在高风险和低风险的澳大利亚儿童中,对风湿性心脏病进行心声扫描查
Kathryn Roberts1, Graeme Maguire, Alex Brown
1Menzies School of Health Research, Darwin, Northern Territory, Australia (K.R., B.R., J.-Y.S., J.R.C.); Department of Paediatrics (K.R.) and Northern Territory Cardiac Services (B.R.), Royal Darwin Hospital, Darwin, Northern Territory, Australia; Baker IDI Central Australia, Alice Springs, Northern Territory, Australia (G.M., A.B.); Cairns Clinical School, School of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia (G.M.); South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia (A.B.); School of Population Health, University of South Australia, Adelaide, Australia (A.B.); Rural Clinical School of Western Australia, University of Western Australia, Broome, Western Australia, Australia (D.A.); Kimberley Aboriginal Medical Services Council, Broome, Western Australia, Australia (D.A.); Department of Cardiology, Women's and Children's Hospital, Adelaide, South Australia, Australia (G.W., A.K.); Flinders University, Adelaide, South Australia, Australia (G.W.); Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India (R.K.K.); Centre for Disease Control, Department of Health, Darwin, Northern Territory, Australia (J.-Y.S.); Telethon Kids Institute, University of Western Australia, Perth, Australia (J.R.C.).
在澳大利亚土著儿童的风湿性心脏病 (RHD) 查中,使用新的世界心脏联合会标准,确定的RHD的流行率为8.6/1000. 边界RHD在高风险和低风险组中都被发现,需要进一步研究.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 儿科 儿科 儿科
背景情况:
- 对风湿性心脏病 (RHD) 的心声检查正在增加,但定义各不相同.
- 世界心脏联合会 (WHF) 最近发布了针对RHD的新诊断标准.
- 这项研究解决了风险人群中标准化RHD诊断的需求.
研究的目的:
- 用WHF标准确定澳大利亚原住民高风险儿童中RHD的患病率.
- 为了比较高风险儿童的RHD患病率与低风险的澳大利亚队列.
- 验证WHF标准用于诊断儿科人群中的RHD.
主要方法:
- 在偏远的澳大利亚,便携式心声扫描被用于查3946名高风险土著儿童 (5-15岁).
- 同时还对1053名低风险的非土著城市儿童进行了查.
- 心声图以标准化,盲目的方式进行分析.
主要成果:
- 在高风险组中,确定的RHD的患病率为每1000名儿童中8.6 (95% CI,6.0-12.0).
- 在高风险儿童中,边界性RHD患病率为每1000人中16.7人 (95%CI,13.0-21.2人),在低风险儿童中发现5人.
- 高风险儿童的确定的或边界RHD的几率明显更高 (aOR,5.7;P<0.001).
结论:
- 高风险澳大利亚土著儿童的确定的RHD患病率符合预期.
- 在低风险组中没有检测到明确的RHD,支持WHF标准的特异性.
- 需要进行纵向研究,以澄清边界RHD发现的临床意义.
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