先天性心脏病流行病学材料.ppt

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1、Congenital heart malformation:Prevalence,severity,survival,and quality of life,先天性心脏病流行病学,The lowest values/1000 live births,Author Region Fyler 2.10 New England,USAGardiner 2.17 Toronto,CanadaAkman 3.20 Bogalusa,USAMacMahon 3.20 Birmingham,UKMckeown 4.20 Birmingham,UKBosi 4.60 ItalyBierman 4.70 Haw

2、aii,Prevalence of congenital heart malformation at birth,the highest values/1000 births,author Region Fischer 8.20 Tyrol,AustriaKerrebijn 8.26 Leiden,NetherlandGrech 8.80 MaltaHoffmann 8.82 San Francisco,USAMeberg 9.02 NorwayNakazawa 10.00 JapanManetti 12.30 Florence,ItalyYerushalmi 11.70 California

3、,USA,Prevalence of congenital heart malformation at birth,The oldest surveys/1000 live births,Author Date Prevalence()Macmahon 194049 3.23Carlgren 1941 50 6.35Harris 194450 5.90Pleydell 194457 3.20Landtman 1945 63 8.00Richards 194653 5.50Gardiner 194849 2.17Mustachi 194951 5.88,Prevalence of congeni

4、tal heart malformation at birth,Recent data/1000 live births,Author Date Prevalence()Grech 1990-94 8.80Robida 1984-94 12.23Bosi 1992-93 4.60Anderson 1987-90 10.20Cerboni 1988-90 6.08Ferencz 1981-89 4.23Pexieder 1986-87 6.04Meberg 1982-88 9.02,Prevalence of congenital heart malformation at birth,Prev

5、alence of congenital heart malformation at birthRegional differences/1000 live births,Region Mean Range difference place Europe 6.67 3.20 Birmingham,UK 12.30 Florence,ItalyUSA 5.76 3.20 Bogalusa 8.56 San FranciscoCanada 3.97 2.17 Toronto 5.54 AlbertaOther countries 8.97 6.08 Guadeloupe,Yearly fluctu

6、ation in Bohemian data from 1980 through 1989,Year No.of malformation Prevalence/1000 646 7.04 547 6.39 568 6.771983 548 6.73 566 6.97 495 6.16 436 5.53 455 5.82 402 5.11 367 4.80,Prevalence of congenital heart malformation at birth,The prevalence was highest in October,and lowest in December,June a

7、nd July.The peak of the prevalence coincided with the epidemics of influenza in early pregnancy 8 and 9 months previously.,There was a definite seasonal variation,Ratio of boys to girls,Boys to girls with CHD:51.9%to 48.1%,A higher proportion of boys was found with:DORV(2.68:1);HLHS(2.25:1)cTGA(2.11

8、:1);,A higher proportion of girls was found with:,PDA(1:1.66);Ebsteins malformation(1:1.57)Common arterial trunk(1:1.22),Distribution of congenital heart malformation,VSD 41.59%ASD 8.67%Aortic stenosis 7.77%Pulmonary stenosis 5.81%cTGA 5.39%Aortic coarctation 5.29%PDA 5.07%,Greater than 5%of the ove

9、rall number of malformation,Distribution of congenital heart malformation,AVSD 4.00%HLHS 3.42%TOF 3.36%,DORV,common arterial trunk and pulmonary atresia 1.05-1.37%,TAPVC 0.80%Tricuspid 0.78%Ebstein malformation 0.44%Interrupted aortic arch 0.44%,Spontaneous closure in 576 of 2092 recognized ventricu

10、lar Septal defects,accounting for 27.5%of the cases,Critical heart malformation in neonates,10 most frequent Number proportion of total Malformations number seen(%),cTGA 102 84Pul atresia 39 74Coarctation 34 49HLHS 34 94Tricuspid atresia 13 77DORV 20 50VSD 8 8Common AT 8 50TOF 7 28,Critical heart di

11、sease:which threaten life,which manifested by severve Congestive heart failure,deep cyanosis,or both symptoms,Death rate of children born with CHD,Survival in most frequent cardiac malformation,CHD Number survival(%)at age of 1 5 15yrs,VSD 2097 91 90 89ASD 436 94 93 93Aortic stenosis 391 90 89 88PS 292 96 96 96cTGA 271 62 56 54Coarctation 266 68 65 65PDA 255 91 91 91AVSD 201 62 55 54HLHS 172 0 0 0TOF 169 84 78 77,Questionnaires,1564例8-13岁先心病患儿生存质量调查,83.2%未用任何药 3.2%体能差 59.5%可参加娱乐消遣性活动 6.7%可参加竞争性的运动 35.5%上学延迟 6.9%学习差 身高及体重与同龄人无区别 先心病儿给父母造成心理紧张,生活质量,