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中国南方地区轻链心脏淀粉样变性的诊断和预后的真实世界研究。

A real-world study on diagnosis and prognosis of light-chain cardiac amyloidosis in Southern China.

机构信息

Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, No. 139 Middle Renmin Road, Furong District, Changsha City, 410011, Hunan Province, China.

Department of Cardiology, Huaihua Hospital of Traditional Chinese Medicine, Huaihua, 418000, China.

出版信息

BMC Cardiovasc Disord. 2021 Sep 18;21(1):452. doi: 10.1186/s12872-021-02256-3.

Abstract

BACKGROUND

Light-chain cardiac amyloidosis (AL-CA) has been highly valued in developed countries, but in developing countries, the recognition and diagnosis of this condition is still limited. There are currently few reports on a large number of Chinese patients with AL-CA. The present study aimed to report real-world clinical characteristics and prognosis of AL-CA in China.

METHODS AND RESULTS

Consecutive patients with AL-CA diagnosed at the Second Xiangya Hospital of Central South University between June 2012 and September 2020 were reviewed. A total of 170 patients with AL-CA have been recruited, whose mean ages were 60.81 ± 10.46. 70.59% of the patients were male. They were from eight provinces in southern China, 55.7% were referred patients, and 37.3% had been misdiagnosed previously. 64 (37.6%) patients received chemotherapy. The median survival time for patients with AL-CA was 8.00 months, and survival time for patients who received chemotherapy was 13.00 months, which was significantly longer than that of patients with palliative treatment (13.00 vs 6.00, p = 0.004).

CONCLUSIONS

Although clinicians have improved their understanding of AL-CA in recent years, the prognosis of AL-CA is still poor, and the misdiagnosis rate and missed diagnosis rate are still very high in China. It is imperative to improve the recognition and early diagnosis of this condition, which may require multidisciplinary collaboration among cardiologists, hematologists and nephrologists.

摘要

背景

轻链心脏淀粉样变(AL-CA)在发达国家受到高度重视,但在发展中国家,对这种疾病的认识和诊断仍然有限。目前关于大量中国 AL-CA 患者的报告较少。本研究旨在报告中国 AL-CA 的真实临床特征和预后。

方法和结果

回顾了 2012 年 6 月至 2020 年 9 月期间在中南大学湘雅二医院诊断为 AL-CA 的连续患者。共纳入 170 例 AL-CA 患者,平均年龄为 60.81±10.46 岁。70.59%的患者为男性。他们来自中国南方的 8 个省份,55.7%为转诊患者,37.3%以前曾误诊。64 例(37.6%)患者接受了化疗。AL-CA 患者的中位生存时间为 8.00 个月,接受化疗的患者生存时间为 13.00 个月,明显长于姑息治疗的患者(13.00 与 6.00,p=0.004)。

结论

尽管近年来临床医生对 AL-CA 的认识有所提高,但 AL-CA 的预后仍然很差,在中国,误诊率和漏诊率仍然很高。提高对该病的认识和早期诊断迫在眉睫,这可能需要心脏病专家、血液科医生和肾病学家之间的多学科合作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9393/8449466/d24db7ec1399/12872_2021_2256_Fig1_HTML.jpg

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