Liu Xin, Yang Guang, Wang Li-xin, Wei Jin, Tan Wu-hong, Zhu Yan-he
Sichuan Da Xue Xue Bao Yi Xue Ban. 2016 May;47(3):398-401, 424.
To observe ten-year prognosis of patients with latent Keshan disease (KD) and to determine its associated risk factors.
A total of 448 patients with newly diagnosed latent KD were monitored and followed up for 10 years. Their ECG abnormalities were classified as major or minor using the Minnesota Code. COX proportional hazards regression models were established to identify risk factors associated with the development of chronic KD.
A final sample of 414 cases was included in analyses, with an average of (112.9 ± 17.5) months of follow-up. At the end of follow-up, 92 (22. 2%) patients developed chronic KD. Older age (> 15 years), male, family history of KD, smoking, lower level of blood selenium (< 60 µg/L), major ECG abnormalities, and 18.5 kg/m² ≤ body mass index (BMI) 23.9 kg/m² were associated with higher cumulative incidence of chronic KD. The COX regression models showed that major ECG abnormalities, BMI, selenium deficiency, hypertension, and ventricular premature complex (VPC) abnormalities contributed to increased risk of chronic KD. A positive linear correlation (r = 0.719, P < 0.01) between GPx activity and blood selenium concentration was found.
Major ECG abnormalities, BMI, selenium deficiency, hypertension and VPC abnormalities are associated with the development of chronic KD.
观察潜在型克山病（KD）患者的十年预后情况，并确定其相关危险因素。
对448例新诊断的潜在型KD患者进行监测并随访10年。采用明尼苏达编码将其心电图异常分为主要或次要异常。建立COX比例风险回归模型以识别与慢性KD发生相关的危险因素。
最终414例纳入分析，平均随访时间为（112.9±17.5）个月。随访结束时，92例（22.2%）患者发展为慢性KD。年龄较大（>15岁）、男性、有KD家族史、吸烟、血硒水平较低（<60μg/L）、主要心电图异常以及18.5kg/m²≤体重指数（BMI）<23.9kg/m²与慢性KD的累积发病率较高相关。COX回归模型显示，主要心电图异常、BMI、硒缺乏、高血压和室性早搏（VPC）异常会增加慢性KD的风险。发现谷胱甘肽过氧化物酶（GPx）活性与血硒浓度之间呈正线性相关（r = 0.719，P<0.01）。
主要心电图异常、BMI、硒缺乏、高血压和VPC异常与慢性KD的发生有关。
