在15年（1985-2000）的研究当中发现，成人的严重先天性心脏病的发病率升高了85%，儿童上升了22%。先天性心脏缺陷是一些器质性的问题，这些问题在出生以前就已经存在，主要表现为心脏及其周围大血管的结构异常。
这项研究的主要负责人，加拿大魁北克蒙特利尔McGill大学的McGill Aduit Unit的负责人Ariane J. Marelli博士表示：“这是在对先天性心脏病的治疗管理取得明显进展的一段时间以来，第一次对北美人群中病人人数变化进行的调查研究。”
该研究分别在四个时间点（1985、1990、1995和2000年）监测了疾病的发病率、年龄以及成人相对于儿童的比例，并分析了用于一般人群卫生保健的官方数据库。其中魁北克占了加拿大总人口数的25%。
“这是在北美地区进行过的最大的一次对人群中的CHD的调查。”Marelli说，“没有理由认为魁北克以及加拿大的主要以高加索人种为主的人群与美国的人群有甚么区别。”
根据这项研究的结果来推断美国人群，Marelli估计在2000年，180万美国人患有CHD，并且这个数字还在增长，还会与妇女、妊娠以及遗传学相关联。她估计大约90万的成人以及90万的儿童患有CHD。
研究表明，在2000年，每85个儿童以及每250个成人中各有一个患有CHD。
“作为对比，每4500个新生儿中有一个发生囊性纤维病，所以患有CHD的儿童是患有囊行纤维病的儿童的45倍。而现在，这些儿童中的大部分正在转变为成人”，Marelli说。
此外，研究发现，自1985年以来，成人相对于儿童更多的人发生了CHD，尤其是女性。
Marelli认为：“在1985年到2000年的这段时间里，病人当中人数上升最为迅速的就是患有严重CHD的成人。所以，到了2000年，患有严重CHD的成人与儿童的人数几乎相当。”
根据研究，CHD当中增加最为明显的就是13到17岁阶段的青少年以及18到25岁的成人。自1985年至2000年，这些患有严重CHD人群的平均年龄有了明显的升高，从1985年的11岁变为2000年的17岁。
Marelli表示：“CHD曾经被认为是一种只会在儿童期发生的疾病，可是现在它已经转变为一种同样可以发生于成人的严重病变。”研究者们还认为，研究中大量的新资料反映出对于CHD的诊断以及外科手术治疗的进步。
Marelli认为：“自从二十世纪八十年代中期，心脏超声的出现提高了对于CHD的诊断水平。这项技术可以在生后一年内检查出CHD的存在。儿科的心脏矫形手术的进步也产生了重大的影响，它延长了患有CHD儿童的生存时间。”同时Marelli认为，CHD是北美的一项主要的公共卫生问题，可目前它被大大忽视。
“CHD发病率增加，说明这些孩子存活时间更长了，同时他们也可能并存其他各种各样的心脏问题。”Marelli说，“这就需要我们对于CHD更多关注，这样才能让我们更好地照顾好越来越多的患有心脏疾病的年轻人。”
Congenital Heart Disease Increasingly More Common In Adults, Children
Main Category: Cardiovascular / Cardiology News
Article Date: 10 Jan 2007 - 14:00 PST
The prevalence of congenital heart disease (CHD) has increased strikingly in adults and children in a new population study, researchers reported in Circulation: Journal of the American Heart Association.
Severe CHD has risen in adults by 85 percent and 22 percent in children during the 15-year study (1985-2000). Congenital heart defects are structural problems arising from abnormal formation of the heart or major blood vessels near the heart that occurs before birth. Most heart defects either obstruct blood flow in the heart or vessels near it, or cause blood to flow through the heart in an abnormal way.
"This is the first study to measure the changing number of patients in a North American population during a period of major progress in the management of CHD," said Ariane J. Marelli, M.D., lead author of the study and director of the McGill Adult Unit for Congenital Heart Disease Excellence at McGill University in Montreal, Quebec, Canada.
The study measured prevalence, age and proportion of adults relative to children at four time points: 1985, 1990, 1995 and 2000, and analyzed the Quebec administrative databases recorded for the general population where access to health care is universal. Quebec accounts for 25 percent of Canada's population.
"This is the largest population study of CHD to have been performed in North America," Marelli said. "There is no reason to believe that the predominantly Caucasian population of Quebec and Canada is different from the United States."
Extrapolating the study findings to the U.S. population, Marelli estimated 1.8 million Americans had CHD in 2000 and that this number is increasing and will have implications for women, pregnancy and genetics. She estimated about 900,000 adults and 900,000 children had CHD.
In 2000, the study indicated that one of every 85 children had CHD and one of 250 adults had CHD.
"For comparison purposes, cystic fibrosis occurs in one of 4,500 live births, so there are 45 times more children with CHD than children with cystic fibrosis and most of these children are now becoming adults," Marelli said.
Furthermore, more adults have had CHD than children since 1985, and a preponderance are women, the study found.
"Between 1985 and 2000, the group of patients that rose the most rapidly were adults with severe CHD, so, as of 2000, there was a nearly equal number of children and adults with severe CHD," Marelli said
The most significant increases in CHD were in adolescents (13 to 17 years old) and in young adults (18 to 25), according to the study. The median age of those with severe CHD increased markedly from 1985 to 2000. The median age in 1985 was 11 years compared to 17 years in 2000.
"CHD has been thought of as a disease of childhood, but it has become an important disease of adulthood as well," Marelli said. Researchers said the significant new data in the study reflects advances in the diagnosis and surgical treatment of CHD.
"Since the mid-1980s, the advent of cardiac ultrasound has improved the diagnosis of CHD," Marelli said. "This technique can be used to detect CHD beyond the first year of life. Advances in corrective pediatric cardiac surgery have made an impact, enabling children with CHD to live longer." Marelli considers CHD a major public health problem in North America that is largely under-recognized.
"The increasing prevalence of CHD means these children will live longer and acquire other forms of heart disease," Marelli said. "We need to increase public awareness for congenital heart disease in order to be able to better care for the increasing number of young people with heart disease."
The study was funded by the Heart and Stroke Foundation of Canada, the Fonds de la Recherche en Santé du Québec and the Canadian Institutes of Health Research.
Co-authors are Andrew S. Mackie, M.D., S.M.; Raluca Ionescu-Ittu, M.Sc.; Elham Rahme, Ph.D.; and Louise Pilote, M.D., M.P.H., Ph.D.
Statements and conclusions of study authors published in the American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect association policy or position. The American Heart Association makes no representation or warranty as to their accuracy or reliability.
http://www.medicalnewstoday.com/medicalnews.php?newsid=60421
编辑：ache
