Zhang WanZhu, Okello Emmy, Nyakoojo Wilson, Lwabi Peter, Mondo Charles K
Uganda Heart Institute, Cardiology.
Uganda Heart Institute.
Afr Health Sci. 2015 Dec;15(4):1182-8. doi: 10.4314/ahs.v15i4.17.
Since the establishment of the Uganda Rheumatic Heart Registry, over 900 patients have been enrolled. We sought to stratify the patients in the registry according to disease severity and optimal management strategy.
We reviewed data of 618 patients who had enrolled in the Registry between March 2010 and February 2013. The 67 patients who had died were excluded leaving 551 patients who were recruited. The optimum management strategy was determined according to the 2012 European Society of Cardiology guidelines on the management of valvular heart disease.
Out of the 551 patient's records evaluated, 398 (72.3%) required invasive intervention, with 332(60.3%) patients requiring surgery and 66 (12.0%) requiring percutaneous mitral commissurotomy (PMC). This leaves only 27.7% of patients who required only medical management. Currently, majority of the patients (498, 90.4%) in the registry are on medical treatment. Of the 60.3% requiring surgical intervention, only 8.0% (44 patients) underwent valvular surgery and 5(1.0%) patients of the 66 (12.0%) underwent PMC successfully.
There is a high proportion of patients with severe disease that require surgical treatment yet they cannot access this therapy due to absence of local expertise.
自乌干达风湿性心脏病登记处成立以来，已登记了900多名患者。我们试图根据疾病严重程度和最佳管理策略对登记处的患者进行分层。
我们回顾了2010年3月至2013年2月期间登记处618名患者的数据。排除67名死亡患者，剩余551名患者被纳入研究。根据2012年欧洲心脏病学会瓣膜性心脏病管理指南确定最佳管理策略。
在评估的551份患者记录中，398例（72.3%）需要侵入性干预，其中332例（60.3%）患者需要手术，66例（12.0%）需要经皮二尖瓣交界切开术（PMC）。仅27.7%的患者仅需药物治疗。目前，登记处大多数患者（498例，90.4%）正在接受药物治疗。在需要手术干预的60.3%患者中，只有8.0%（44例）接受了瓣膜手术，66例（12.0%）中的5例（1.0%）成功接受了PMC。
有很大比例的重症患者需要手术治疗，但由于缺乏当地专业知识，他们无法获得这种治疗。
