Coura J R, de Abreu L L, Pereira J B, Willcox H P
Mem Inst Oswaldo Cruz. 1985 Jan-Mar;80(1):73-80. doi: 10.1590/s0074-02761985000100011.
An evolutive study of the "case-control" type was carried out in an endemic area of Chagas' disease in Minas Gerais State, Brazil, using two cross-section evaluations with an interval of ten years between them (1974-1984). Patients were paired for sex and age. In the first cross-section study 264 pairs one with a positive serology and the other with a negative serology for T. cruzi antibodies were included. In the second evaluation, ten years later, 235 patients among those with previous positive serology and 216 with negative serology were located, but only 110 pairs could be recomposed and reexamined (clinical examination, ECG and Rx of the heart and esophagus). The incidence of chagasic cardiopathy in the cases with positive serology but previously assymptomatic was 38.3% during the ten year period. On the other hand there was a deterioration in 24% of the patients with chagasic cardiopathy since the first examination. Considering all clinical forms of the disease in 34.5% of the patients the clinical situation deteriorated, in 57.3% there was no change and in 8.2% the situation improved. The general mortality in the period was 23% in the chagasic group and 10.6% in the control group, but the lethality by cardiopathy was 17% in chagasic group and only 23.3% in the control group. The mortality was twice as high in males than in females, mainly in the age group from 30 to 59 years.
在巴西米纳斯吉拉斯州恰加斯病的一个流行地区，进行了一项“病例对照”类型的演进性研究，采用了两次横断面评估，两次评估之间间隔十年（1974 - 1984年）。患者按性别和年龄配对。在第一次横断面研究中，纳入了264对患者，其中一对血清学检测克氏锥虫抗体呈阳性，另一对呈阴性。十年后的第二次评估中，找到了之前血清学检测呈阳性的235名患者和呈阴性的216名患者，但只能重新组成并重新检查110对（进行临床检查、心电图以及心脏和食管的X光检查）。血清学检测呈阳性但之前无症状的病例中，恰加斯性心脏病的发病率在十年期间为38.3%。另一方面，自第一次检查以来，24%的恰加斯性心脏病患者病情恶化。考虑到该疾病的所有临床形式，34.5%的患者临床状况恶化，57.3%无变化，8.2%病情改善。该期间恰加斯病组的总死亡率为23%，对照组为10.6%，但心脏病致死率在恰加斯病组为17%，对照组仅为23.3%。男性死亡率是女性的两倍，主要集中在30至59岁年龄组。
