河北省15个县孕前优生健康检查高风险人群回顾性分析

Retrospective analysis on high risk population of progestational eugenic health examination in 15 counties of Hebei province

目的:探索科学界定孕前优生健康检查和风险评估高风险人群的方法。方法:对河北省15个国家免费孕前优生健康检查项目县(市)的风险评估情况进行回顾性分析。结果:2010年7月～2012年3月共有249 470例接受检查,评估高风险人群数为31 140例(12.48%),高风险人群评估比例呈阶段性下降趋势。结果显示,环境风险中吸烟在男性人群所占比例最高(57.50%),既往及家族病史中糖尿病所占比例最高(1.47%),实验室检查项目异常主要为:ALT异常(12.98%)、乙肝五项(除HBsAb外)中1项以上阳性(12.06%)、Cr异常(10.96%);女性高风险人群中,体重超重或肥胖比例最高(34.75%),其次为TSH异常(18.11%)、ALT异常(16.41%)、乙肝五项(除HBsAb外)中1项以上阳性(11.36%)、年龄<18岁或>35岁(10.87%)、环境中接触猫狗等宠物(9.99%)、被动吸烟(6.77%)等。结论:规范和统一风险评估标准,对于提高孕前优生健康检查和风险评估水平具有重要意义。充分提高风险评估的针对性,探索出适合本地区的工作模式才能使项目顺利全面推进。

Objective： To explore the method to scientifically define high risk population of progestational eugenic health examina- tion and risk assessment. Methods： The data of risk assessment in 15 counties （cities） conducting free progestational eugenic health exami- nation items in Hebei province were analyzed retrospectively. Results： A total of 249 470 cases received examination from July 2010 to March 2012, and 31 140 cases （ 12.48% ） were found as high risk population, the proportion showed a decreasing trend. The proportion of smoking among male population in environmental risks was the highest （57. 50% ） , and the proportion of diabetes mellitus among previous histories and family histories was the highest （ 1.47% ） . The main abnormalities of laboratory items were alanine aminotransferase （ALT） （ 12. 98% ）, more than one positive item among five items of hepatitis B （ except HBsAb） （ 12.06% ）, Cr （ 10. 96% ） ; among female high risk population, the proportion of cases with overweight and obesity was the highest （34. 75% ）, followed by abnormal thyroid stimulating hormone （ TSH ） （ 18.11% ）, abnormal ALT （ 16. 41% ）, more than one positive item among five items of hepatitis B （ except HBsAb）, less than 18 years old or more than 35 years old （10. 87% ）, contacting pets, such as cats, dogs （9. 99% ）, and passive smoking （6. 77% ） . Conclusion： Standardizing and unifying risk evaluation criteria has important significance for improving levels of progestational eugenic health examination and risk assessment. Comprehensively improving the pertinence of risk evaluation and finding out work pattern suitable for the area can promote the project successfully.