嘉兴市20436例新生儿先天性心脏病流行病学调查

Congenital heart disease among 20 436 live births in jiaxing city

为取得嘉兴地区代表性的新生儿先天性心脏病（简称先心病）发病情况，对１９９２年１月１日～１９９５年１２月３１日嘉兴市市区产科出生的全部活产婴儿２０４３６例进行前瞻性调查。检出先心病２９４例，其中彩色多普勒超声心动图诊断２８４例，尸检确诊１０例。患病率１４．３９‰。以单纯性房间隔缺损（ＡＳＤ）２９．６％和单纯性室间隔缺损（ＶＳＤ）１９．４％居多，其中又以Ⅱ孔型ＡＳＤ和膜部ＶＳＤ最多。复合畸形占３７．１％，以动脉导管未闭（ＰＤＡ）＋ＡＳＤ（１１．９％）居多。出生～７天发生心力衰竭３６例，新生儿期死亡２４例，死亡率１．１７‰。以青紫型复杂畸形为主。提示：先心病的发生与母妊娠早期呼吸道感染有关（χ２＝２１．８４，Ｐ＜０．０１），ＰＤＡ与围产期窒息密切相关（χ２＝２８．００，Ｐ＜０．０１）。

To understand the prevalence of congenital heart diseases (CHD) in this area, in a 4 year prospective study the authors investigated 20 436 live births in Jiaxing City, in which 294 were diagnosed as having CHD by color Doppler blood flow mapping (CDFM) or autopsy. The incidence of CHD was 14.39‰. Eighty seven cases (29.6‰) had simple, atrial septal defect (ASD), the incidence of which ranked the first. Fifty seven cases (19.4%) had simple ventricular septal defect (VSD), which ranked the second of incidence. Among them complex deformity was 37.1%. Thirty six cases deveopled cardiac failure during the first week, and 24 died within the first 28 days. The mortality was 1.17‰. Most of those who died had complex deformity with phyoxemia. Epidemiologic survey of 294 cases of CHD showed that respiratory infection during early pregnancy was correlated greatly with the incidence of CHD. Asphyxia during perinatal period was correlated closely with the incidence of patent ductus arteriosus.