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目的:探讨重庆三峡库区环境因素对儿童先天性心脏病的相关影响,为先天性心脏病人群干预及其病因学研究提供参考。方法:利用重庆市病残儿医学鉴定平台,收集、回访、调查、整理三峡库区所属区、县5645例病残儿医学鉴定中筛选出先天性心脏病的患儿319例,分析先天性心脏病与库区环境因素之关系。结果:相关的危险因素顺位一是孕早期接触农药、杀虫剂、除草剂等;二是呼吸道感染与不慎用药史;三是接触皮鞋制造、印染、油漆、涂料、家具、化工原料如苯和铅等;四是不良生活习俗,如嗜烟、酒及长期食用经农药、生长激素、防腐剂等污染的食品、蔬菜、水果、肉类;五是孕妇自身疾病以及不良流产、高龄妊娠等;六是遗传因素,若父母之一为先天性心脏病患者,其子女的再发风险增加。结论:母亲在孕前、孕早期/长期接触不良环境因素,可明显增加儿童患先天性心脏病的风险。加强孕早期保健、防护,重视产前健康检查,对预防儿童先天性心脏病具有重要的现实意义。
Objective: To explore the impact of environmental factors on children with congenital heart disease in the Three Gorges Reservoir in Chongqing, and to provide reference for population intervention and etiology in children with congenital heart disease. Methods: 319 cases of congenital heart disease were screened out by medical identification of 5645 cases of disabled children in districts and counties under the jurisdiction of the Three Gorges Reservoir. Relationship between disease and environmental factors in reservoir area. Results: The related risk factors were the first in the first trimester exposure to pesticides, insecticides, herbicides, etc .; the second is the history of respiratory infections and careless use of drugs; third contact with the shoe manufacturing, printing and dyeing, paints, coatings, furniture, chemical raw materials Such as benzene and lead; Fourth, bad habits, such as tobacco, alcohol and long-term consumption of pesticides, growth hormones, preservatives and other contaminated food, vegetables, fruits, meat; five pregnant women with their own diseases and abortion, Pregnancy, etc .; six genetic factors, if one of the parents of congenital heart disease, the risk of their children’s recurrence increased. Conclusion: Maternal exposure to adverse environmental factors before pregnancy, early pregnancy / long-term pregnancy can significantly increase the risk of congenital heart disease in children. Strengthening early pregnancy health care, protection, emphasis on prenatal health checks, prevention of congenital heart disease in children is of important practical significance.