| 闫黎娜,郭彦孜,郑玲芳,何 平,乔 红,周 娜.西安咸阳地区先天性心脏病危险因素的病例对照研究[J].,2020,(12):2280-2283 |
| 西安咸阳地区先天性心脏病危险因素的病例对照研究 |
| A Case-control Study on Risk Factors of Congenital Heart Disease in Xi'an and Xianyang |
| 投稿时间：2019-12-30 修订日期：2020-01-25 |
| DOI：10.13241/j.cnki.pmb.2020.12.016 |
| 中文关键词: 西安咸阳地区 先天性心脏病 危险因素 病例对照研究 |
| 英文关键词: Xianyang District of Xi'an Congenital heart disease Risk factors Case-control study |
| 基金项目:陕西中医药大学科学研究计划项目（2017QN06）；陕西省中医管理局中医药科研项目（JCPT004） |
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| 中文摘要: |
| 摘要 目的：探究西安咸阳地区先天性心脏病危险因素的病例相关对照研究。方法：选择2014年1月至2019年1月于西安医学院第二附属医院及陕西中医学院第二附属医院进行治疗的常住地为西安咸阳地区8周以上孕妇为研究对象，将产前确诊为先天性心脏病（Congenital heart disease, CHD）孕妇列为病例组（68例），将排除CHD和（或）其他先天性疾病孕妇设为对照组（136例），对两组孕妇实施问卷调查，了解其家庭状况、孕妇情况、孕期环境污染、孕妇生活事件等因素与CHD发生的相关性。结果：经分析研究68例CHD胎儿产妇及136例对照组资料，按照α=0.05位水准，使用 χ2检验对59个研究因素进行单因素分析，初步筛选出14个可疑危险因素（妊娠高血压、妊娠糖尿病、感冒发烧、孕早期接触农药、孕早期服用抗生素、孕早期服用解热镇痛药、孕早期接触射线、被动吸烟、吸烟、母亲不良精神史、不良生育史、先兆流产史、父亲年龄、母亲年龄），再通过二项分类Logistic逐步回归法实施多因素分析，最终得到吸烟、孕早期接触农药、母亲不良精神史、先兆流产史、感冒发烧5个危险因素。结论：孕早期是胎儿心脏发育的关键时期，如果母亲孕早期有不良精神史、感冒发烧、先兆流产史、接触农药、吸烟，会直接增加CHD发病几率，提示母亲孕早期应加强保健防护，重视孕早期检查。 |
| 英文摘要: |
| ABSTRACT Objective: To investiigate the risk factors of congenital heart disease in Xi'an and Xianyang, a case-control study was conducted. Methods: Prenatal fetal echocardiography and postnatal pediatric echocardiography or autopsy, ICD-10 were classified as pregnant women with a residence of more than 8 weeks in the Second Affiliated Hospital of Xi'an Medical College and the Second Affiliated Hospital of Shaanxi College of Traditional Chinese Medicine from January 2014 to January 2019. Pregnant women diagnosed as congenital heart disease (CHD) were classified as case group (68 cases). Pregnant women excluding CHD and/or other congenital diseases were divided into control group (136 cases). Questionnaires were conducted to investigate the correlation between family status, pregnant women's situation, environmental pollution during pregnancy, life events of pregnant women and the occurrence of CHD. Results: According to the data of 136 cases of control group, according to the level of alpha=0.05, 59 factors were analyzed by χ2 test. Fourteen suspicious risk factors (pregnancy hypertension, gestational diabetes mellitus, cold and fever, pesticide exposure in early pregnancy, antibiotics in early pregnancy, antipyretic and analgesic drugs in early pregnancy, exposure to radiation in early pregnancy, passive smoking, smoking, mother's unhealthy spirit) were preliminarily screened out. History, adverse birth history, threatened abortion history, father's age, mother's age, and then through binomial logistic stepwise regression analysis, we finally got five risk factors: smoking, exposure to pesticides in the early pregnancy, mother's bad mental history, threatened abortion history, cold and fever. Conclusion: Early pregnancy is the key period of fetal heart development, if the mother has adverse effects in the early pregnancy. Mental history, cold, fever, threatened abortion, exposure to pesticides and smoking will directly increase the incidence of CHD, suggesting that mothers should strengthen health protection and pay attention to early pregnancy examination. |
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