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在患有神经性厌食症的患者中,心血管结果的发生率和风险
Mei-Chih Meg Tseng1,2,3, Kuan-Rau Chiou4, Joni Yu-Hsuan Shao5,6
1Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
JAMA network open
|December 19, 2024
概括
患有神经性厌食症 (AN) 的患者面临重大心血管不良事件和其他心脏病的风险显著增加. 这些风险随着时间的推移而变化,突出了对AN患者持续心血管监测的需要.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 流行病学 流行病学
背景情况:
- 神经性厌食症 (AN) 经常与严重的心血管并发症有关.
- 了解AN患者的长期心血管风险轨迹对于患者管理至关重要.
研究的目的:
- 为了调查在全国范围内的一群被诊断为台湾神经性厌食症的患者中心血管疾病风险的不断变化.
- 分析AN诊断后各种心血管事件的发生率和特定风险.
主要方法:
- 一项使用台湾国家医疗保险数据库 (2011-2021) 的纵向队列研究.
- 患有AN的患者的倾向得分与基于人口统计和社会经济因素的对照进行了匹配 (1:10).
- 条件考克斯比例危险回归和卡普兰-梅尔曲线被用来评估心血管事件风险和累积发病率.
主要成果:
- 该研究包括2081名AN患者和20810名对照. AN患者的重大心血管不良事件 (MACE) (aHR,3.78) 和任何心血管疾病 (aHR,1.93) 的风险显著增加.
- 在诊断后早期观察到充血性心力衰竭,导电障碍和结构性心脏病的风险增加,在60个月后减少.
- 在AN患者中注意到延迟性缺血性心脏病风险增加,在60个月的随访后出现.
结论:
- 这项研究表明,患有神经性厌食症的患者患有心血管疾病的风险大幅增加,具有明显的时间模式.
- 心血管并发症需要在AN患者的整个临床过程中进行警监测,从初始诊断到长期随访.
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