【摘要】 目的:探讨儿童不分型先天性心脏病(CHD)与室间隔缺损(VSD)两者的致病危险因素及其异同。方法:采用1∶1配对病例对照研究方法,分析115对CHD患儿与对照儿父母的环境暴露因素并检测其亚甲基四氢叶酸还原酶(MTH-FR)C677T与胱硫醚β-合成酶(CBS)T833C基因型,对不分型CHD与VSD可能的危险因素进行单因素及多因素Logistic回归分析。结果:妊娠合并症(OR=2.069,OR=2.963)、孕期情绪紧张或忧郁(OR=4.653,OR=3.98)为不分型CHD和VSD共同的危险因素,孕早期接触农药(OR=8.62)、孕早期感冒(OR=4.125)、母MTHFR基因677TT型(OR=3.872)为不分型CHD的危险因素,孕早期服中成药(OR=4.026)仅为VSD的危险因素。结论:一些危险因素可能会引起多个部位的先天性心血管畸形,而某些危险因素仅引起某一部位的先天性心血管畸形,各类型CHD的致病因素存在着各自特有的危险因素的可能。更多还原

【Abstract】 Objective:To explore risk factors of congenital heart diseases (CHD),including of total types of CHD and ventricular septal defects (VSD).Methods:1∶ 1 case-control study was carried out to investigate 115 pairs case-control children and their parents to identify parents’ MTHFR gene 677 C→T mutation and CBS gene 833 T→C mutation. The possible risk factors were analysed by simple and multiple factors logistic regression.Results: Suffering from diseases during pregnancy (OR=2.069,OR=2.963) and depressed or nervous condition during pregnancy (OR=4.653,OR=3.98) were common risk factors of total types of CHD and VSD. Maternal exposures to pesticides in the early stage of pregnancy (OR=8.62),catching a cold in the early stage of pregnancy (OR=4.125) and maternal MTHFR 677 TT genotype (OR=3.872) were related with the occurrence of total types of CHD Using Chinese medicine in the early stage of pregnancy (OR=4.026) was only risk factor of VSD..Conclusion:Some risk factors can cause various types of CHD,but some factors only result in specific structural malformations,there may be specific factors for specific structural malformations besides common risk factors.更多还原