单静脉心脏患者的长期存活率:全国性的基于登记的队列研究
Ayse-Gül Öztürk1,2, Mikael Dellborg3, Anna Damlin4,5
1Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
International journal of cardiology. Congenital heart disease
|December 23, 2024
概括
患有单体心脏 (UVH) 的儿童面临的死亡风险明显更高,比对照人群高50倍以上. 虽然最近出生的UVH患者的生存率有所改善,但患有低可塑性左心综合征 (HLHS) 的患者的生存率仍然低于75%.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病流行病学
- 公共卫生 公共卫生
背景情况:
- 单心室性心脏 (UVH) 疾病在没有及时干预的情况下,显著限制了预期寿命.
- 在一个全面的,未经选择的全国队列中,单心脏病患者的长期存活数据在很大程度上仍未定义.
- 了解生存趋势对于改善患者结果和医疗保健策略至关重要.
研究的目的:
- 确定被诊断患有单体心脏病 (UVH) 的患者的长期生存率.
- 为了比较UVH患者的生存结果,包括未接受手术治疗的患者,与瑞典的一般人口对照组进行比较.
- 根据出生十年来分析随时间推移的生存趋势.
主要方法:
- 利用瑞典国家登记册识别了5075名1970年至2017年间出生的UVH患者.
- 匹配每个UVH患者与10名出生年份和性别相同的对照个体,没有先天性心脏病.
- 采用Cox比例回归模型和Kaplan-Meier生存分析来估计死亡风险,并对患者进行随访,直到死亡或移植.
主要成果:
- 紫外高温患者的整体死亡风险是对照组的53倍以上 (危险比率53.0).
- 患有低可塑性左心综合征 (HLHS) 的患者面临着更大的死亡风险 (危险比率163.5).
- 在几十年后出生的UVH和HLHS患者的第一年生存率显著改善,尽管HLHS生存率仍低于75%.
结论:
- 与普通人群相比,UVH患者的死亡风险明显增加.
- 超高温患者的生存率在连续几十年的出生时间里有所改善,这表明治疗和护理的进展.
- 尽管有所改善,但HLHS患者的长期存活仍然是一个关键问题,需要继续研究和治疗进展.
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