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先天性心脏缺陷——染色体异常、综合征及心外畸形

Congenital heart defects--chromosomal anomalies, syndromes and extracardiac malformations.

作者信息

Meberg Alf, Hals Jardar, Thaulow Erik

机构信息

Department of Paediatrics, Vestfold Hospital, Tønsberg, Norway.

出版信息

Acta Paediatr. 2007 Aug;96(8):1142-5. doi: 10.1111/j.1651-2227.2007.00381.x. Epub 2007 Jun 21.

Abstract

AIM

To register chromosomal anomalies, syndromes and extracardiac malformations in patients with Congenital heart defects (CHDs).

METHOD

Population-based prospective observational study.

RESULTS

Of 57 027 live births during 1982-2005, CHDs were detected in 662 (11.6 per 1000), of whom 146 (22%) had associated anomalies. Of these 52 (36%) had chromosomal anomalies (exclusive microdeletions), 26 (18%) genetic syndromes/microdeletions, 1 (0.7%) a teratogenous syndrome and 67 (46%) extracardiac malformations. In perimembraneous ventricular septal defects (VSDs), associated anomalies occurred in 22 of 70 (31%) compared to 27 of 298 (9%) in VSDs located in the muscular part of the septum (p < 0.0001). The prevalence of CHDs with associated disorders increased significantly from the cohort born during 1982-1993 to those born during 1994-2005 (2.0 vs. 3.1 per 1000, respectively; p < 0.0001), mainly caused by an increase of chromosomal trisomies (0.5 vs. 1.1 per 1000; p = 0.026). The percentage of women giving live birth at 35 years of age or more was 7.6% for the period 1982-1993 compared to 13.4% for 1994-2005 (p = 0.001).

CONCLUSIONS

Chromosomal anomalies, syndromes and extracardiac malformations occurred in nearly one-fourth of CHD cases. Muscular VSDs had a low prevalence of such conditions. The prevalence of CHDs with chromosomal trisomies increased, and was probably related to an increasing age of women giving birth.

摘要

目的

登记先天性心脏病(CHD)患者的染色体异常、综合征及心外畸形。

方法

基于人群的前瞻性观察研究。

结果

在1982年至2005年期间的57027例活产儿中,检测出662例CHD(每1000例中有11.6例),其中146例(22%)伴有相关异常。在这些患者中,52例(36%)有染色体异常(不包括微缺失),26例(18%)有遗传综合征/微缺失,1例(0.7%)有致畸综合征,67例(46%)有心外畸形。在膜周部室间隔缺损(VSD)中,70例中有22例(31%)伴有相关异常,而位于室间隔肌部的VSD中,298例中有27例(9%)伴有相关异常(p<0.0001)。伴有相关疾病的CHD患病率从1982年至1993年出生的队列显著增加至1994年至2005年出生的队列(分别为每1000例中有2.0例和3.1例;p<0.0001),主要是由于染色体三体增加(每1000例中有0.5例和1.1例;p=0.026)。1982年至1993年期间,35岁及以上活产的女性比例为7.6%,而1994年至2005年为13.4%(p=0.001)。

结论

近四分之一的CHD病例存在染色体异常、综合征及心外畸形。肌部VSD此类情况的患病率较低。染色体三体CHD的患病率增加,可能与生育女性年龄增加有关。

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