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先天性心脏病成人患者心血管危险因素分析

Analysis of Cardiovascular Risk Factors in Adults with Congenital Heart Disease.

作者信息

Moon Ju Ryoung, Song Jinyoung, Huh June, Kang I-Seok, Park Seung Woo, Chang Sung-A, Yang Ji-Hyuk, Jun Tae-Gook

机构信息

Grown-Up Congenital Heart Clinic, Heart Vascular Stroke Institute, Seoul, Korea.

Department of Pediatrics, Grown-Up Congenital Heart Clinic, Heart Vascular Stroke Institute, Seoul, Korea.

出版信息

Korean Circ J. 2015 Sep;45(5):416-23. doi: 10.4070/kcj.2015.45.5.416. Epub 2015 Aug 20.

Abstract

BACKGROUND AND OBJECTIVES

The objective of this study was to analyze cardiovascular risk factors in adults with congenital heart disease (ACHD).

SUBJECTS AND METHODS

The subjects for this study comprised 135 patients, aged 18 years and above, who visited the ACHD clinic at the Samsung Medical Center and 135 adults with a structurally normal heart who were randomly selected from the Center for Health Promotion during the same period. For the analysis, the ACHD group was further divided into an ACHD group that underwent correction by cardiac surgery and a cyanotic group.

RESULTS

The mean (standard diviation) age (years) of patients in the surgically corrected group was 48.4 (10.9) years, while that of patients in the cyanotic group was 43.1 (9.0) years and that of patients in the control group was 47.1 (10.3) years (p=0.042). The adjusted odds ratios (ORs) for past smoking, hypertension, diabetes mellitus, hypercholesterolemia, obesity, and metabolic syndrome were significantly higher in the surgically corrected patients than in the controls. However, the ORs for all variables excluding past smoking were significantly lower in the cyanotic group compared with the control group. After adjustment for age, gender, smoking, alcohol use, and exercise, the ORs for metabolic syndrome were 0.46 (0.35-0.57, p<0.001) and 1.48 (1.14-1.92, p=0.003) in the cyanotic and surgically corrected groups, respectively.

CONCLUSION

Cardiovascular risk factors need to be considered in surgically corrected ACHD patients as well as in adults with a structurally normal heart. A further study with a long-term follow-up is needed for developing guidelines for prevention.

摘要

背景与目的

本研究的目的是分析成人先天性心脏病(ACHD)患者的心血管危险因素。

对象与方法

本研究的对象包括135例年龄在18岁及以上的患者,他们前往三星医疗中心的ACHD诊所就诊,以及135例同期从健康促进中心随机选取的心脏结构正常的成年人。为了进行分析,ACHD组进一步分为接受心脏手术矫正的ACHD组和青紫组。

结果

手术矫正组患者的平均(标准差)年龄(岁)为48.4(10.9)岁,青紫组患者为43.1(9.0)岁,对照组患者为47.1(10.3)岁(p = 0.042)。手术矫正患者过去吸烟、高血压、糖尿病、高胆固醇血症、肥胖和代谢综合征的调整后比值比(OR)显著高于对照组。然而,与对照组相比,青紫组除过去吸烟外所有变量的OR均显著较低。在对年龄、性别、吸烟、饮酒和运动进行调整后,青紫组和手术矫正组代谢综合征的OR分别为0.46(0.35 - 0.57,p < 0.001)和1.48(1.14 - 1.92,p = 0.003)。

结论

在接受手术矫正的ACHD患者以及心脏结构正常的成年人中都需要考虑心血管危险因素。需要进行进一步的长期随访研究以制定预防指南。

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