云南省367例先天性心脏病患儿发病影响因素的研究
发布时间：2018-09-05 15:26
【摘要】：[目的]本研究旨在探讨我省先天性心脏病(Congenital heart disease,CHD)发病的影响因素,并对不同亚型CHD发病的影响因素进行初步分析,为提出针对性的预防措施提供参考,并为今后进一步开展不同CHD表型的病因学研究提供方向。[方法]采用病例对照研究的方法。选择昆明医科大学第一附属医院2016年1月至2016年12月期间于心内科、心外科、儿科住院部及心内科、心外科、儿科、儿保科门诊就诊的来自于我省各州、市、县的经心脏彩超、心血管CT确诊的367名0～10岁CHD患儿为病例组,同期随机选取我院儿科住院部、儿科、儿保科门诊就诊的来自于我省各州、市、县的无任何先天畸形的367名0～10岁儿童作为对照组。对两组患儿的父母采用统一的问卷调查表,由研究者本人当面询问填写,内容包括:母亲信息、父亲信息、儿童信息。采用Epidata3.1软件录入数据,采用SPSS20.0软件进行单因素及多因素logistic回归分析。[结果]本研究多因素logistic回归分析结果显示:母亲文化程度(OR=0.462,95%CI:0.326-0.654)、母亲不良生育史(OR=1.828,95%CI:1.520-2.197)、母亲孕早期发热(OR=2.675,95%CI:1.762-4.061)、母亲孕早期精神事件(OR=6.560,95%CI:4.407-9.766)、母亲孕早期被动吸烟(OR=4.092,95%CI:3.002-5.577)、母亲孕早期接触农药(OR=4.183,95%CI:1.829-9.565)、母亲孕期补充营养(OR=0.112,95%CI:0.033-0.377)、父亲文化程度(OR=0.261,95%CI:0.122-0.558)与CHD的发生有关联。不同亚型CHD发病的影响因素不完全相同,影响房间隔缺损(Atrial septal defect,ASD)发生的因素为母亲文化程度(OR=0.476,95%CI:0.275-0.826)、母亲不良生育史(OR=2.625,95%CI:1.781-3.869)、母亲孕早期接触农药(OR=6.007,95%CI:3.812-9.466)、母亲孕早期精神事件(OR=3.967,95%CI:2.397-6.565);影响室间隔缺损(Ventricular septal defect,VSD)发生的因素为母亲文化程度(OR=0.215,95%CI:0.102-0.455)、母亲不良生育史(OR=2.257,95%CI:1.396-3.648)、母亲孕早期精神事件(OR=5.028,95%CI:2.979-8.485)、母亲孕早期被动吸烟(OR=2.807,95%CI:1.624-4.849)、父亲接触农药(OR=2.625,95%CI:1.763-3.907);影响动脉导管未闭(Patent ductus arteriosus,PDA)发生的因素为母亲文化程度(OR=0.763,95%CI:0.654-0.891)、母亲不良生育史(OR=1.923,95%CI:1.003-3.687)、母亲孕早期精神事件(OR=3.180,95%CI:1.777-5.692)、胎数2(OR=1.556,95%CI:1.383-1.750);影响复杂CHD发生的因素为母亲孕早期发热(OR=3.080,95%CI:1.228-7.723)及出生体重异常(OR=3.831,95%CI:2.026-7.243)。[结论]1、母亲不良生育史、母亲孕早期发热、母亲孕早期精神事件、母亲孕早期被动吸烟、母亲孕早期接触农药是CHD的危险因素;2、父母文化程度高、母亲孕期补充优质蛋白、以叶酸为主的多种维生素及微量元素为CHD的保护因素;3、导致不同亚型CHD发生的影响因素不完全相同;4、提高父母文化程度,加强孕前遗传咨询和筛查,重视孕期心理健康保健,合理营养,预防感染,避免接触二手烟及农药,以预防和减少各型CHD的发生。
[Abstract]:[objective] to explore the influencing factors of congenital heart disease (Congenital heart disease,CHD) in our province, and to analyze the influencing factors of different subtypes of CHD. It also provides the direction for further research on the etiology of different CHD phenotypes. [methods] A case-control study was conducted. From January 2016 to December 2016, the first affiliated Hospital of Kunming Medical University was selected from the outpatient clinics of Department of Cardiology, Cardiology, Department of Pediatrics and Cardiology, Cardiology surgery, Department of Pediatrics, Department of Pediatrics and Paediatrics from the states, cities and counties of our province. At the same time, 367 patients with 10 years old CHD diagnosed by cardiovascular CT were randomly selected from the inpatient department of pediatrics, and pediatric care department from the provinces and cities of our province. 367 0-year-old 10-year-old children without any congenital malformations in county were used as control group. The parents of the two groups were investigated with a unified questionnaire, which was filled out by the researcher in person. The contents included: mother information, father information, and children information. Epidata3.1 software was used to input data and SPSS20.0 software was used to carry out univariate and multivariate logistic regression analysis. [results] the results of multivariate logistic regression analysis showed that: mother's education level (OR=0.462,95%CI:0.326-0.654), mother's bad birth history (OR=1.828,95%CI:1.520-2.197), mother's first trimester fever (OR=2.675,95%CI:1.762-4.061), mother's early mental event (OR=6.560,95%CI:4.407-9.766), mother's passive smoking (OR=4.092,95%CI:3.002-5.577), mother's early pregnancy contact. Pesticides (OR=4.183,95%CI:1.829-9.565), maternal supplemental nutrition (OR=0.112,95%CI:0.033-0.377) and father's education (OR=0.261,95%CI:0.122-0.558) were associated with the occurrence of CHD. The influencing factors of different subtypes of CHD were not identical. The factors that affect the occurrence of atrial septal defect (Atrial septal defect,ASD) are OR=0.476,95%CI:0.275-0.826, OR=2.625,95%CI:1.781-3.869, OR=6.007,95%CI:3.812-9.466, OR=3.967,95%CI:2.397-6.565 and (Ventricular septal defect,VSD. 鍖栫▼搴，
本文编号：2224683
[Abstract]:[objective] to explore the influencing factors of congenital heart disease (Congenital heart disease,CHD) in our province, and to analyze the influencing factors of different subtypes of CHD. It also provides the direction for further research on the etiology of different CHD phenotypes. [methods] A case-control study was conducted. From January 2016 to December 2016, the first affiliated Hospital of Kunming Medical University was selected from the outpatient clinics of Department of Cardiology, Cardiology, Department of Pediatrics and Cardiology, Cardiology surgery, Department of Pediatrics, Department of Pediatrics and Paediatrics from the states, cities and counties of our province. At the same time, 367 patients with 10 years old CHD diagnosed by cardiovascular CT were randomly selected from the inpatient department of pediatrics, and pediatric care department from the provinces and cities of our province. 367 0-year-old 10-year-old children without any congenital malformations in county were used as control group. The parents of the two groups were investigated with a unified questionnaire, which was filled out by the researcher in person. The contents included: mother information, father information, and children information. Epidata3.1 software was used to input data and SPSS20.0 software was used to carry out univariate and multivariate logistic regression analysis. [results] the results of multivariate logistic regression analysis showed that: mother's education level (OR=0.462,95%CI:0.326-0.654), mother's bad birth history (OR=1.828,95%CI:1.520-2.197), mother's first trimester fever (OR=2.675,95%CI:1.762-4.061), mother's early mental event (OR=6.560,95%CI:4.407-9.766), mother's passive smoking (OR=4.092,95%CI:3.002-5.577), mother's early pregnancy contact. Pesticides (OR=4.183,95%CI:1.829-9.565), maternal supplemental nutrition (OR=0.112,95%CI:0.033-0.377) and father's education (OR=0.261,95%CI:0.122-0.558) were associated with the occurrence of CHD. The influencing factors of different subtypes of CHD were not identical. The factors that affect the occurrence of atrial septal defect (Atrial septal defect,ASD) are OR=0.476,95%CI:0.275-0.826, OR=2.625,95%CI:1.781-3.869, OR=6.007,95%CI:3.812-9.466, OR=3.967,95%CI:2.397-6.565 and (Ventricular septal defect,VSD. 鍖栫▼搴，
本文编号：2224683
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