实验室测量运动能力和心室特征和功能与Fontan手术后的功能健康状况的联系很弱
Brian W McCrindle1, Victor Zak, Lynn A Sleeper
1Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8. brian.mccrindle@sickkids.ca
Circulation
|December 23, 2009
概括
通过常见的实验室测量,Fontan手术患者的功能健康状况并不能被强烈预测. 这些发现表明,实验室值可能不是在这个人群中进行临床试验的理想代用终点.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病是一种先天性心脏病.
- 丰田程序的结果
背景情况:
- 接受Fontan手术的患者面临着功能健康下降的风险.
- 了解实验室测量和健康状况之间的关联对于干预和临床试验结果至关重要.
研究的目的:
- 调查Fontan手术幸存者的功能健康状况和各种实验室和成像测量之间的关系.
- 确定实验室测量是否可以作为临床试验中有效的代用终点.
主要方法:
- 利用儿童健康问卷 (CHQ) 来评估511名Fontan患者 (6-18岁) 的功能健康状况.
- 进行了回归分析,以将CHQ物理和心理社会功能总结分数 (FSS) 与运动测试,心声学,MRI和大脑天然尿素水平相关联.
主要成果:
- 较高的物理FSS与较高的最大工作率在炼测试中存在弱相关性 (9%的变化).
- 心声学因子 (较低的Tei指数,较低的末端缩体积,没有AV反) 和MRI发现 (较低的质量与末端透气体积比率) 与更好的物理FSS相关 (14%和11%的变化,分别).
- 脑性尿素与身体FSS的相关性较弱 (1%的变化);心理社会功能与实验室测量相关性较少,较弱.
结论:
- 实验室测量仅解释了相对健康的Fontan患者功能健康状况变化的很小一部分.
- 目前的实验室测量可能不是评估Fontan幸存者的治疗干预措施的最佳代用终点.
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