深圳市先天性心脏病流行病学特征研究

Study on the epidemiological characteristics of congenital heart disease in Shenzhen city

目的:研究深圳市2010～2011年胎儿及早期新生儿先天性心脏病(CHD)的流行病学特征。方法:利用深圳市2010～2011年出生缺陷监测数据,把CHD病例分为单发和合并其他系统畸形两类,计算主要病种的发生率、产前诊断率,并分析患儿的转归、社会人口学特征以及多发CHD的伴发畸形情况。结果:深圳市2010～2011年包括怀孕以来的先天性心脏病儿总发生率为58.97/万;单发的心脏畸形占86.93%,合并其他系统畸形的心脏畸形组占13.07%,以合并染色体异常、神经系统和总唇裂畸形为主,以产后确诊为主,足月儿的动脉导管未闭、室间隔缺损、房间隔缺损为主要类型;以主动脉缩窄、右室双出口、单心室、右心发育不良等严重先天性心脏畸形的产前诊断率较高;与单发先天性心脏病组相比,合并其他系统畸形组产妇高龄、流动人口比例较高,28周前终止妊娠、死胎、婴儿死亡的比例较高,转归较差。结论:深圳市胎儿及早期新生儿先天性心脏病总发生率水平低于广东省医院出生缺陷监测水平,先天性心脏病分型较复杂,以合并其他系统畸形的严重先天性心脏病预后较差,提示应重视CHD的病因学研究和预防工作。

Objective： To research the epidemiological characteristics of congenital heart disease（CHD） in fetuses and early neonates in Shenzhen city from 2010 to 2011.Methods： Shenzhen birth defect surveillance data from 2010 to 2011 were analyzed.The patients with CHD were divided into isolated CHD group and complex CHD group（the patients were found with malformations of other systems）;the incidence rates of main diseases and prenatal diagnostic rate were calculated,the prognosis,social and demographic characteristics and co existed anomalies of the patients were analyzed.Results： The total prevalence rate of CHD in Shenzhen city from 2010 to 2011 was 58.97 / 10 000,including the pregnant women;the proportions of isolated cardiac malformations and complex cardiac malformations were 86.93% and 13.07%,respectively;the main types of complex cardiac malformations were chromosomal abnormalities,nerve system malformations and total cleft lip,postpartum diagnosis was the main diagnostic method;among the full-term neonates,patent ductus arteriosus（PDA）,ventricular septal defect（VSD） and atrial septal defect（ASD） were the main types of cardiac malformations;the prenatal diagnostic rates of coarctation of aorta,double outlet of right ventricular,univentricular and hypoplastic right heart were relatively high among the severe CHD;compared with isolated CHD group,the proportions of pregnant women of advanced maternal age and floating population in complex CHD group were relatively high;among the cases who terminated pregnancy before 28 gestational weeks,the proportions of stillbirth and infantile death were relatively high,and the prognosis was poor.Conclusion： The total prevalence rate of CHD among fetuses and early neonates in Shenzhen city is lower than the birth defect monitoring level of hospitals in Guangdong province,the classification of CHD are complicated,the prognosis of patients with severe CHD combined with malformations of other systems is poor,which indicates that the etiological study and prevention of CHD should be paid more attention to.