CAJ | 학술논문

目的：了解珠海地区先天性心脏病（CHD）的流行状况，筛查与CHD相关的主要危险因素，为制订相应的干预措施提供依据。方法将2013年和2014年珠海市妇幼保健院和珠海市斗门区妇幼保健院出生的所有活产新生儿作为调查对象，调查CHD的流行状况。以确诊的CHD患儿为病例组，采用1：1配对病例对照研究方法，通过调查问卷的方式，调查其父母工作生活环境、生活行为习惯等因素。采用Logistic回归分析统计方法，筛查出珠海地区与CHD发病相关的高危因素。结果珠海地区2013年CHD发病率为0.83%。2014年CHD发病率为0.86%。最常见的心脏病类型为室间隔缺损，占56.03%。通过Logistic回归分析筛查出珠海地区CHD相关的高危因素，包括孕妇高龄（OR=3.74，P=0.000）、孕妇吸烟或被动吸烟（OR=1.52，P=0.009）、孕早期不良精神刺激（OR=2.08，P=0.000）、孕早期患呼吸道疾病（OR=13.06，P=0.014）、孕期化学毒物接触（OR=5.34，P=0.031）。结论珠海地区CHD发病率高，其中以简单型CHD为主。母亲应适龄怀孕、避免吸烟，孕期避免不良精神刺激及化学毒物的接触，预防感冒，以减少CHD的发生。
목적：료해주해지구선천성심장병（CHD）적류행상황，사사여CHD상관적주요위험인소，위제정상응적간예조시제공의거。방법장2013년화2014년주해시부유보건원화주해시두문구부유보건원출생적소유활산신생인작위조사대상，조사CHD적류행상황。이학진적CHD환인위병례조，채용1：1배대병례대조연구방법，통과조사문권적방식，조사기부모공작생활배경、생활행위습관등인소。채용Logistic회귀분석통계방법，사사출주해지구여CHD발병상관적고위인소。결과주해지구2013년CHD발병솔위0.83%。2014년CHD발병솔위0.86%。최상견적심장병류형위실간격결손，점56.03%。통과Logistic회귀분석사사출주해지구CHD상관적고위인소，포괄잉부고령（OR=3.74，P=0.000）、잉부흡연혹피동흡연（OR=1.52，P=0.009）、잉조기불량정신자격（OR=2.08，P=0.000）、잉조기환호흡도질병（OR=13.06，P=0.014）、잉기화학독물접촉（OR=5.34，P=0.031）。결론주해지구CHD발병솔고，기중이간단형CHD위주。모친응괄령부잉、피면흡연，잉기피면불량정신자격급화학독물적접촉，예방감모，이감소CHD적발생。
Objective To learn the prevalence of congenital heart disease (CHD) in Zhuhai and screen the major risk factors associated with CHD, so as to lay a foundation for the development of appropriate interventions. Methods The survey was conducted in all living newborns born in Zhuhai Maternal and Child Health Hospital and Doumen Maternal and Child Health Hospital of Zhuhai City in 2013 and 2014 to investigate the prevalence of CHD. A 1:1 matched case-control study was carried out, in which children diagnosed with CHD was the case group. Through a questionnaire survey, factors such as their parents' working and living environment, living habits and so on were explored. The Logistic regression analysis was used to screen out the high risk factors associated with the incidence of CHD in Zhuhai City. Results The incidence of CHD in Zhuhai was 0.83% in 2013 and 0.86%in 2014. The most common type of CHD was ventricular septal defect, accountted for 56.03%. High risk factors associated with CHD in Zhuhai included advanced maternal age (OR=3.74, P=0.000), smoking or passive smoking when pregnant (OR=1.52, P=0.009), adverse mental stimulation in early pregnancy (OR=2.08, P=0.000), suffering from respiratory diseases in early pregnancy (OR=13.06, P=0.014), and exposure to chemical poisons during pregnancy (OR=5.34, P=0.031). Conclusion CHD incidence is high in Zhuhai, mainly based on simple-type CHD. Mothers should get pregnant at the right age, avoid smoking and exposure to adverse mental stimulation and chemical poisons during pregnancy, prevent colds, maybe reduce the incidence of CHD.