东北地区先天性马蹄内翻足病例-对照研究

A case-control study on Idiopathic Talipes Equinovarus in northeast region of China

目的探讨中国东北地区(辽宁、吉林,黑龙江省)先天性马蹄内翻足(Idiopathic Talipes Equinovarus,ITEV)发生的可能危险因素。方法以随访和问卷调查方式获得121个ITEV患者家系资料信息,同时选择220个正常者与其相匹配,进行病例-对照研究。结果排除9例因合并其他畸形的ITEV患者后,剩余112例,男性与女性患者比为2.6:1,双侧马蹄足约占50%;在单侧发病的病例中,右侧多于左侧。夏冬季发病率明显高于春秋季节。在众多环境因素中,母亲孕前及孕期服药在对照组与病例组之间差异有统计学意义(χ2=8.64及13.49,P<0.01);孕期胎儿发育受限占病例组总例数的65.2%,与对照组相比差异有统计学意义(χ2=49.29,P<0.01),是ITEV的高危因素;母亲孕期吸烟、饮酒及患病史在病例组及对照组间差异无统计学意义(P>0.05)。结论母亲孕前及孕期用药、胎儿发育受限可能是ITEV的危险因素。

Objective To investigate the proper etiology of Idiopathic Talipes Equinovarus（ITEV）in Liaoning, Jilin and Heilongiang province of China. Methods 121 proposita data information were obtained by follow-up and questionnaire survey. 220 normal person information matched with control group to complete case-control study for some risk factors of ITEV. Results 9 persons were excluded since they had some other deformities. After this process. 112 proposita were involved. The ratio of ITEV between male and female was 2.6 ： 1, and bilateral deformity was seen in 50 % or more of ITEV cases. And in unilateral cases, the right side was more often involved than that of left side. There were more ITEV births in summer/winter than that of spring/autumn. Among all environmental factors, taking medicine before or during pregnancy was significant difference between case and control group（x^2 = 8.64 and 13.49 ; P 〈 0.01 ）. And 65.2 % mother had abnormal uterus factors in ease group, which had significant difference compared with control group（x^2 = 49.29, P 〈 0.01 ）. There was no difference in maternal smoking, drinking and having disease during pregnancy between case and control group（ P 〉 0.05 ）. Conclusion Taking medicine before or during pregnancy and abnormal uterus factors may play important roles in etiology of ITEV,