青海省海东地区三县4～18岁人群先天性心脏病的流行病学调查

Epidemiological survey of congenital heart disease among people aged from 4 to 18 in Haidong area of Qinghai province

目的调查研究青海省海东地区平安县、乐都县、互助县等3个县4～18岁人群先天性心脏病（COHD）流行病学特征。方法对3个县97718名4—18岁在校学生按初筛、复筛、彩色超声多普勒确定3个阶段进行调查。分析了COHD病种分布，比较了性别、各年龄段及各民族之间的患病率差异。结果检出COHD496例。总患病率为5．076‰（496／97718）。男、女性患病率分别为5．046‰（256／50730）和5．108‰（240／46988），两者间差异无统计学意义（χ^2=0．018，P〉0．05）。3个县患病率分别为：乐都县5．46‰、互助县5．45‰、平安县3．64‰，不同县之间患病率差异有统计学意义（χ^2=10．62，P〈0．01），其中乐都县、互助县患病率高于平安县（χ^2值分别为8．37、9．91，P〈0．01）。汉族的COHD患病率为5．09‰（391／76822），藏族为5．45‰（23／4220），蒙古族为4．04‰（3／743），土族为5．02‰（57／11345），不同民族间患病率差异无统计学意义（χ^2=0．33，P〉0．05）。在496例COHD中，房间隔缺损（ASD）与室间隔缺损（VSD）分别占37．30％和35．69％，动脉导管未闭（PDA）占22．18％。结论青海省海东3个县4～18岁人群COHD总患病率为5．076‰，不同性别、不同民族的COHD患病率基本相同。

Objective To investigate the epidemiological characteristics of congenital heart disease （COHD） among 4 to 17 years old children in Haidong area of Qinghai province. Methods All 97 718 children were surveyed with the following 3 steps ： prescreening, countercheck and confirmation with color Doppler. The distribution patterns were analyzed by national groups, ages and genders respectively. Results There were 496 COHD cases detected. The total incidence was 5. 076‰（496/97 718）. The incidences of male and female were 5. 046‰ （ 256/50 730） and 5. 108‰ （ 240/46 988 ） （ χ^2 = 0. 018, P 〉 0. 05 ）. There was a significant difference between Pingan county and the others （ χ^2 = 10. 62, P 〈 0. 01 ）. The highest incidence was in Ledu （5.46‰） , the incidences of Huzhu and Pingan county were 5. 45‰ and 3.64‰ respectively. There was no significant difference among different national groups （ χ^2 = 0. 33, P 〉 0. 05 ）. Among 496 COHD cases, the ratio of artial septal defect （ ASD ）, ventrieular septal defect （ VSD ）, patent ductus arteriosus （PDA）were 37. 30% ,35.69% and 22. 18% respectively. Conclusion Total incidence of COHD was 5. 076‰ in Haidong area of Qinghai province. The incidence was not different in both genders and national groups. The constitution of COHD in different counties were different.