乌鲁木齐3~36月龄儿童先心病危险因素调查

目的 了解乌鲁木齐地区3~36月龄儿童先天性心脏病(先心)的患病情况及其流行特征.方法 对2014年6月至2015年2月在乌鲁木齐市妇幼保健院儿保科门诊进行健康体检的3~36月龄儿童开展先天性心脏病的普查,对所有儿童进行问诊、体格检查和彩色多普勒超声心动图检查,并对先天性心脏病的患病率、病种分布及影响因素进行统计学分析.结果 共确诊先天性心脏病儿童56名,其中房间隔缺损16人(0.59%)、室间隔缺损23人(0.84%)、动脉导管未闭11人(0.40%);对27项影响因素进行Logistic回归分析发现:是否患先天性心脏病与患儿月龄(χ2=-3.97,P=0.000)、家距马路距离(χ2=6.74,P=0.000)、孕期宫内发育迟缓(χ2=2.96,P=0.003)、宫内窘迫(χ2=4.59,P=0.000)有关联,且差异均具有统计学意义;同时与母亲孕龄(χ2=2.38,P=0.017)、孕期体检次数(χ2=-6.34,P=0.000)、孕期是否患有上呼吸道感染(χ2=5.52,P=0.000)及不良嗜好(χ2=4.81,P=0.000)有关联,且差异均具有统计学意义.结论 该地区儿童先天性心脏病检出率高于全国水平,先天性心脏病的构成比与同类文献报道相似;孕妇健康状况对先天性心脏病的发生有明显影响,应高度关注.

Investigation on risk factors of congenital heart disease of children aged 3-36 months in Urumqi

Objective To investigate the prevalence and epidemiological characteristics of congenital heart disease(CHD)in children aged 3-36 months in Urumqi area.Methods Screening of CHD was carried out in children aged 3-36 months receiving health examination at Child Health Care Department of Urumqi Maternal and Child Health Care Hospital from June 2014 to February 2015.All children underwent interrogation, physical examination and color Doppler echocardiography.Prevalence, distribution and influencing factors of congenital heart disease were analyzed.Results A total of 56 children were diagnosed with CHD, including 16 patients with atrial septal defect (0.59%), 23 patients with ventricular septal defect (0.84%), and 11 patients with patent ductus arteriosus (0.40%).Logistic regression analysis on 27 factors showed that CHD was related with age of children (χ2=-3.97,P=0.000), distance between home and road (χ2=6.74,P=0.000), intrauterine growth retardation (χ2=2.96, P=0.003), fetal distress (χ2=4.59, P=0.000), and differences were statistically significant.It was also related with gestational age of mother (χ2=2.38,P=0.017), physical examination times during pregnancy (χ2=-6.34,P=0.000), upper respiratory infection status during pregnancy (χ2=5.52,P=0.000) and bad habits (χ2=4.81,P=0.000), and the differences had statistical significance.Conclusion Detection rate of CHD in Urumchi is higher than national level.Constituent ratio of CHD is similar with what reported in similar literatures.Health status of pregnant women has a significant impact on incidence of congenital heart disease, which should attract great attention.