先天性心脏病流行病学PPT课件.ppt

Congenitalheartmalformation:Prevalence,severity,survival,andqualityoflife,先天性心脏病流行病学,Thelowestvalues/1000livebirths,AuthorRegionFyler2.10NewEngland,USAGardiner2.17Toronto,CanadaAkman3.20Bogalusa,USAMacMahon3.20Birmingham,UKMckeown4.20Birmingham,UKBosi4.60ItalyBierman4.70Hawaii,Prevalenceofcongenitalheartmalformationatbirth,thehighestvalues/1000births,authorRegionFischer8.20Tyrol,AustriaKerrebijn8.26Leiden,NetherlandGrech8.80MaltaHoffmann8.82SanFrancisco,USAMeberg9.02NorwayNakazawa10.00JapanManetti12.30Florence,ItalyYerushalmi11.70California,USA,Prevalenceofcongenitalheartmalformationatbirth,Theoldestsurveys/1000livebirths,AuthorDatePrevalence()Macmahon1940493.23Carlgren1941506.35Harris1944505.90Pleydell1944573.20Landtman1945638.00Richards1946535.50Gardiner1948492.17Mustachi1949515.88,Prevalenceofcongenitalheartmalformationatbirth,Recentdata/1000livebirths,AuthorDatePrevalence()Grech1990-948.80Robida1984-9412.23Bosi1992-934.60Anderson1987-9010.20Cerboni1988-906.08Ferencz1981-894.23Pexieder1986-876.04Meberg1982-889.02,Prevalenceofcongenitalheartmalformationatbirth,PrevalenceofcongenitalheartmalformationatbirthRegionaldifferences/1000livebirths,RegionMeanRangedifferenceplaceEurope6.673.20Birmingham,UK12.30Florence,ItalyUSA5.763.20Bogalusa8.56SanFranciscoCanada3.972.17Toronto5.54AlbertaOthercountries8.976.08Guadeloupe,YearlyfluctuationinBohemiandatafrom1980through1989,YearNo.ofmalformationPrevalence/10006467.045476.395686.7719835486.735666.974956.164365.534555.824025.113674.80,Prevalenceofcongenitalheartmalformationatbirth,TheprevalencewashighestinOctober,andlowestinDecember,JuneandJuly.Thepeakoftheprevalencecoincidedwiththeepidemicsofinfluenzainearlypregnancy8and9monthspreviously.,Therewasadefiniteseasonalvariation,Ratioofboystogirls,BoystogirlswithCHD:51.9%to48.1%,Ahigherproportionofboyswasfoundwith:DORV(2.68:1);HLHS(2.25:1)cTGA(2.11:1);,Ahigherproportionofgirlswasfoundwith:,PDA(1:1.66);Ebsteinsmalformation(1:1.57)Commonarterialtrunk(1:1.22),Distributionofcongenitalheartmalformation,VSD41.59%ASD8.67%Aorticstenosis7.77%Pulmonarystenosis5.81%cTGA5.39%Aorticcoarctation5.29%PDA5.07%,Greaterthan5%oftheoverallnumberofmalformation,Distributionofcongenitalheartmalformation,AVSD4.00%HLHS3.42%TOF3.36%,DORV,commonarterialtrunkandpulmonaryatresia1.05-1.37%,TAPVC0.80%Tricuspid0.78%Ebsteinmalformation0.44%Interruptedaorticarch0.44%,Spontaneousclosurein576of2092recognizedventricularSeptaldefects,accountingfor27.5%ofthecases,Criticalheartmalformationinneonates,10mostfrequentNumberproportionoftotalMalformationsnumberseen(%),cTGA10284Pulatresia3974Coarctation3449HLHS3494Tricuspidatresia1377DORV2050VSD88CommonAT850TOF728,Criticalheartdisease:whichthreatenlife,whichmanifestedbyseverveCongestiveheartfailure,deepcyanosis,orbothsymptoms,DeathrateofchildrenbornwithCHD,Survivalinmostfrequentcardiacmalformation,CHDNumbersurvival(%)atageof1515yrs,VSD2097919089ASD436949393Aorticstenosis391908988PS292969696cTGA271625654Coarctation266686565PDA255919191AVSD20162