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慢性病或高血压在儿童癌症之后
Asaf Lebel1,2, Rahul Chanchlani3, Vedran Cockovski1
1Division of Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
儿童癌症幸存者 (CCS) 面临患慢性病 (CKD) 和治疗后高血压的风险明显更高. 在CCS中早期发现和管理这些疾病对于减少死亡率和长期并发症至关重要.
科学领域:
- 儿科瘤学 儿科瘤学
- 腎臟病學 (nephrology) 是一種醫學.
- 心血管健康 心血管健康
背景情况:
- 儿童癌症幸存者 (CCS) 经常经历长期健康问题,包括慢性病 (CKD) 和高血压.
- 在CCS中,CKD和高血压的确切发病率和比较风险尚未得到充分确立.
- 了解这些风险对于改善这一群体的长期结果至关重要.
研究的目的:
- 调查儿童癌症治疗与随后的CKD或高血压发展之间的关联.
- 为了比较CCS中CKD和高血压的风险与住院和一般儿科患者的风险.
主要方法:
- 一项基于人口的匹配队列研究在加拿大安大略省进行,涉及1993年至2020年期间接受癌症治疗的儿童.
- 儿童癌症幸存者 (CCS) 与两个对照组进行了比较:住院队列和一般儿科人口,根据年龄,性别和社会经济因素进行匹配.
- 用细分和灰分区危险建模来分析CKD或高血压的复合结果,考虑竞争风险.
主要成果:
- 该研究包括超过10,000名CCS患者,与超过40,000名住院患者和35,000名一般儿科患者相匹配.
- 与住院队列 (aHR, 2.00) 和一般儿科人口 (aHR, 4.71) 相比,儿童癌症幸存者患CKD或高血压的风险显著增加.
- 与一般儿科队列 (8.05%) 相比,CKD或高血压的累积发病率在CCS (20.85%) 中显著更高.
结论:
- 儿童癌症幸存者患慢性病和高血压的风险明显增加.
- 这些癌症后的疾病与死亡率的增加有关,这强调了积极监测的必要性.
- 在CCS幸存者中实施CKD和高血压的早期检测和治疗策略可能可以减轻长期并发症并提高生存率.
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