先天性心脏病流行病学材料

先天性心脏病流行病学材料第1页/共17页Congenitalheartmalformation:Prevalence,severity,survival,andqualityoflife先天性心脏病流行病学第2页/共17页Thelowestvalues/1000livebirthsAuthor‰Region

Fyler2.10NewEngland,USAGardiner2.17Toronto,CanadaAkman3.20Bogalusa,USAMacMahon3.20Birmingham,UKMckeown4.20Birmingham,UKBosi4.60ItalyBierman4.70HawaiiPrevalenceofcongenitalheartmalformationatbirth第3页/共17页thehighestvalues/1000births

author‰RegionFischer8.20Tyrol,AustriaKerrebijn8.26Leiden,NetherlandGrech8.80MaltaHoffmann8.82SanFrancisco,USAMeberg9.02NorwayNakazawa10.00JapanManetti12.30Florence,ItalyYerushalmi11.70California,USAPrevalenceofcongenitalheartmalformationatbirth第4页/共17页Theoldestsurveys/1000livebirthsAuthorDatePrevalence(‰)Macmahon1940—493.23Carlgren1941–506.35Harris1944—505.90Pleydell1944—573.20Landtman1945–638.00Richards1946—535.50Gardiner1948—492.17Mustachi1949—515.88Prevalenceofcongenitalheartmalformationatbirth第5页/共17页Recentdata/1000livebirthsAuthorDatePrevalence(‰)Grech1990-948.80Robida1984-9412.23Bosi1992-934.60Anderson1987-9010.20Cerboni1988-906.08Ferencz1981-894.23Pexieder1986-876.04Meberg1982-889.02Prevalenceofcongenitalheartmalformationatbirth第6页/共17页PrevalenceofcongenitalheartmalformationatbirthRegionaldifferences/1000livebirthsRegionMeanRangedifferenceplaceEurope6.673.20Birmingham,UK12.30Florence,ItalyUSA5.763.20Bogalusa8.56SanFranciscoCanada3.972.17Toronto5.54AlbertaOthercountries8.976.08Guadeloupe第7页/共17页YearlyfluctuationinBohemiandatafrom1980through1989YearNo.ofmalformationPrevalence/10006467.045476.395686.7719835486.735666.974956.164365.534555.824025.113674.80Prevalenceofcongenitalheartmalformationatbirth第8页/共17页TheprevalencewashighestinOctober,andlowestinDecember,JuneandJuly.Thepeakoftheprevalencecoincidedwiththeepidemicsofinfluenzainearlypregnancy8and9monthspreviously.Therewasadefiniteseasonalvariation第9页/共17页RatioofboystogirlsBoystogirlswithCHD:51.9%to48.1%Ahigherproportionofboyswasfoundwith:

DORV(2.68:1);HLHS(2.25:1)cTGA(2.11:1);Ahigherproportionofgirlswasfoundwith:PDA(1:1.66);Ebstein’smalformation(1:1.57)Commonarterialtrunk(1:1.22)第10页/共17页DistributionofcongenitalheartmalformationVSD41.59%ASD8.67%Aorticstenosis7.77%Pulmonarystenosis5.81%cTGA5.39%Aorticcoarctation5.29%PDA5.07%

Greaterthan5%oftheoverallnumberofmalformation第11页/共17页DistributionofcongenitalheartmalformationAVSD4.00%HLHS3.42%TOF3.36%DORV,commonarterialtrunkandpulmonaryatresia1.05----1.37%TAPVC0.80%Tricuspid0.78%Ebstein’malformation0.44%Interruptedaorticarch0.44%第12页/共17页Spontaneousclosurein576of2092recognizedventricularSeptaldefects,accountingfor27.5%ofthecases第13页/共17页Criticalheartmalformationinneonates,10mostfrequentNumberproportionoftotalMalformationsnumberseen(%)cTGA10284Pulatresia3974Coarctation3449HLHS3494Tricuspidatresia1377DORV2050VSD88CommonAT850TOF728Criticalheartdisease:whichthreatenlife,whichmanifestedbyseverveCongestiveheartfailure,deepcyanosis,orbothsymptoms第14页/共17页DeathrateofchildrenbornwithCHD第15页/共17页Survivalinmostfrequentcardiacmalformation

CHDNumbersurvival(%)atageof1515yrsVSD2097919089ASD436949393Aorticsten