重庆三峡库区先天性心脏病与环境因素的相关性

目的:探讨重庆三峡库区环境因素对儿童先天性心脏病的相关影响,为先天性心脏病人群干预及其病因学研究提供参考。方法:利用重庆市病残儿医学鉴定平台,收集、回访、调查、整理三峡库区所属区、县5645例病残儿医学鉴定中筛选出先天性心脏病的患儿319例,分析先天性心脏病与库区环境因素之关系。结果:相关的危险因素顺位一是孕早期接触农药、杀虫剂、除草剂等;二是呼吸道感染与不慎用药史;三是接触皮鞋制造、印染、油漆、涂料、家具、化工原料如苯和铅等;四是不良生活习俗,如嗜烟、酒及长期食用经农药、生长激素、防腐剂等污染的食品、蔬菜、水果、肉类;五是孕妇自身疾病以及不良流产、高龄妊娠等;六是遗传因素,若父母之一为先天性心脏病患者,其子女的再发风险增加。结论:母亲在孕前、孕早期/长期接触不良环境因素,可明显增加儿童患先天性心脏病的风险。加强孕早期保健、防护,重视产前健康检查,对预防儿童先天性心脏病具有重要的现实意义。

The relativity of the congenital heart disease and the environmental factors in Three Gorges Reservoir area of Chongqing

Objective:To explore the influence of ironmental factors on the children with congenital heart defects in Three Gorges reservoir of Chongqing.And to provide the reference for intervening population with congenital heart disease and the etiology researches.Methods:Using the platform of Chongqing medical disability identification,319 cases of congenital heart disease from 5 645 cases of disability abuse with the medical identification in Three Gorges reservoir area's districts and counties were collected,returned,investigated and sorted out,and the relationship between congenital heart disease and environmental factors was analyzed.Results:The risk factors related sequence were the following :first:to exposure pesticides,insecticides,herbicides,etc in the early stages of pregnancy; second:to have the history of respiratory tract infection and medication accidentally; third:to exposure shoe manufacturing,printing and dyeing,paint,furniture,chemicals such as benzene,lead; fourth:to have bad customs such as smoking,drinking and long-term consumption of contaminated food,vegetables,fruits,meat by pesticides,Su-long reminder,preservatives,etc; fifth:pregnant women had the disease itself,non-performing abortions and old age pregnancy; sixth:genetic factors.Conclusion:The mother exposure long-term to bad environmental factors before pregnancy,pregnancy early can obviously increase the risk of the children suffering from congenital heart defects.It has am important practical significance for the prevention of children with congenital heart disease to strengthen the pregnant women's care,protection in the early stage of pregnancy and pay attention to prenatal health check-ups during pregnancy.