Wilcken D E, Hickey A J
Department of Cardiovascular Medicine, University of New South Wales, Prince Henry Hospital, Sydney, Australia.
Circulation. 1988 Jul;78(1):10-4. doi: 10.1161/01.cir.78.1.10.
Severe mitral regurgitation requiring surgery is the most common life-threatening complication of mitral valve prolapse (MVP) and is due to progressive myxomatous change in the valve. We identified all residents of New South Wales, Australia, who had mitral valve surgery for myxomatous valve disease during 1982 and, using these data and the adult population statistics from 1982, estimated the cumulative risk of valve surgery in patients with MVP. In 1982, 50 of the 5.36 million New South Wales residents required surgery for this complication of MVP. Of the 50, 36 were men and 14 were women, which was significantly different from the population sex distribution (p less than 0.02) for mean age +/- SD of 60 +/- 11 years (range, 26-78 years). Using our previously determined 4% prevalence of adult MVP in New South Wales, we estimated the number of male and female patients with MVP at risk for each 5-year age interval and calculated age-specific event rates. The results show that the cumulative risk is minimal below the age of 50 years but then rises steeply, particularly in men. The risks in men aged 50, 60, and 70 years (with 95% confidence intervals) were 1:202 (130-448), 1:53 (37-82), and 1:28 (22-41), respectively. In women, the risk was less than half that in men (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
需要手术治疗的严重二尖瓣反流是二尖瓣脱垂（MVP）最常见的危及生命的并发症，其病因是瓣膜进行性黏液样变性。我们确定了1982年在澳大利亚新南威尔士州因黏液样瓣膜病接受二尖瓣手术的所有居民，并利用这些数据以及1982年的成年人口统计数据，估算了MVP患者接受瓣膜手术的累积风险。1982年，新南威尔士州536万居民中有50人因MVP的这一并发症需要手术。这50人中，36人为男性，14人为女性，这与总体性别分布存在显著差异（p<0.02），平均年龄±标准差为60±11岁（范围26 - 78岁）。利用我们之前确定的新南威尔士州成年MVP患病率4%，我们估算了每5岁年龄区间有风险的男性和女性MVP患者数量，并计算了特定年龄的事件发生率。结果显示，50岁以下累积风险极小，但之后急剧上升，尤其是男性。50岁、60岁和70岁男性的风险（95%置信区间）分别为1:202（130 - 448）、1:53（37 - 82）和1:28（22 - 41）。女性的风险不到男性的一半（p<0.001）。（摘要截短于250字）
