印度尼西亚风湿性心脏病的特征和问题:INA-RHD多中心研究
Amiliana Mardiani Soesanto1, Prima Almazini2, Rina Ariani1
1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia/National Cardiovascular Center Harapan Kita, Jakarta, Indonesia.
JACC. Asia
|May 14, 2025
概括
这项研究强调了印度尼西亚风湿性心脏病 (RHD) 的重大负担,主要影响着关节狭窄和晚期疾病的女性. 管理方面的挑战包括抗凝血和二次预防的不足利用.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 风湿性心脏病 (RHD) 在全球范围内构成了重大公共卫生挑战.
- 印度尼西亚缺乏关于RHD发病率和流行率的全面国家数据.
研究的目的:
- 描述印尼RHD患者的人口统计,临床表现和管理.
- 确定印尼背景下与RHD护理相关的负担和挑战.
主要方法:
- 对来自印尼21家医院的3431名18岁以上RHD患者的病历进行了回顾性分析.
- 收集临床和心声回声数据,以评估疾病特征,严重程度和并发症.
主要成果:
- 研究人口 (平均年龄44岁) 主要是女性 (64.4%). 最常见的膜损伤 (39.6%) 是孤立的关狭窄症. 观察到呼吸不全 (85.7%),心房动 (62.5%) 和中风史 (6.6%) 的高发病率.
- 肺高血压和右心参与是常见的,许多患者在25%的病例中呈现先进的NYHA功能类 (III-IV).
- 确定了低于最佳的抗凝剂使用 (70.3%的处方是维生素K对抗剂) 和二次预防的不足使用 (37.3%的处方,23.2%的定期).
结论:
- 印度尼西亚的RHD不成比例地影响女性,并且通常在晚期被诊断出来.
- 高频率的心房动和膜病变,如心肌狭窄症,需要改进的抗凝策略.
- 由于二次预防的使用不足,这在RHD管理中是一个关键的缺口,增加了复发性风湿性发烧和并发症的风险.
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