补硒对慢型克山病10年生存率的影响  

Effect of selenium supplementation on 10-year survival rate of chronic Keshan disease

作　　者：杨正军[1] 郭鲜妮 刘婵 常虹 朱延河 Yang Zhengjun;Guo Xianni;Liu Chan;Chang Hong;Zhu Yanhe(Department for Kashin-Beck Disease and Keshan Disease Prevention,Shaanxi Institute for Endemic Disease Control and Research,Xi'an 710003,China;Institute for Endemic Diseases Control,School of Public Health,Xi'an Jiaotong University Health Science Center,Xi'an 710061,China)

机构地区：[1]陕西省地方病防治研究所大骨节病克山病防研室,西安710003 [2]西安交通大学医学部公共卫生学院地方病研究所,西安710061

出　　处：《中华地方病学杂志》2022年第11期894-897,共4页Chinese Journal of Endemiology

基　　金：陕西省科学技术研究发展计划项目(2019SF-200)。

摘　　要：目的观察补硒对慢型克山病患者10年生存率的影响。方法采用回顾性研究方法, 自陕西省地方病防治研究所及西安交通大学收集陕西省克山病监测点302例慢型克山病患者的10年跟踪随访资料, 其中170例(56.3%)患者在随访期内进行补硒(口服亚硒酸钠, 每周1次, 1 mg/次),即为补硒组, 其余132例为非补硒组。采用多因素COX比例风险模型, 分析慢型克山病10年生存率的影响因素;随访期内慢型克山病10年生存率分析采用Kaplan-Meier法, 组间慢型克山病患者10年生存率比较采用Log-rank检验。结果随访截止日期是2019年10月。在随访期内, 共199例(199/302, 65.9%)慢型克山病患者死亡, 其中101例(101/170, 59.4%)为补硒组, 98例(98/132, 74.2%)为非补硒组。在COX比例风险模型中, 经过其他基线特征[年龄、性别、身体质量指数(BMI)、克山病家族史、吸烟、血压、心率、心电图异常、初始心胸比、左室射血分数(LVEF)、血硒含量]调整后, 补硒、使用血管紧张素转换酶抑制剂+ β-受体阻滞剂(ACEI + BBs)治疗均是慢型克山病患者10年生存的保护因素[补硒:风险比(HR) = 0.39, 95%置信区间(CI):0.28 ~ 0.53;ACEI + BBs:HR = 0.57, 95%CI:0.39 ~ 0.84]。慢型克山病患者补硒后10年生存率明显高于非补硒组(Log-rank检验, P < 0.05)。结论补硒以及使用ACEI + BBs治疗, 对于慢型克山病患者10年生存率有积极影响。Objective To observe the effect of selenium supplementation on 10-year survival rate of chronic Keshan disease(KD).Methods The 10-year follow-up data of 302 patients with chronic KD at the KD surveillance sites in Shaanxi Province were collected from the Shaanxi Institute for Endemic Disease Control and Research and Xi'an Jiaotong University,170(56.3%)cases were given selenium supplementation(oral administration of sodium selenite tablet,once a week,1 mg/time)until the end point of follow-up as selenium supplementation group,and the rest(132 cases)were non-selenium supplementation group.Cox proportional hazards models were used to identify the independent predictors for 10-year survival rate of chronic KD.Kaplan-Meier method was used to analyze the 10-year survival rate of patients with chronic KD during the follow-up period and the Log-rank test was used to compare the 10-year survival rate between groups.Results The follow-up deadline was October 2019.During the follow-up period,a total of 199 patients(199/302,65.9%)of chronic KD died,including 101 patients(101/170,59.4%)in the selenium supplementation group and 98 patients(98/132,74.2%)in the non-selenium supplementation group.In COX proportional hazards model,after adjustment for other baseline characteristics[age,sex,body mass index(BMI),family history of KD,smoking,blood pressure,heart rate,ECG abnormalities,initial cardiothoracic ratio,left ventricular ejection fraction(LVEF),and blood selenium content],selenium supplementation and combined use of angiotensin-converting enzyme inhibitor+βreceptor blocker(ACEI+BBs)were protective factors for 10-year survival in patients with chronic KD(selenium supplementation:HR=0.39,95%CI:0.28-0.53;ACEI+BBs:HR=0.57,95%CI:0.39-0.84).The 10-year survival rate of chronic KD patients after selenium supplementation was significantly higher than that of non-selenium supplementation group(Log-rank test,P<0.05).Conclusion Selenium supplementation and combined use of ACEI+BBs in chronic KD patients,are associated with better surv

关 键 词：硒 慢型克山病 跟踪随访 危险因素 

分 类 号：R542.3[医药卫生—心血管疾病]