure,housing renovation,hair perming and dyeing and parental occupational exposure.Results The CHD infants weighed less than control group (P ＜ 0.01).However two groups had no significant differences in age,height,parental age or heart rate.Educational levels of parents had a negative correlation with CHD.Conotruncal defect and simple ventricular septum defect were the most common cardiac abnormalities.Therapeutic drug exposure,viral infection and occupational exposure all had a high level of correlation with conotruncal defect (OR =6.74,OR =3.73,OR =2.82 respectively).And ventricular septum defect was associated with therapeutic drug exposure,home decoration,hair perming and dyeing and parental exposure of work environment (OR =2.77,OR =1.76,OR =1.89 respectively).Conclusion Multiple nongenetic risk factors may contribute to the occurrence of CHD.