1988～1991年中国神经管缺陷和唇腭裂畸形率分析

Analyses of the Prevalences for Neural Tube Defects and Cleft Lip and Palate in China from 1988 to 1991

报道我国１９８８～１９９１年出生缺陷动态监测期间两类主要出生缺陷——神经管缺陷（ＮＴＤ）和唇腭裂（ＣＬＰ）的监测结果。资料的收集采用以医院为基础的监测方法。１９８８年１月至１９９１年１２月，共监测２７５０５８８例围产儿，查出先天畸形儿２８１６８例，畸形总率为１０２．４／万，其中ＮＴＤ６８８５例，畸形率为２５．０／万。ＮＴＤ的发病在我国存在着明显的地理差异，以北方为高（尤以太行山脉周围地区最高），从北到南，逐渐下降。ＣＬＰ４５４８例，畸形率为１６．５／万。全国各省份唇腭裂的畸形率波动在１１．２／万～２５．７／万之间。ＮＴＤ的发生有明显的季节波动，以冬季为发生高峰。ＮＴＤ的性别比例为０．５９，女性围产儿畸形率（３２．１／万）明显高于男性（１７．４／万）（Ｐ＜０．０１）。ＣＬＰ的性别比例为１．３３，男性患儿多于女性。但腭裂的性别比例为０．８０，与唇裂或唇裂合并腭裂的性别比例（１．４６）比较有显著性差异（Ｐ＜０．０１）。城乡围产儿ＮＴＤ畸形率分别为１４．４／万和４４．３／万，两者间有显著性差异（Ｐ＜０．０１），乡村围产儿ＮＴＤ畸形率是城镇的３．０倍。城乡围产儿ＣＬＰ畸形率无显著性差异（Ｐ＞０．０５）。

This paper reports the monitoring re-sults of two main categories of birth defects-neuraltube defects(NTD)and cleft of lip and palate(CLP )in China during the period of continuous monitoring(1988-1991).The method of hospital-based monitor-ing was adopted for data collection. From Jan. 1988 toDec.1991,a total of 2 750 588 births were monitored,and 28 168 cases of congenital malformations wereidentified. The prevalence of total birth defects was102.4 per 10 000.6885 cases of NTD were identifiedduring this period,the prevalence of NTD being 25.0per 10 000. The prevalence of NTD varied geographi-cally;it declined gradually from the north to the southof China with the highest rate of NTD in the TaihangMountain Regions. A total of 4548 cases of CLP wereidentified, and the provincial prevalence of CLP variedfrom 11.2 to 25.7 per 10000 with a mean of 16.5 per10000. The prevalence of NTDs varied seasonally withthe peak in winter(January).The sex ratio of NTDwas 0.59,the prevalences in female births(32. 1 per10 000) being higher than that in male births (17.4 per10 000)(P<0.01 ).The sex ratio of CLP was 1.33.Asignificant difference was noted between the sex ratioof cleft palate( 0. 80 ) and that of the total cleft lip(1.46)(P<0.01 ).The prevalence of NTD in ruralareas (44. 3 per 10 000)was 3 times as high as that inurban areas (14. 4 per 10 000),but no difference in oc-currence of CLP was observed between the urban andrural areas(P>0.05).