| 裴丽君,李竹,李松,洪世欣,叶荣伟,陈新,郑俊池,王太梅,赵秀琴,肖岚,王丽娜,张伯兰,刘志欣,周永兰,姜梅芳,孙霞美,陈海兰,李敏,杨晓玲,沈泉珍,邵佩云,谢连云.中国神经管畸形高低发地区季节及性别分布特征[J].Chinese journal of Epidemiology,2003,24(6):465-470 |
| 中国神经管畸形高低发地区季节及性别分布特征 |
| The epidemiology of neural tube defects in high-prevalence and low-prevalence areas of China |
| Received:January 07, 2003 Revised:June 18, 2012 |
| DOI： |
| KeyWord: 神经管畸形 病因异质性 流行病学 |
| English Key Word: Neural tube defects Heterogeneity Epidemiology |
| FundProject:美国CDC1993年404号项目经费资助(UII/CCU0065);国家“八五”(85-918-06-12);“九五”重点攻关基金资助项目(96-904-06-01) |
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| Abstract: |
| 目的分析中国高低发区神经管畸形(NTDs)的流行病学分布特点。方法利用1992～1994年期间“中美预防神经管畸形合作项目”监测资料,按照国际上采用的脊柱裂高低位不同损害水平分类方法,将NTDs分为四类,即无脑畸形、脑膨出、高位和低位脊柱裂(SB),同时再将每一类按照是否合并其他畸形分为单纯与合并型,比较中国南北方、城乡、季节、性别NTDs发生率。分析中对城乡、季节、NTDs种类、性别分别进行调整,计算调整率。结果326874名新生儿(包括孕20周及以上的活产、死胎和死产)中,NTDs784例,北方NTDs发生率为5.57‰,南方为0.88‰。各类NTDs发生率存在南北方差别(P<0.01)。调整其他影响因素后,北方总NTDs发生率大约是南方的3～7倍;NTDs发生率存在城乡差别(P<0.01),调整后北方农村NTDs发生率大约是城市的3～4倍,调整后南方农村NTDs发生率大约是城市的1.6～1.9倍;北方高位SB发生率在9～11月有季节性升高现象,南方无脑畸形率9～11月低于其他季节,其他类型NTDs在南北方无明显季节变化。结论中国北方是世界上NTDs高发地区。NTDs发生率存在南北方、城乡差别,北方高位SB发生率有季节升高现象。不同类型NTDs之间在流行病学特征和表型上存在病因异质性。 |
| English Abstract: |
| Objective To describe the epidemiology of neural tube defects (NTDs) in high-and low-prevalence areas of China.Methods Birth defects surveillance data, collected from 1992 through 1994 was analyzed. These data were collected as part of the Sino-American cooperative project on NTDs prevention. We classified NTDs as anencephaly,encephalocele, high-level and low-level spina bifida (SB) according to location of the lesion (high vs low) and whether the defect was isolated or occurred in association with other birth defects. Rates were compared in the high-prevalence (North) region and the low-prevalence (South) region, after adjusted for classification, urban and rural,season and sex,and calculated the adjusted rate of NTDs.Results Among seven hundred and eighty-four NTDs cases in 326 874 recorded births (include in livebirth,stillbirth and fetal death with a gestational age of at least 20 weeks), the overall NTDs prevalence in the North was 5.57/ 1 000 births, and in the South was 0.88/ 1 000. There were also significant differences in the prevalence of anencephaly, encephalocele, high-level and low-level SB between North (0.97, 0.49, 2.75 and 1.11/ 1 000 birth) and South (0.36, 0.15, 0.21 and 0.14/ 1 000 birth)(P 0.01), with adjusted prevalences in the North 3-7 times higher than those in the South. There were significant difference between urban (2.04) and rural areas (6.57/ 1 000 birth) in the North (P 0.01), urban (0.52) and rural areas (0.95/ 1 000 birth) in the South (P 0.05). Adjusted prevalence rates in the rural were 3- 4 times higher than those of urban in the North and 1.6- 1.9 times higher than in theSouth;Theseasonalrateofhigh levelSBincreasedbetweenSeptemberandNovemberintheNorth (3.44 / 10 0 0birth),whiletheseasonalrateofanencephalydecreasedbetweenSeptemberandNovember (0.18/ 10 0 0birth)intheSouth.HowevertherewerenoseasonalchangesinotherclassifiedNTDsbothinthe SouthandNorth.Conclusions ThebirthprevalenceofNTDsintheNorthofChinawasthehighestinthe world.ThereweresignificantdifferencesbetweentheNorthandtheSouth,urbanandrural.Therewas seasonalchangeinhigh levelSBintheNorth,whichwasinaccordancetothephenotypeofNTDs.Itwas suggestedthattheremightexistetiologicalheterogeneityamonganecephalus,low andhigh levelSB. |
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