阿克苏地区儿童先天性心脏病流行病学特征及危险因素分析

Epidemiological Characteristics and Risk Factors Analysis of Congenital Heart Disease in Children in Aksu Region

摘要: 目的：探讨阿克苏地区儿童先天性心脏病(congenital heart disease, CHD)的流行病学特征及影响因素，为CHD的一级预防和病因学研究提供参考依据。方法：对阿克苏地区儿童进行横断面研究，对2021年11月~2022年3月阿克苏地区流行病学调查中0~14岁儿童进行分析，总共18,878人。采用体格检查和心脏彩色多普勒超声心动图进行诊断，并通过对确诊病例和健康儿童发放调查问卷，进行病例对照研究，分析CHD的影响因素。结果：总共确诊CHD患儿274例，总患病率为14.5‰，其中房间隔缺损发病率最高为3.92‰，室间隔缺损次之。多因素Logistic回归分析表明：母亲妊娠年龄(OR = 1.681, 95% CI: 1.250~2.261)、流产次数(OR = 2.011, 95% CI: 1.031~3.924)、孕早期感染(OR = 2.758, 95% CI: 1.226~6.201)、吸烟史(主动/被动) (OR = 1.684, 95% CI: 1.112~2.548)均是CHD的独立危险因素；服用叶酸(OR = 0.249, 95% CI: 0.126~0.494)是CHD的独立保护因素。影响维吾尔族、汉族发生CHD的影响因素存在差异(χ² = 16.2, P < 0.05)。结论：CHD发病是受多种危险因素影响的结果，阿克苏地区人口的CHD危险因素存在差异，对新疆地区精准开展CHD一级预防工作有指导意义。

Abstract: Objective: To investigate the epidemiological characteristics and influencing factors of congenital heart disease (CHD) in children in Aksu Region, and to provide a reference for the primary preven-tion and etiological research of CHD. Methods: A cross-sectional study was conducted on 18,878 children aged 0~14 years in the epidemiological survey of Aksu Region from November 2021 to March 2022. Physical examination and cardiac color Doppler echocardiography were used for diag-nosis. Case-control study was carried out by distributing questionnaires to diagnosed cases and healthy children to analyze the influencing factors of CHD. Results: A total of 274 children were di-agnosed with CHD, with a total morbidity of 14.5‰. Atrial septal defect had the highest incidence of 3.92‰, followed by ventricular septal defect. Multivariate logistic regression analysis showed that maternal age at pregnancy (OR = 1.681, 95% CI: 1.250~2.261), number of abortions (OR = 2.011, 95% CI: 1.031~3.924), early pregnancy infection (OR = 2.758, 95% CI: 1.226~6.201), smoking his-tory (active/passive) (OR = 1.684, 95% CI: 1.112~2.548) were independent risk factors for CHD; taking folic acid (OR = 0.249, 95% CI: 0.126~0.494) was an independent protective factor against CHD. There were differences in influencing factors of CHD occurrence between Uygur and Han popu-lations (χ² = 16.2, P < 0.05). Conclusion: The morbidity of CHD is the result of multiple risk factors. There are differences in CHD risk factors among the population in Aksu area. It has guiding signifi-cance for carrying out precise primary prevention of CHD in Xinjiang.