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| 1 | 儿童扩张型心肌病的发病率、病因及预后显示文摘背景:扩张型心肌病(dilated cardiomyopathy,DCM)是儿童心肌病最常见的类型,也是小儿心脏移植最常见的原因。但是,目前尚不清楚儿童DCM的流行病学特点和临床过程。
目的:详细描述儿童DCM的发病率、病因、预后及相关危险因素。
设计及地点:本项以人群为基础的前瞻性纵向队列研究入选1996年1月至2003年2月在89个儿科心脏中心诊断为DCM的儿童以及1990年1月至1995年12月在北美大型三级治疗中心诊断的患儿。
参试者:共入选1426例来自美国和加拿大的18岁以下DCM患儿。通过严格的超声心动图和/或病理学标准来诊断原发性DCM。因内分泌、免疫、药物中毒及其他原因患病者除外。
主要观测指标:每年每10万儿童的发病率、死亡率和心脏移植率。
结果:18岁以下儿童DCM每年的总发病率为0.57/10万,男孩的年发病率高于女孩(分别为0.66/10万和0.47/10万;P〈0.001),黑人的年发病率高于白人(分别为0.98/10万和0.46/10万;P〈0.001),婴儿(〈1岁)的年发病率高于儿童(分别为4.40/10万和0.34/10万;P〈0.001)。绝大部分属特发性,最常见的病因为心肌炎(46%)和神经肌肉性疾病(26%)。1年和5年死亡/移植率分别为31%和46%。死亡/移植的独立危险因素包括患儿诊断DCM时年龄较大、伴有充血性心力衰竭、左室收缩期Z评分较低以及DCM的病因(P均〈0.001)。
结论:儿童DCM有其多样性。患儿预后主要取决于病因、年龄和心力衰竭状况。人种、性别和年龄对发病率有一定影响。大部分患儿无明确病因,限制了特异性治疗。 | Jeffrey A. Towbin April M. Lowe Steven D. Colan Lynn A. Sleeper E. John Orav Sarah Clunie Jane Messere Gerald F. Cox Paul R. Lurie Daphne Hsu Charles Canter James D. Wilkinson Steven E. Lipshultz 康俊萍(译) 马长生(校) | 2007 | 美国医学会杂志(中文版)2007，26，4： | 3 |
| 2 | An operation definition of the homebound 显示文摘 | Gilbert GH Branch LG Orav EJ | 1992 | Health Serv Res1992，26，： | 1 |
| 3 | The reproducibility of the revised American Fertility Society classification of endometriosis显示文摘 | Hornstein MD Gleason RE Orav J | 1993 | Fertil Steril1993，59，： | 1 |
| 4 | The association of intraoperative factors with the development of postoperative delirium 显示文摘 | Marcantonio ER Golderman L Orav EJ | 1998 | Am J Med1998，105，5： | 1 |
| 5 | The association of intraoperative factors with the development of postoperative delirium显示文摘 | Marcantonio ER Goldman L Orav EJ | 1998 | Am J Med1998，105，5： | 1 |
| 6 | Hemoconcentration in an early marker for organ failure and necrotizing pancreatitis显示文摘 | Brown A Orav J Banks PA | 2000 | Pancreas2000，20，4： | 1 |
| 7 | Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or =60 y显示文摘 | Bischoff-Ferrari HA Dietrich T Orav EJ et aT | 2004 | Am J C]in Nutr2004，80，： | 1 |
| 8 | Somatization increa- ses medical utilization and costs Independent of psyehiatric and medical comorbidity显示文摘 | BARSKY A J ORAV E J BATES D W | 2005 | Arch Gel Psychiatry2005，62，8： | 1 |
| 9 | Incidence and Types of Adverse Events and Negligent Care in Utah and Colorado显示文摘 | Eric J. Thomas David M. Studdert Helen R. Burstin E. John Orav Timothy Zeena Elliott J. Williams K. Mason Howard Paul C. Weiler Troyen A. Brennan | 2000 | Medical Care2000，，3： | 1 |
| 10 | The Relationship Between Perceived Practice Quality and Quality Improvement Activities and Physician Practice Dissatisfaction, Professional Isolation, and Work-Life Stress显示文摘 | Mariah A. Quinn Allison Wilcox E John Orav David W. Bates Steven R. Simon | 2009 | Medical Care2009，，8： | 1 |
| 11 | Determinants of patient Satisfaction and willingness to return with emergency care显示文摘 | SUN B C ADAMS J ORAV E J | 2000 | Ann Emerg Med2000，35，： | 1 |
| 12 | Higher 25 hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged 》or=60 Y显示文摘 | Bischoff-Ferrari HA Dietrich T Orav EJ | | 0，，： | 1 |
| 13 | Patient quality of life during the 12 months following joint replacement surgery显示文摘 | Fitzgerald JD Orav EJ Lee TH | 2004 | Arthritis Rheum2004，51，1： | 1 |
| 14 | Incidence and types of adverse events andnegligent care in Utah and Colorado显示文摘 | Thomas EJ Studdert DM Burstin HR Orav EJ Zeena T Williams EJ | 2000 | Med Care2000，38，： | 1 |
| 15 | Variation in surgical-readmis- sion rates and quality of hospital care显示文摘 | Tsai T C Joynt K E Orav E J | 2013 | The New England journal of medicine2013，369，12： | 1 |
| 16 | Atrial fibrillation and quality of life after pacemaker implantation for sick sinus syndrome:data from the Mode Selection Trial (MOST)显示文摘 | Fleischmann KE Orav EJ Lamas GA | 2009 | Am Heart J2009，158，： | 1 |
| 17 | The reproducibility of the revised American Fertility Society classification of endometriosis显示文摘 | Hornstein MD Gleason RE Orav J | 1993 | Fertil Steril1993，59，5： | 1 |
| 18 | The repro- ducibility of the revised American Fertility Society classification of endometriosis显示文摘 | HORNSTEIN M D GLEASON R E ORAV J | 1993 | Fertil Steril1993，59，5： | 1 |
| 19 | Atrial fibrillationand quality of life after pacemaker implantation for sick sinussyndrome: data from the Mode Selection Trial(MOST) 显示文摘 | Fleischmann KE Orav EJ Lamas GA | 2009 | Am Heart J2009，158，1： | 1 |
| 20 | Dexrazoxane-associated risk for secondary malignancies in pediatric Hodgkin's disease:a claim without compelling evidence显示文摘 | Lipshultz SE Lipsitz SR Orav EJ | | 0，，21： | 1 |
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