先天性马蹄内翻足畸形严重程度多因素相关性分析

Multi-factor correlation analysis of the severity of congenital clubfoot deformity

目的进行先天性马蹄内翻足严重程度多因素分析,为临床预判先天性马蹄内翻足预后提供参考。方法选取2015年1月至2018年12月该院就诊的先天性马蹄内翻足患儿153例作为研究对象,根据出生后患儿患肢足Pirani评分,分为接近正常、轻度异常、中度异常、重度异常4个级别,回顾性分析患儿性别、孕妇生产史、家族史、周围环境、母孕期情况、遗传病史等多因素。采用logistic回归统计方法对先天性马蹄内翻足进行多因素分析。结果logistic二元回归分析结果显示,遗传病史、母孕期雌激素水平与先天性马蹄内翻足严重程度相关,而单双侧、患儿性别、子宫内因素、父母吸烟、电离辐射、孕激素水平,绒毛促性腺激素等均与先天性马蹄足无明显相关性。结论遗传病史、母孕期雌激素水平与先天性马蹄内翻足严重程度相关性强,可为临床医生治疗提供参考,为家长孕期提供建议。

Objective To carry out a multi-factor analysis of the severity of congenital clubfoot to provide a reference for clinical prediction of the prognosis of patients.Methods A total of 153 children with congenital clubfoot who were treated in the hospital from January 2015 to December 2018 were selected as the research objects.According to the Pirani score of the limbs and feet of the children after birth,they were divided into four levels:close to normal,mild abnormality,moderate abnormality,and severe abnormality.A retrospective analysis of multiple factors such as the gender of the child,the birth history of the pregnant woman,the family history,the surrounding environment,the condition of the mother during pregnancy,and the history of genetic disease were retrospectively analyzed.The logistic regression statistical method was used for multivariate analysis of congenital clubfoot.Results The logistic binary regression analysis showed that genetic history,maternal estrogen levels during pregnancy were related to the severity of congenital clubfoot.Unilateral and bilateral,children′s gender,intrauterine factors,parental smoking,ionizing radiation,progesterone levels,and chorionic gonadotropin were not significantly correlated with congenital clubfoot.Conclusion The genetic history and the estrogen level during pregnancy are strongly correlated with the severity of congenital clubfoot,which can provide reference for the treatment of clinicians and provide suggestions for parents during pregnancy.