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|本期目录/Table of Contents|

先天性心脏病门诊患者的分布特征

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2012年第5期
页码:
596-599
栏目:
临床研究
出版日期:
2012-10-25

文章信息/Info

Title:
Epidemiological study of congenital heart disease in patients attending outpatient clinics
作者:
朱鲜阳; 张玉威; 张端珍; 韩秀敏; 王琦光; 邓东安; 侯传举
(沈阳军区总医院全军心血管病研究所先心病内科，辽宁 沈阳 110840)
Author(s):
ZHU Xian-yang;  ZHANG Yu-wei;  ZHANG Duan-zhen;  HAN Xiu-min;  WANG Qi-guang;  DENG Dong-an;  HOU Chuan-ju
(Department of Congenital Heart Disease, PLA Cardiovascular Disease Institutes, General Hospital, Shenyang Military Area Command, Shenyang 110840, Liaoning, China)
关键词:
门诊; 心脏缺损; 心脏病; 先天性; 流行病学调查
Keywords:
outpatients;  cardiac lesions;  heart disease;  congenital;  epidemiology
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的:调查和描述先天性心脏病（先心病）门诊患者的分布特征。方法： 从2005年1月起，由先心病内科专家门诊负责，对先心病明确诊断的初诊患者连续登记至2011年1月，共11 780例，由26种畸形组成。统计分析26种先天畸形构成比以及其中8种常见畸形（VSD、ASD、PDA、TOF、PS、AVSD、AS、TGA）在婴幼儿、儿童和成年人等阶段比例和单病种先心病中不同年龄段所占比例;4种常见先心病（VSD、ASD、PDA、AS）的3种并发症（肺动脉高压，心房颤动，感染性心内膜炎）呈现特点。结果： ①不同年龄段疾病构成比不同， VSD，TOF和TGA婴幼儿期明显高于成年人，VSD，TOF和TGA在婴幼儿和成人比例分别为53.8%和26.6%，8.6%和2.5%，5.1%和0.2%，而ASD和AS则成年人显著高于婴幼儿期，分别为41.1%和5.7%，6.8%和0.4%；②并发症呈现特点：艾森曼格综合征在VSD、ASD和PDA患者中绝大多数系成人，占97%，存活达50岁以上不足10%；心房颤动在ASD比较常见（2.4%），其次是PDA（1.1%），而VSD少见（0.2%）；感染性心内膜炎在AS中较常见，发生率为6.1%，VSD和PDA分别为0.52%和0.55%。 结论： 先心病在各种不同年龄阶段的构成比不同；婴幼儿期或儿童期手术可预防致残或影响生活质量的并发症。
Abstract:
AIM:To evaluate the relative incidence, the proportion and the complications of congenital heart disease (CHD) in patients attending outpatient clinics. METHODS: A cohort of 11,780 patients diagnosed as having CHD consisting of 26 types of cardiac lesions was registered from January 2005 to January 2011. The proportion of the 26 types of cardiac lesions, the relative incidence and proportion of 8 common lesions, including atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA), tetralogy of Fallot (ToF), pulmonic stenosis (PS), atrioventricular septal defect (AVSD), aortic valve stenosis (AS) and transposition of great arteries (TGA), in infants, children and adults, and the characteristics of three complications, including pulmonary hypertension, atrial fibrillation and infectious endocarditis in patients with VSD, ASD, PDA or AS were analyzed. RESULTS: The proportions of VSD (53.8% vs. 26.6%; P<0.01), ToF (8.6% vs. 2.5%; P<0.01) and TGA (5.1% vs. 0.2%; P<0.01) in children were significantly higher than those in adults, while the proportions of ASD (5.7% vs. 41.1%; P<0.01) and AS (0.4% vs. 6.8%; P<0.01) in children were significantly lower than those in adults. Eisenmenger syndrome was the commonest complication that contraindicated surgery. Of patients with VSD, ASD and PDA, 97% of them contraindicated surgery because of associated Eisenmenger syndrome. Only 10% of the patients with Eisenmenger syndrome survived 50 years. The incidence of atrial fibrillation was 2.4% in ASD, 1.1% in PDA and 0.2% in VSD population. The incidence of infective endocarditis was 6.1% in AS, 0.55% in PDA and 0.52% in VSD population. CONCLUSIONS: The prevalence and the survival rate of CHD patients vary with cardiac lesions and ages. Cardiac intervention in infants and children may prevent disability and complications that affect the life quality of the patients.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2012-03-07.
作者简介：朱鲜阳，主任医师Email:xyangz@yahoo.com.cn
更新日期/Last Update: 2012-11-16