先天性心脏病危险因素1∶1配对病例对照研究
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1∶1 matched case-control study on risk factors of congenital heart disease
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    摘要:

    目的:探讨先天性心脏病(congenital heart disease,CHD)发生的危险因素,为研究CHD的病因及其科学的预防措施提供参考依据。方法:采用以医院为基础的1∶1配对病例对照研究,对CHD组和对照组儿童的父母进行统一的问卷调查。对所有研究因素经单因素分析和多因素条件Logistic回归分析,筛选出与CHD发生相关的危险因素。结果:研究分析了260对CHD患儿和对照的资料,按a=0.05水准,用单因素Logistic回归分析对研究因素进行单因素分析,初步筛选出21个可疑危险因素,用多因素条件Logistic回归模型进行多因素综合分析,最终筛选出与CHD发生相关的5个因素,包括3个危险因素:母亲年龄(>35岁:OR=3.075,P=0.010;<20岁:OR=5.084,P=0.012)、被动吸烟(少量:OR=1.728,P=0.040;经常:OR=3.903,P=0.000)、孕早期感冒(OR=1.787,P=0.023),2个保护因素:规律服用叶酸(OR=0.447,P=0.004)、食用肉类(≥4次/周:OR=0.293,P=0.001;1~3次/周:OR=0.372,P=0.008)。结论:孕早期是胎儿心脏发育的关键时期,母亲高龄或低龄、接触烟草、孕早期感冒会增加胎儿发生CHD的风险,而规律服用叶酸、多食用肉类则对胎儿有保护作用。

    Abstract:

    Objective:To explore the risk factors of congenital heart disease(CHD) and to provide references for research in the etiol-ogy of CHD and its scientific precautions. Methods:A hospital-based CHD 1∶1 matched case-control study was conducted. Patients were diagnosed by echocardiogram,cardiac catheterization or surgery and controls with no congenital disease were selected at the corresponding period. Children’s parents were interviewed with a unified face-to-face questionnaire. All factors were analyzed by univariate and multivariate conditional Logistic regression;risk factors associated with CHD were screened out. Results:Information of 260 pairs of children with CHD and controls were analyzed. All factors were analyzed by univariate Logistic regression at a=0.05 level and 21 suspected risk factors were initially screened out then multivariate conditional Logistic regression was used to do multi-variate comprehensive analysis. Results indicated that maternal age(>35 years:OR=3.075,P=0.010;<20 years:OR=5.084,P=0.012),passive smoking(small amount:OR=1.728,P=0.040;large amount:OR=3.903,P=0.000) and catching a cold in early pregnancy(OR=1.787,P=0.023) were the risk factors of CHD;taking folic acid regularly(OR=0.447,P=0.004) and eating meat(≥4 times/week:OR=0.293,P=0.001;1-3 times/week:OR=0.372,P=0.008) were significantly associated with a reduced risk for CHD. Conclusions:The first trimester is a critical period of fetal heart development. Mother old or young,exposuring to tobacco and catching a cold in early pregnancy are at increased risk for giving birth to a child with CHD;taking folic acid regularly and eating more meat are associated with a reduced risk for CHD.

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许春华,田 杰,吕铁伟.先天性心脏病危险因素1∶1配对病例对照研究[J].重庆医科大学学报,2013,(3):283-288

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  • 在线发布日期: 2013-05-16
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