Zheng Jian-Yong, Qiu Yi-Gang, Li Dong-Tao, He Jiang-Chun, Chen Yu, Cao Yi, Liu Ying-Ming, Li Xian-Feng, Chi Hai-Tao, Li Tian-Chang
Department of Cardiology,PLA Navy General Hospital,Beijing,People's Republic of China.
Cardiol Young. 2017 Oct;27(8):1497-1503. doi: 10.1017/S1047951117000567. Epub 2017 Apr 10.
The prevalence of CHD has been well described worldwide except in Tibet. This study aimed to illustrate the prevalence and composition of CHD in Tibetan children according to altitude. Methods and results In the first part, we prospectively recruited 7088 unselected Tibetan children (4-17 years) from south-west Tibet. The total prevalence of CHD increased from 4.6/1000 below 4200 m to 13.4/1000 above 4700 m, with a female-to-male ratio of 1.3:3.1. The total prevalence and female prevalence of patent ductus arteriosus increased more than 10-fold. Females living above 4700 m had exceptionally high prevalence of patent ductus arteriosus (14.9/1000). The prevalence of atrial septal defect was comparable among different altitudes (3.3-3.8/1000). The prevalence of ventricular septal defect was 1.3/1000 below 4700 m, and no cases were found above this altitude. In the second part, we retrospectively reviewed the clinical data of 383 CHD children in Tibet and 73 children at lower altitudes. The percentage of isolated ventricular septal defect decreased from 54.8 to 3.1%, and the percentage of isolated patent ductus arteriosus increased from 8.2 to 68.4% with elevation. Children living below 4200 m (10.4-13.7%) had a larger proportion of complex CHD than those above this altitude (2.0-3.1%). Of the 20 Tibetan children with complex CHD, 14 (70.0%) lived below 4200 m.
A wide variation in CHD prevalence and composition existed in Tibetan children among different altitudes.
除西藏外，全球范围内冠心病（CHD）的患病率已有详尽描述。本研究旨在阐明不同海拔高度下藏族儿童冠心病的患病率及构成情况。方法与结果：在第一部分中，我们前瞻性地从西藏西南部招募了7088名未经过筛选的藏族儿童（4至17岁）。冠心病的总患病率从海拔4200米以下的4.6/1000增加到海拔4700米以上的13.4/1000，男女比例为1.3:3.1。动脉导管未闭的总患病率和女性患病率增加了10倍以上。生活在海拔4700米以上的女性动脉导管未闭患病率极高（14.9/1000）。不同海拔高度房间隔缺损的患病率相当（3.3 - 3.8/1000）。室间隔缺损的患病率在海拔4700米以下为1.3/1000，在此海拔以上未发现病例。在第二部分中，我们回顾性分析了383名西藏冠心病儿童和73名低海拔地区儿童的临床资料。随着海拔升高，单纯室间隔缺损的比例从54.8%降至3.1%，单纯动脉导管未闭的比例从8.2%升至68.4%。生活在海拔4200米以下的儿童（10.4 - 13.7%）中复杂冠心病的比例高于此海拔以上的儿童（2.0 - 3.1%）。在20名患有复杂冠心病的藏族儿童中，14名（70.0%）生活在海拔4200米以下。
不同海拔高度的藏族儿童冠心病患病率及构成存在很大差异。
