摘要
目的分析克山病患者的临床特征及全因死亡影响因素。方法自四川省及云南省克山病病区收集克山病患者的临床资料,回顾性分析患者临床特征及定期随访时的生存情况。根据患者的生存情况将调查对象分为存活组与死亡组,以全因死亡(指患者在整个随访期间内因各种原因导致的死亡)为研究终点,进行Kaplan-Meier(K-M)生存曲线分析和对数秩检验(log-rankχ^(2));采用单因素及多因素Cox回归分析克山病患者全因死亡影响因素。结果共收集176例克山病患者临床资料,其中四川省92例、云南省84例。全部患者中,男性105例,占比为59.66%,女性71例,占比为40.34%;年龄为(53.89±13.19)岁。全因死亡35例,病死率为19.89%。存活组和死亡组的年龄(t=2.09,P=0.038)、纽约心脏协会(NYHA)心功能分级(χ^(2)=14.62,P<0.001)和室性期前收缩检出率(χ^(2)=6.82,P=0.009)比较,差异均有统计学意义。K-M生存曲线分析显示,合并室性期前收缩、心功能分级高(Ⅲ、Ⅳ级)的克山病患者全因死亡率高(log-rankχ^(2)=8.72、22.49,均P<0.05)。单因素Cox回归分析显示,NYHA心功能分级与室性期前收缩(HR=3.09、2.71,均P<0.05)是克山病患者全因死亡的影响因素。多因素Cox回归分析显示,NYHA心功能分级(HR=6.57,P=0.002)与室性期前收缩(HR=2.98,P=0.050)是克山病患者全因死亡的独立影响因素。结论176例克山病患者中,心功能较差(NYHA心功能分级为Ⅲ、Ⅳ级)、心律失常的人数较多。NYHA心功能分级、室性期前收缩是影响克山病患者全因死亡的独立影响因素。
Objective To analyze the clinical characteristics and all-cause mortality influencing factors of patients with Keshan disease.Methods Clinical data of patients with Keshan disease from Keshan disease areas in Sichuan Province and Yunnan Province were collected and retrospectively analyzed for clinical characteristics and survival status during regular follow-up.According to the survival status of patients,the survey subjects were divided into a survival group and a death group.All-cause mortality(referring to the death caused by various reasons throughout the follow-up period)was used as the study endpoint.Kaplan-Meier(K-M)survival curve analysis and log-rankχ^(2)test were performed,univariate and multivariate Cox regression analysis were used for all-cause mortality factor analysis.Results A total of 176 patients with Keshan disease were collected,including 92 cases in Sichuan Province and 84 cases in Yunnan Province.Among all the patients,there were 105 males,accounting for 59.66%,and 71 females,accounting for 40.34%.The age was(53.89±13.19)years old.Thirty-five cases died from all causes,with a mortality rate of 19.89%.There were significant differences in age(t=2.09,P=0.038),New York Heart Association(NYHA)cardiac function grading(χ^(2)=14.62,P<0.001)and ventricular premature contraction(χ^(2)=6.82,P=0.009)between the survival group and the death group.K-M survival curve analysis showed that patients with Keshan disease complicated by premature ventricular contraction and high NYHA cardiac function grading(ⅢandⅣ)had higher all-cause mortality(log-rankχ^(2)=8.72,22.49,P<0.05).Univariate Cox regression analysis showed that NYHA cardiac function grading and ventricular premature contraction(HR=3.09,2.71,P<0.05)were predictive influencing factors for all-cause mortality in patients with Keshan disease.Multivariate Cox regression analysis showed that NYHA cardiac function grading(HR=6.57,P=0.002)and ventricular premature contraction(HR=2.98,P=0.050)were independent factors for all-cause mortality in patie
作者
李淑娟
洪英
鲍建忠
罗蓉
马慧慧
张红梅
蔡卫
李锋
李津蜀
黄慧
刘明江
王安伟
黄宁波
李小平
Li Shujuan;Hong Ying;Bao Jianzhong;Luo Rong;Ma Huihui;Zhang Hongmei;Cai Wei;Li Feng;Li Jinshu;Huang Hui;Liu Mingjiang;Wang Anwei;Huang Ningbo;Li Xiaoping(Yunnan Institute of Endemic Disease,Dali 671000,China;Department of Cardiology,Sichuan Provincial People's Hospital,Chengdu 610072,China;Clinical Medical College,Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China;Department for Endemic and Parasitic Diseases Control,Chuxiong Prefecture Center for Disease Prevention and Control,Chuxiong 651699,China;Institute of Geriatric Cardiovascular Disease,Chengdu Medical College,Chengdu 610500,China;Department of Echocardiography,Sichuan Provincial People's Hospital,Chengdu 610072,China;Institute of Endemic Disease,Sichuan Center for Disease Control,Chengdu 610041,China)
出处
《中华地方病学杂志》
CAS
北大核心
2024年第6期482-486,共5页
Chinese Journal of Endemiology
基金
四川省科技厅-区域创新合作项目(24QYCX0097)
四川省科技厅重点研发项目(2019YFS0345)
四川省人民医院基金项目(2018LY02)
关键词
克山病
临床特征
全因死亡
影响因素
Keshan disease
Clinical characteristics
All-cause mortality
Influencing factor
