国人尿道下裂的流行病学特征

An epidermiological investigation of hypospadias in China

利用１９８７～１９９２年间中国出生缺陷监测网收集的资料，描述国人围产儿尿道下裂的发生水平及其流行病学特征。采用以医院为基础的监测方法收集资料。调查对象为孕２８周到产后７天住院分娩的围产儿，包括活产、死胎、死亡和７天内死亡者。尿道下裂定义为：以尿道异常开口于阴茎腹侧或会阴为特征的先天畸形。病例包括单发和多发。Ｐｏｉｓｏｎ回归用于检验长期趋势和季节波动。结果：１９８７～１９９２年间，国人男性围产儿中尿道下裂的发生率为４３０／万，单发为３３８／万，多发为０９２／万。城市男性围产儿尿道下裂发生率为５０２／万，乡村为２９５／万，城市高于农村。上海、福建、广东、广西的尿道下裂发生率均在８０／万以上。８７２％的尿道下裂患儿是存活的。没有发现尿道下裂发生有长期趋势和季节性波动。２１４％的尿道下裂合并有其它畸形，最常合并的是泌尿生殖系统畸形，尤其是睾丸未降，占全部病例的６５％。本调查结果显示，我国平均２３２５个男性围产儿中有１例不同程度的尿道下裂；上海、福建、广东、广西的发生率较高；城市的尿道下裂发生率明显高于农村。

During 1987 to 1992,hospitalbased cluster sampling method was adopted for collecting the data to investigate the incidence of hypospadias in China.All alive or still births over that period with 28 weeks of gestation or more were assessed within 7 days of delivery.The incidence of hypospadias in China was 4.30 per 10 000 male births,in 3.38 of which the hypospadias being the sole malformation while in the other 0.92 with concomitant other malformations.The incidence in urban areas (5.02 per 10 000 male births) was higher than that in rural areas (2.95 per 10 000 male births).The incidence in Shanghai,Fujian,Guangdong and Guangxi was more than 8 per 10 000 male births.97.2% of the hypospadias cases have been alive.No secular or seasonal fluctuation has been observed.21.4% of the cases had at least one another anomaly,the most frequent being other malformations of the genitourinary system especially cryptoorchidism,ocurring in 6.4% of all the cases.1 in every 2 325 male born in China has some degree of hypospadias.High incidence of hypospadias has been observed in Shanghai,Fujian,Guangdong and Guangxi and the incidence has been higher in urban areas than in rural areas.