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首页> 外文期刊>International Journal of General Medicine >The new face of rheumatic heart disease in South West Nigeria
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The new face of rheumatic heart disease in South West Nigeria

机译：尼日利亚西南部风湿性心脏病的新面貌

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Purpose: To determine the current prevalence of rheumatic heart disease (RHD), clinical features, types of valvular lesions, complications and mortality, at Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, Osogbo, South West Nigeria.Methods: We conducted a retrospective, descriptive study of all the cases of RHD seen in the medical outpatient clinics and wards of LAUTECH for 9 years, from January 2003 to December 2011. Statistical analysis of data obtained was done using SPSS 16. Results: The total number of attendees of all the medical outpatient clinics during the 9-year period was 67,378, with a subset of 9423 attending the cardiology clinic. There were 11 cases of RHD, which translates to a prevalence of 0.16/1000 and 1.2/1000 for medical outpatient clinics and the cardiology clinic respectively. The mean age of the patients was 25.64 ± 9.65 years, age range 14–40 years and male to female ratio of 1:1.2. The most common valve affected was mitral (90.9%), followed by the aortic (36.4%), and the tricuspid (18.2%). Mitral and aortic lesions coexisted in 18.2% of the patients, and late presentation was common in all RHD cases. Heart failure was the most common complication (90.9%). Other complications were secondary pulmonary hypertension (36.4%), infective endocarditis (27.3%), atrial fibrillation (27.3%), cardioembolic cerebrovascular disease (18.2%), and atrial flutter (9.1%). Mortality was 9.1%, while only one patient (9.1%) had definitive surgery. Financial constraints precluded others from having definitive surgery.Conclusion: The prevalence of RHD has declined considerably as a result of improvements in the primary health care delivery system, with widespread use of appropriate antibiotic therapy for sore throats resulting in the prevention of rheumatic fever and RHD. However, late presentation is still very common, hence we advocate a more aggressive drive to make the Drakensberg declaration on the control of rheumatic fever and rheumatic heart disease functional in our practice area.
机译：目的：在尼日利亚西南奥索博的Ladoke Akintola技术大学（LAUTECH）教学医院，确定风湿性心脏病（RHD）的当前患病率，临床特征，瓣膜病变的类型，并发症和死亡率。回顾性描述性研究，对2003年1月至2011年12月在LAUTECH的门诊诊所和病房中发现的所有RHD病例进行了9年的研究。使用SPSS 16对获得的数据进行统计分析。结果：在这9年中，所有门诊医疗机构为67,378，其中9423个子科就诊于心脏病科。有11例RHD，在门诊和心脏病诊所的患病率分别为0.16 / 1000和1.2 / 1000。患者的平均年龄为25.64±9.65岁，年龄范围为14-40岁，男女比例为1：1.2。最常见的瓣膜受影响是二尖瓣（90.9％），其次是主动脉（36.4％）和三尖瓣（18.2％）。二尖瓣和主动脉病变共存于18.2％的患者中，所有RHD病例均较晚出现。心力衰竭是最常见的并发症（90.9％）。其他并发症包括继发性肺动脉高压（36.4％），感染性心内膜炎（27.3％），房颤（27.3％），心栓性脑血管疾病（18.2％）和房扑（9.1％）。死亡率为9.1％，而只有一名患者（9.1％）进行了明确的手术。经济上的限制使其他人无法进行最终手术。结论：由于初级卫生保健系统的改善，RHD的患病率已大大降低，广泛使用适当的抗生素治疗咽喉痛，从而预防了风湿热和RHD 。但是，迟到的陈述仍然很常见，因此我们主张在我们的实践领域采取更积极的行动，使关于控制风湿热和风湿性心脏病的德拉肯斯堡宣言生效。

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