Laudari S, Subramanyam G
Department of Cardiology, College of Medical Sciences, TH, Bharatpur, Nepal.
Int J Cardiol Heart Vasc. 2017 Apr 21;15:26-30. doi: 10.1016/j.ijcha.2017.03.007. eCollection 2017 Jun.
Rheumatic heart disease is one of the most common cause for heart failure and associated mortalities/morbidities in the young population in developing countries like Nepal imparting huge familial, social and manpower burden.
This is a hospital based descriptive cross-sectional study during June 2014 to April 2016 over a period of 22 months at College of Medical Sciences-Bharatpur including 235 patients with clinical and/or echocardiographic evidence of definite rheumatic heart disease.
The age of the patients ranged from 7 to 76 years with mean age 39.82 ± 4.2 years with female preponderance (F:M = 2.1:1) ( < 0.01). Majority of the rheumatic heart disease patients belonged to 30-44 years (28.78%) followed by 15-29 years (25.75%) and 45-59 years (25.00%). Majority belonged to the low socioeconomic status (60.60%) ( < 0.05). The predominantly involved isolated valve was mitral in 110 patients (46.80%) followed by isolated aortic valve in 22 patients (9.36%) and 79 (33.62%) had dual valvular involvement. The common rheumatic valvular lesions were pure mitral stenosis in 32 (13.61%), isolated mitral regurgitation in 58 (24.68%), combined mitral stenosis/regurgitation in 36 (15.32%), combined mitral/aortic regurgitation in 23 (9.78%) and combined aortic stenosis/regurgitation in 18 (7.66%) patients with few overlappings. The common complications encountered were heart failure in 90 (38.30%) and arrhythmias in 124 (51.00%) patients.130 patients (55.32%) received injectable benzathine penicillin whereas 45 patients (19.15%) preferred oral penicillin V. Surgical intervention was done in 54 (22.97%) patients. 12 (5.10%) expired in the CCU during the course of treatment.
RHD is a leading cause of heart failure among young populations with requirement of prolonged duration of medical treatment and many of them requiring surgery.
在尼泊尔等发展中国家的年轻人群中，风湿性心脏病是导致心力衰竭及相关死亡率/发病率的最常见原因之一，给家庭、社会和人力带来了巨大负担。
这是一项基于医院的描述性横断面研究，于2014年6月至2016年4月在巴拉特普尔医学科学学院进行，为期22个月，纳入了235例有明确风湿性心脏病临床和/或超声心动图证据的患者。
患者年龄范围为7至76岁，平均年龄39.82±4.2岁，女性占优势（女：男=2.1:1）（P<0.01）。大多数风湿性心脏病患者年龄在30 - 44岁（28.78%），其次是15 - 29岁（25.75%）和45 - 59岁（25.00%）。大多数患者属于社会经济地位较低者（60.60%）（P<0.05）。主要受累的单一瓣膜中，二尖瓣受累110例（46.80%），其次是主动脉瓣单独受累22例（9.36%），79例（33.62%）有双瓣膜受累。常见的风湿性瓣膜病变包括单纯二尖瓣狭窄32例（13.61%）、单纯二尖瓣反流58例（24.68%）、二尖瓣狭窄/反流合并36例（15.32%）、二尖瓣/主动脉瓣反流合并23例（9.78%）以及主动脉瓣狭窄/反流合并18例（7.66%），有少量重叠情况。常见并发症包括心力衰竭90例（38.30%）和心律失常124例（51.00%）。130例患者（55.32%）接受了苄星青霉素注射，而45例患者（19.15%）选择口服青霉素V。54例患者（22.97%）接受了手术干预。12例患者（5.10%）在重症监护病房治疗期间死亡。
风湿性心脏病是年轻人群中心力衰竭的主要原因，需要长期药物治疗，其中许多患者需要手术治疗。
