Singh Pritinesh I P K, Carapetis Jonathan R, Buadromo Eka M, Samberkar Prashant N, Steer Andrew C
Department of Pathology, Fiji Ministry of Health, Colonial War Memorial Hospital, Suva, Fiji Islands.
Cardiol Young. 2008 Feb;18(1):62-9. doi: 10.1017/S1047951107001734. Epub 2007 Dec 20.
Rheumatic heart disease causes more than 200,000 deaths worldwide annually, with the vast majority of these deaths occurring in developing countries, yet there are few autopsy studies of rheumatic heart disease in these countries. We performed a retrospective review of 6218 autopsies performed during the period from 1990 through 2006, searching for cases of rheumatic heart disease based upon the macroscopic pathologic examination of the heart. We found 147 cases (2.4%) of rheumatic heart disease. There was an apparent increase in the number of cases in the past 5 years. There were 95 deaths that were directly attributable to rheumatic heart disease, with congestive cardiac failure being the most common cause of death in 75 cases. The mean age at death due to rheumatic heart disease was 38 years. There were more cases of rheumatic heart disease in Indigenous Fijians than Indo-Fijians, with an adjusted relative risk of 1.26 (95% confidence intervals from 0.87 to 1.86). Our findings reflect the high burden and early age of death due to rheumatic heart disease in Fiji and the Pacific region generally, and underline the need for early detection and adequate secondary penicillin prophylaxis in this region.
风湿性心脏病每年在全球导致超过20万人死亡，其中绝大多数死亡发生在发展中国家，但这些国家对风湿性心脏病进行尸检研究的却很少。我们对1990年至2006年期间进行的6218例尸检进行了回顾性研究，通过对心脏的宏观病理检查寻找风湿性心脏病病例。我们发现了147例（2.4%）风湿性心脏病病例。在过去5年中病例数明显增加。有95例死亡直接归因于风湿性心脏病，其中75例的最常见死因是充血性心力衰竭。因风湿性心脏病死亡的平均年龄为38岁。斐济原住民患风湿性心脏病的病例比印度裔斐济人多，调整后的相对风险为1.26（95%置信区间为0.87至1.86）。我们的研究结果反映了斐济及整个太平洋地区风湿性心脏病造成的高负担和早逝情况，并强调了该地区早期检测和充分二级青霉素预防的必要性。
