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目的:明确长期慢性咽炎与隐袭性风湿活动所致的风湿性心脏瓣膜病之间的关系。方法:从238例慢性咽炎病人中,筛选76例初次就诊时抗链球菌溶血素O(ASO)在400kU/L~500kU/L,无明确风湿热表现和病史者随访观察,用二步半定量溶血法检测ASO,同时检测肌酸激酶同功酶MB(CKMB)、心室碎裂电位(VFP)切迹数(NVFP),并用超声心动图观察心脏瓣膜形态。结果:①76例中1例在随访第3年患典型风湿热。32例于随访第1、第2或第3年后ASO持续低于400kU/L者,无检出二尖瓣病变。②43例ASO长期在400kU/L~500kU/L,且CKMB、NVFP长期在正常高限者,随访第7年后有16例发现二尖瓣增厚,但尚无狭窄和关闭不全。③有二尖瓣增厚病变者CKMB、NVFP明显高于无病变者(P<005),但ASO水平无显著差异(P>005)。结论:ASO、CKMB、NVFP持续在正常高限的长期慢性咽炎病人中,部分存在隐袭性风湿活动,并可由此导致风湿性心脏瓣膜病变。  相似文献   

3.

Abstract

Cardiovascular disease (CVD) is the leading cause of mortality worldwide and an important cause of disability. In Africa, the burden of CVD is increasing rapidly and it is now a public health concern. Epidemiological data on diseases is scarce and fragmented on the continent.

Aim

To review available data on the epidemiology and pattern of heart disease in Sudan.

Methods

Data were obtained from the Sudan Household Survey (SHHS) 2006, annual health statistical reports of the Sudan Federal Ministry of Health, the STEPS survey of chronic disease risk factors in Sudan/Khartoum, and journal publications.

Results

The SHHS reported a prevalence of 2.5% for heart disease. Hypertensive heart disease (HHD), rheumatic heart disease (RHD), ischaemic heart disease (IHD) and cardiomyopathy constitute more than 80% of CVD in Sudan. Hypertension (HTN) had a prevalence of 20.1 and 20.4% in the SHHS and STEPS survey, respectively. There were poor control rates and a high prevalence of target-organ damage in the local studies. RHD prevalence data were available only for Khartoum state and the incidence has dropped from 3/1 000 people in the 1980s to 0.3% in 2003. There were no data on any other states. The coronary event rates in 1989 were 112/100 000 people, with a total mortality of 36/100 000. Prevalence rates of low physical activity, obesity, HTN, hypercholesterolaemia, diabetes and smoking were 86.8, 53.9, 23.6, 19.8, 19.2 and 12%, respectively, in the STEPS survey. Peripartum cardiomyopathy occurs at a rate of 1.5% of all deliveries. Congenital heart disease is prevalent in 0.2% of children.

Conclusion

Heart diseases are an important cause of morbidity and mortality in Sudan. The tetrad of hypertension, RHD, IHD and cardiomyopathy constitute the bulk of CVD. Hypertension is prevalent, with poor control rates. A decline in rheumatic heart disease was seen in the capital state and no data were available on other parts of the country. No recent data on IHD were available. Peripartum cardiomyopathy and congenital heart disease occur at similar rates to those in other African countries.  相似文献   

4.
Anton E. Becker 《Herz》1998,23(7):415-419
A survey of 200 surgically excised valves in 1996, from a single academic center, revealed that degenerative disease is by far the most common type of underlying pathology, both for the mitral valve and the aortic valve. This observation relates also to the fact that the vast majority of patients was 60 years or older. Post-inflammatory (rheumatic) disease was relatively rare; younger individuals with post-inflammatory valve pathology usually originated from parts in the world known to be endemic for rheumatic fever. The results further emphasize the shift in health costs related to an aging population.   相似文献   

5.
冠心病严重威胁人类健康。研究发现,女性冠心病与男性相比,发病机制、危险因素、疾病特点、治疗和预后均存在特殊性,现就近年来女性冠心病研究进展做一综述。  相似文献   

6.
Improvement in the control of infectious diseases and malnutrition associated with changes in lifestyle has led to a new epidemiological pattern in many low- and middle-income countries. Non-communicable diseases, mainly cardiovascular disorders, have emerged as major causes of morbidity and mortality in most sub-Saharan African countries.1 Hospital-based studies indicate that heart failure (HF) accounts for 3–7% of all admissions to African hospitals.2,3-7Although there has been increasing interest in the epidemiology of cardiovascular diseases in the African continent,7-9 recent data from Uganda are scarce7,10 but most needed to guide public health policies. Most registers originate from South Africa and cannot be transposed to poorer sub-Saharan countries.2,11Echocardiography is a mainstay in the assessment of HF. Unfortunately, access to echocardiography remains limited in many African countries due to cost and lack of skilled health workers, thereby leading to little data on cardiovascular diseases.12We report on the distinctive patterns of HF through a prospective, cross-sectional, hospital-based study in patients referred for suspected heart disease in urban Kampala, Uganda, in order to characterise the features of HF and to tailor future interventions. We also aimed at assessing access to invasive interventions and outcomes in patients with surgical indications.  相似文献   

7.
类癌性心脏病   总被引:1,自引:0,他引:1  
类癌是一种主要发生于胃肠道,但也可位于胃肠外器官的能产生小分子多肽类或肽类激素的肿瘤。类癌综合征是由类癌细胞分泌、释放一些生物活性物质所引起的一组具有多种复杂症状、体征的症候群。类癌性心脏病是指类癌综合征累及心脏,引起的以右侧心脏瓣膜和心内膜病变为主的心脏病,多发生于类癌晚期出现肝脏转移的患者。由于生长抑素类似物的应用以及针对转移性肿瘤的治疗,类癌患者存活延长,应该考虑瓣膜外科治疗减轻心脏症状。  相似文献   

8.
9.
200例心电图Q—Tc离散度分析   总被引:4,自引:0,他引:4  
丁Xu 《心电学杂志》1997,16(1):12-14
为评价Q-T_c离散度(Q-T_(cd))的临床意义,观察100例正常人,50例冠心病和50例高血压心脏病患者12导联ECG的Q-T_(cd)。发现正常组男、女之间Q-T_c有显著性差异(P<0.001),平均女比男长18ms;但Q-T_(cd)无显著性差异(P>0.05)。冠心组和高心组的Q-T_(cmin)接近于正常组(395.9±24.6ms),而Q-T_(cmax)则均明显大于正常组(418.5±24.7ms);Q-T_(cd)冠心组和高心组(50.3±17.0ms、48.1±18.3ms)明显大于正常组(22.7±8.1ms,P<0.001)。在正常组由X、Y、Z导联测得的Q-T_(cd)(15.7±11.4ms)比12导联测值偏小。Q-T_(cd)增大多见于VCG中T环呈圆形或马蹄形患者,冠心组中有24例,其Q-T_(cd)平均达63.0±12.7ms。认为Q-T_d增大是预告严重室性心律失常简明有用的指标。  相似文献   

10.
目的探讨肺心病合并冠心病心电图的特点。方法回顾我院住院病例选择肺心病和肺心病合并冠心病各120例均行同步十二导联心电图检查,必要时进行24 h动态心电图检查对比心电图的变化。结果肺心病合并冠心病组(合并组)比肺心病组心电图改变明显,两者有显著差异结论心电图及动态心电图的某些特殊改变能提示肺心病合并冠心病。  相似文献   

11.
Cardiomyopathy has been considered to be the most prevalent form of heart disease amongst Blacks in Southern Africa. In the present study we evaluated 5725 patients with heart disease. Rheumatic heart disease was most prevalent accounting for 42% of cardiac diseases. Ischemic heart disease was extremely rare.  相似文献   

12.
功能性三尖瓣关闭不全的分析和治疗   总被引:9,自引:1,他引:8  
目的为提高治疗功能性三尖瓣关闭不全(TR)水平,总结近5年临床体会。方法分析35例经手术治疗TR患者,其中瓣膜病组26例,先心病组9例。瓣膜病组与同期79例患者资料比较,手术行三尖瓣环成形术。结果瓣膜病组TR发生率为552%,其与病程、心胸比值、EF、左房大小有关(P<0.05),其中828%为心房颤动(P均<0.01),重度肺高压672%(P<0.05)。先心病组中左向右分流患者均为重度肺动脉高压,有紫绀患者均有右心扩大。随访24例,心功能Ⅰ级17例、Ⅱ级6例、Ⅲ级1例。结论三尖瓣环成形术是治疗TR有效方法,应根据临床表现、右心功能、肺血管阻力及TR程度决定手术指征。  相似文献   

13.
目的比较经胸超声心动图(TTE)与经食管超声心动图(TEE)对先天性与获得性主动脉瓣病变诊断的准确率.方法应用TTE与TEE检查,诊断先天性与获得性主动脉瓣病变及并发症.结果107例患者主动脉瓣听诊区可闻及Ⅱ~Ⅲ级收缩期及舒张期杂音,TTE检查不能明确诊断.而TEE检查均可明确诊断.结论TEE检查可进一步明确诊断先天性与获得性心脏病,有利于临床诊断及治疗.  相似文献   

14.
小儿及少年感染性心内膜炎20例临床分析   总被引:2,自引:0,他引:2  
目的 :为少儿感染性心内膜炎 (IE)的诊治及预防寻找对策。方法 :对 2 0例少儿 IE的临床资料进行回顾性分析。结果 :IE2 0例中 ,非青紫型先天性心脏病 1 0例 ,均为室间隔缺损 (VSD) ,其中 5例合并主动脉瓣关闭不全 (AI) ;青紫型先天性心脏病 2例 ;风湿性心脏病 6例 ;心脏结构正常 2例。部分患者伴有明显的免疫功能紊乱。血培养阳性 1 0例。超声心动图检查发现瓣膜赘生物1 7例。治疗主要用青霉素等。死亡 5例。结论 :1心脏结构异常是 IE的主要基础病因 ;2先天性心脏病 VSD合并 AI、风湿性心脏病有二尖瓣脱垂和联合病变者为发生 IE的高危儿 ,对这些患儿应定期用抗生素积极预防 ;3超声心动图检查对 IE的诊断有重要价值。4对确诊或高度疑诊的 IE患儿 ,首先应内科治疗。  相似文献   

15.
先心病介入封堵治疗的新进展   总被引:4,自引:0,他引:4  
先天性心脏病的发病率为8‰~12‰,传统外科手术是主要的治疗方法。随着微创介入手术的飞速发展,先心病介入封堵治疗日益成熟,现就目前几种常见先心病的介入封堵治疗的新进展做一综述。  相似文献   

16.
We describe the second reported case of congenital aortic atresia with normal left ventricle and intact ventricular septum. We believe this to be the first case diagnosed by cross-sectional echocardiography.  相似文献   

17.

Background

Diseases of the heart valves constitute a major cause of cardiovascular morbidity and mortality worldwide with rheumatic heart disease (RHD) being the dominant form of valvular heart disease (VHD) in developing nations. The current study was undertaken at a tertiary care cardiac center with the objective of establishing the incidence and patterns of VHD by Echocardiography (Echo).

Methods

Among the 136,098 first-time Echocardiograms performed between January 2010 and December 2012, an exclusion criterion of trivial and functional regurgitant lesions yielded a total of 13,289 cases of organic valvular heart disease as the study cohort.

Results

In RHD, the order of involvement of valves was mitral (60.2%), followed by aortic, tricuspid and pulmonary valves. Mitral stenosis, predominantly seen in females, was almost exclusively of rheumatic etiology (97.4%). The predominant form of isolated MR was rheumatic (41.1%) followed closely by myxomatous or mitral valve prolapse (40.8%). Isolated AS, more common in males, was the third most common valve lesion seen in 7.3% of cases. Degenerative calcification was the commonest cause of isolated AS (65.0%) followed by bicuspid aortic valve (BAV) (33.9%) and RHD (1.1%). Multiple valves were involved in more than a third of all cases (36.8%). The order of involvement was MS + MR > MS + AR > MR + AR > AS + AR > MR + AS > MS + AS. Overall, 9.7% of cases had organic tricuspid valve disease.

Conclusion

RHD contributed most to the burden of VHD in the present study with calcific degeneration, myxomatous disease and BAV being the other major forms of VHD. Multiple valves were affected in more than a third of all cases.  相似文献   

18.
慢性肺心病合并冠心病41例临床分析   总被引:1,自引:0,他引:1  
陈全德 《临床肺科杂志》2013,18(10):1819-1821
目的 探讨慢性肺心病(肺心病)合并冠心病的临床特点.方法 对41例肺心病合并冠心病患者(肺冠合并组)和30例单纯肺心病(单纯肺心组)进行临床比较、统计、分析临床特点及诊断方法.结果 在易患因素上,两组在长期吸烟、高血压、高脂血症、肥胖等有显著性差异(P<0.05或P<0.01).在临床表现方面,其左心室肥大、双心室增大、合并左束枝传导阻滞,持续ST-T改变等均有显著性差异(P<0.01).结论 慢性肺心病患者如伴有高血压、糖尿病、肥胖、左心室肥大、持续ST-T改变,心梗/左心衰时,在排除少数相关疾病后即可临床诊断为肺心病合并冠心病.  相似文献   

19.
OBJECTIVE—To determine the outcome of heart transplantation for end stage amyloid heart disease in patients treated at a single centre.
DESIGN—Records of all patients with amyloid heart disease who underwent heart transplantation were examined to determine survival, graft involvement by amyloid, the course of systemic amyloid disease, and the cause of death.
PATIENTS—10 patients, mean (SD) age 54 (8) years, received transplants in the 13 year period 1984 to 1997.
RESULTS—Two patients, both with AL amyloid (primary systemic amyloidosis), died perioperatively. Mean follow up in the remaining eight patients was 49.9 (39.5) months (range 3-116 months). Amyloid deposits in the grafts became evident histologically in five patients with AL amyloid at 5, 11, 12, 28, and 30 months after transplantation, and in one patient with familial amyloid at 60 months. Echocardiography showed no evidence of left ventricular systolic impairment at the time of recurrence. Seven patients died, at 3, 11, 26, 32, 49, 85, and 116 months after transplantation; four of these deaths were related to amyloidosis. Actuarial survival at one and two years was 60% and at five years, 30%.
CONCLUSIONS—Heart transplantation for amyloid heart disease remains controversial because of the scarcity of hearts for transplantation, the systemic nature of amyloidosis, and the potential for amyloid deposition in the graft. Postoperative mortality was high (20%), reflecting extracardiac amyloid. Heart transplantation for end stage cardiac amyloidosis is feasible but, without treatment of the underlying process, it is a palliative procedure.


Keywords: heart transplantation; amyloid heart disease; heart failure  相似文献   

20.
The clinical usefulness of biplane color Doppler transesophageal echocardiography is illustrated by the results obtained in 300 successive examinations. The additional contribution of the newer longitudinal plane was judged significant or major in 64% of the cases. The method was useful mainly for intraoperative examinations, assessment of native valvular disease, prosthetic valve evaluation, search for tumors, and assessment of endocarditis, congenital heart disease, and aortic disease. In contrast, the longitudinal plane option was not contributory in 68% of the cases of thromboembolism. Typically, the technique aided in the evaluation of mitral valve insufficiency and the detection of paraprosthetic leaks. Lesions located at the level of the ascending aorta, the left and right ventricular outflow tracts, and the interatrial septum were also visualized best. The limitations of the method were negligible and the duration of the examination was not significantly increased in comparison to the monoplane method. When available, biplane transesophageal echocardiography seems to be preferred in most clinical settings.  相似文献   

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