阿根廷几家机构对恰加斯型心肌病患者的诊断和管理

R. Chuit, Laura Antonietti, R. N. Agüero, G. Varela, Oscar Daniel Mordini, Emilce Alemandri, M. Abril, M. Días, Z. Yadón, H. Pizzi, R. Pizzi
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摘要

据世界卫生组织估计,由原生动物寄生虫克氏锥虫引起的感染和疾病影响了近600万人,超过100万人患有恰加斯型心肌病(Ch-CMP)。据估计,其中37万6千人生活在阿根廷。本研究描述了阿根廷Ch-CMP患者的特点和医疗管理。这是一项描述性、回顾性、横断面研究,使用2018年1月1日至2021年6月30日期间从该国不同医疗机构收集的历史记录,对Ch-MCP患者的诊断、临床和治疗评估进行研究。在此期间,纳入652例患者(平均年龄61.2岁±12.9岁),其中女性占60.3%。心功能不全占36.0%,心律失常占64.4%。最常见的心血管危险因素是动脉高血压(69.5%)、吸烟(56.6%)和糖尿病(20.9%)。不到一半的受试者(45.4%)接受过心电图(ECG)、胸部x线和超声心动图检查。心电图检查显示传导障碍(38.8%)、左室肥厚(28.1%)、室性心动过速(22.0%)、完全性右束支传导阻滞(8.6%)、房室传导阻滞(2.6%)。按照Kuschnir分类,21.4%的研究对象为3级。研究中纳入的患者与其他研究中发表的患者具有相似的临床表现和疾病史。在评估医疗实践时,我们发现对患者的研究不够充分。虽然很难估计本研究所代表的患者总数的比例,但该研究使我们能够确定患者所接受的护理是不够的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnosis and management of chagasic cardiomyopathy patients in several institutions in Argentina
According to estimates by the World Health Organization, the infection and disease caused by the protozoan parasite Trypanosoma cruzi affects almost 6 million people, and more than 1 million suffer chagasic cardiomyopathy (Ch-CMP). It is estimated that 376,000 of these individuals live in Argentina. This study describes the characteristics and medical management of individuals with Ch-CMP in Argentina.This is a descriptive, retrospective, cross-sectional study on the diagnosis and clinical and therapeutic evaluation of patients with Ch-MCP using historical records collected from different medical institutions in the country between 1 January 2018 and 30 June 2021.During this period, 652 patients (mean age 61.2 years ± 12.9) were included, with women accounting for 60.3% of the sample. The diagnosis of cardiac insufficiency was 36.0% and 64.4% had arrhythmias. The most common cardiovascular risk factors detected were arterial hypertension (69.5%), smoking (56.6%), and diabetes (20.9%). Less than half of the subjects (45.4%) had been studied by electrocardiogram (ECG), chest X-ray, and echocardiogram. ECG studies showed conduction disorders (38.8%), left ventricular hypertrophy (28.1%), ventricular extrasystoles (22.0%), complete right bundle branch block (8.6%), and atrioventricular block (2.6%). According to the Kuschnir classification, 21.4% of the study subjects were in Grade 3.The patients included in the study had a similar clinical presentation and history of the disease to those published in other studies. When evaluating the medical practices, we found that patients were inadequately studied. Although it is difficult to estimate the fraction of the total number of patients represented by the present study, the study allowed us to establish that the care received by patients was not adequate.
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