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目的 为了解上海市智力低下的现状 ,探索危险因素 ,减少发生率 ,上海市儿童保健所于 1997年 5月首次进行 7岁以下儿童该病流行病学调查。方法 采用综合按比例整群抽样方法 ,在上海市所有的 2 0个区县抽取 6岁以下儿童数的 1 2 %为调查对象。诊断为智力低下儿童按 1:2进行配对病例 -对照研究 ,并用Logistic进行回归分析。结果 智力低下患病率 6 87‰ ,3岁组以下患病率明显低于 3岁组以上。市区、郊区患病率有显著性差异。智力低下的儿童神经精神发育明显落后于正常儿童 ,多因素分析最主要的危险因素是出生体重、新生儿期患病住院、新生儿吸氧抢救、新生儿期疾病、父母文化和父母患病。结论 轻度MR占 5 1 14 % ,与 1987年的 70 6 %相比 ,下降了 19 4 6 %。说明轻度智力低下经过干预可以接近正常。在危险因素的研究中发现 ,父母遗传素质起着主要的作用。对一些说话晚、走路晚的孩子要作为高危人群定期检查发现异常及早干预。加大优生优育宣教力度 ,增加妇幼保健的投入 ,减少智力低下的发生。
Objective To understand the status quo of mental retardation in Shanghai, to explore the risk factors and reduce the incidence, Shanghai Children’s Health Center conducted the first epidemiological investigation of the disease in children under 7 years old in May 1997. Methods A comprehensive proportionate cluster sampling method was used to select 12% of children under 6 years of age in 20 districts and counties in Shanghai as the survey subjects. Children diagnosed as having mental retardation were matched by 1: 2 matched-case study and logistic regression analysis was performed. Results The prevalence of mental retardation was 6 87 ‰, the prevalence of the following 3-year-old group was significantly lower than that of the 3-year-old group. The urban and suburban prevalence rates were significantly different. Mental retardation in children with mental retardation lags behind that in normal children. The most important risk factors for multivariate analysis are birth weight, hospitalization during the neonatal period, neonatal respiratory rescue, neonatal disease, parental culture and parental illness. Conclusions Mild MR accounted for 5 1 14%, down 19 4 6% from 70 6% in 1987. Mild mental retardation can be close to normal after intervention. In the study of risk factors, the genetic quality of parents plays a major role. For some people who speak later, children who walk late should be checked for abnormalities as early as possible on a regular basis at high risk. Increase prenatal and postnatal care education, increase the investment in maternal and child health, reduce mental retardation.