风湿性心脏病的全球患病率和性别差异:系统性审查和更新的元分析
Antonio Mutarelli1,2, Alexandre N Pantaleao1,2, Pedro H C Melo3
1School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Frontiers in cardiovascular medicine
|November 24, 2025
概括
这一元分析揭示了风湿性心脏病 (RHD) 影响全球儿童,女性患病率更高. 在城市地区和高收入家庭中观察到较低的RHD率,这表明了关键的风险因素.
科学领域:
- 心脏病学 心脏病学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 风湿性心脏病 (RHD) 是儿童的一种重大心脏病,主要影响低至中等收入国家.
- 虽然急性类风湿性发烧 (ARF) 在儿童中具有相等的性别流行率,但RHD在成年女性中明显更常见 (2:1比).
研究的目的:
- 进行一项元分析,评估RHD的全球流行率.
- 评估RHD流行中的性别差异.
- 为了确定RHD相关的风险因素.
主要方法:
- 在PubMed,Embase,Cochrane和Lilacs系统搜索横截面研究.
- 包括在流行地区的5-20岁个体中使用基于心声图的查的研究.
- 排除仅依赖于听觉的研究;根据2012年WHF或WHO标准定义的RHD.
主要成果:
- 分析了58项研究,包括215552名受试者.
- 全球回声检测到的RHD患病率为24/1000 (95%-CI:20-30),男性患病率始终较低 (RR:0.70).
- 在私立学校,中高收入家庭和城市地区的儿童中,RHD患病率有所降低.
结论:
- 该研究强调了RHD早期发生的性别差异,在显著的门损伤之前观察到女性占主导地位.
- 农村环境,公立学校和低收入家庭的RHD患病率仍然较高.
- 在流行地区的全球RHD流行率被证实为24/1000.
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