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台湾65岁以下人群心肌病的流行病学

Epidemiology of Cardiomyopathy in Taiwanese Population Aged Younger Than 65 Years.

作者信息

Wang Po-Yuan, Wu En-Ting, Lu Frank Leigh, Juang Jyh-Ming Jimmy, Kao Feng-Yu, Huang San-Kuei, Wu Mei-Hwan

机构信息

Department of Pediatrics, Taipei City Hospital Renai Branch.

Department of Pediatrics.

出版信息

Acta Cardiol Sin. 2022 Sep;38(5):564-572. doi: 10.6515/ACS.202209_38(5).20220303A.

Abstract

BACKGROUND

Few studies have investigated the epidemiology of cardiomyopathy (CMP) in the general population in Taiwan. The aim of this study was to investigate this issue.

METHODS

We identified patients aged < 65 years and diagnosed with CMP between 2001 and 2014 from the National Health Insurance Database of Taiwan 2000-2014. Those with known or presumed causes of CMP were further identified.

RESULTS

We identified 38,868 CMP patients (male/female = 2.13). Half had known or presumed causes of CMP, including coronary artery disease (23.6%), congenital heart disease (1.6%), metabolic disease (8.4%), conduction disturbance/dyssynchrony (2.2%), myocarditis (0.5%), muscular dystrophy (1.42%), Kawasaki disease (0.2%), nutrition problems or alcoholism (2.9%), and unspecified causes (12.4%). The incidence rates of CMP without known causes were 1.13 and 8.70 per 100,000 person-years in pediatric (0-19 years) and adult (20-64 years) populations, respectively. After an initial peak during infancy (9.16 per 100,000 person-years), the incidence declined to a nadir in those aged from 5 to 14 years, and then steadily increased during adulthood (26.51 per 100,000 person-years in those aged 60-64 years). Although mortality was higher in the pediatric (11.4%) than in the adult (1.5%) patients, the proportion of sudden death to all deaths was similar in the pediatric (9.9%) and adult (10.5%) patients.

CONCLUSIONS

This study provides an epidemiological continuum of CMP in a Taiwanese population aged < 65 years. The results revealed an initial peak during infancy, followed by a decline in adolescence and a subsequent steady rise. The prognosis was poorer in the pediatric patients, and poorest in the infants. However, the risk of sudden death was the same in the adult and pediatric patients.

摘要

背景

在台湾普通人群中,很少有研究调查心肌病(CMP)的流行病学情况。本研究旨在探讨这一问题。

方法

我们从台湾2000 - 2014年全民健康保险数据库中,识别出年龄小于65岁且在2001年至2014年间被诊断为CMP的患者。进一步确定那些已知或推测患有CMP病因的患者。

结果

我们识别出38,868例CMP患者(男性/女性 = 2.13)。其中一半患者有已知或推测的CMP病因,包括冠状动脉疾病(23.6%)、先天性心脏病(1.6%)、代谢性疾病(8.4%)、传导障碍/不同步(2.2%)、心肌炎(0.5%)、肌肉萎缩症(1.42%)、川崎病(0.2%)、营养问题或酗酒(2.9%)以及不明原因(12.4%)。在儿童(0 - 19岁)和成人(20 - 64岁)人群中,无已知病因的CMP发病率分别为每10万人年1.13例和8.70例。在婴儿期出现首个高峰(每10万人年9.16例)后,发病率在5至14岁年龄段降至最低点,然后在成年期稳步上升(60 - 64岁年龄段为每10万人年26.51例)。尽管儿童患者的死亡率(11.4%)高于成人患者(1.5%),但儿童患者(9.9%)和成人患者(10.5%)中猝死占所有死亡的比例相似。

结论

本研究提供了台湾65岁以下人群CMP的流行病学连续情况。结果显示在婴儿期出现首个高峰,随后在青春期下降,随后稳步上升。儿童患者的预后较差,婴儿患者最差。然而,成人和儿童患者的猝死风险相同。

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