风湿性心脏病再探：尼泊尔东部连续队列的瓣膜受累模式。

Rheumatic heart disease revisited: patterns of valvular involvement from a consecutive cohort in eastern Nepal.

机构信息

Department of Cardiology, BP Koirala Institute of Health, Dharan, Nepal.

出版信息

J Cardiovasc Med (Hagerstown). 2012 Nov;13(11):755-9. doi: 10.2459/JCM.0b013e32835854b6.

DOI:10.2459/JCM.0b013e32835854b6

PMID:22914310

Abstract

BACKGROUND

The burden of rheumatic heart disease (RHD) continues to be a major contributor to morbidity and premature death in poor and developing countries. We investigated patterns of valvular involvement in patients with RHD as observed in a large tertiary care hospital in eastern Nepal.

METHODS

We retrospectively reviewed transthoracic echocardiography reports from patients diagnosed with RHD between June 1999 and February 2011.

RESULTS

Among 10 860 transthoracic echocardiography studies, 1055 female and 658 male patients were diagnosed with RHD, 25.7% of the patients being below 20 years of age. Mitral regurgitation was the most common valvular lesion across all age groups irrespective of sex (n = 1321, 77.1%). Female patients were significantly older as compared to male patients at the time of presentation (32.8 ± 15.2 versus 28.5 ± 15.4 years; P < 0.001) and more commonly presented with mitral stenosis as compared to male patients (62.8 versus 51.5%; P < 0.001), with a peak between the age of 30 and 49 years. Conversely, aortic regurgitation was more common in men as compared to women (55.6 versus 48.9%; P = 0.007). Involvement of both the mitral and the aortic valve was observed in 49.8% of the patients and was more common in men as compared to women (52.7 versus 47.8%; P = 0.047).

CONCLUSION

In this consecutive cohort of patients with RHD in Nepal differential patterns of valvular involvement are observed across sex and age categories.

摘要

背景

风湿性心脏病（RHD）的负担仍是贫穷和发展中国家发病率和过早死亡的主要原因。我们研究了尼泊尔东部一家大型三级保健医院观察到的 RHD 患者的瓣膜受累模式。

方法

我们回顾性地审查了 1999 年 6 月至 2011 年 2 月期间诊断为 RHD 的患者的经胸超声心动图报告。

结果

在 10860 次经胸超声心动图检查中，1055 名女性和 658 名男性患者被诊断为 RHD，25.7%的患者年龄在 20 岁以下。无论性别如何，二尖瓣反流是所有年龄组中最常见的瓣膜病变（n=1321，77.1%）。与男性患者相比，女性患者在就诊时明显年龄更大（32.8±15.2 岁比 28.5±15.4 岁；P<0.001），更常见的是二尖瓣狭窄，而不是男性患者（62.8 比 51.5%；P<0.001），峰值出现在 30 至 49 岁之间。相反，主动脉瓣反流在男性中比女性更常见（55.6 比 48.9%；P=0.007）。49.8%的患者同时累及二尖瓣和主动脉瓣，男性比女性更常见（52.7 比 47.8%；P=0.047）。