Episode Transcript
Interviewer: 心脏病患者并不都是一样的，了解这一点很重要. We'll talk about that next on The Scope.
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Interviewer: I'm talking to Dr. 犹他大学心血管医学助理教授拉什米·沙阿说. What did you find?
Dr. Shah: 大发娱乐研究了有一种叫做心源性休克的特殊并发症的心脏病患者. 心源性休克发生在严重心脏病发作的患者中, 心脏肌肉变得非常虚弱，无法将血液输送到身体的其他部位. These are the sickest of the heart attack patients. In the last decade, we've gotten a lot better at treating heart attacks using stents, interventions and stents, to open the blocked arteries.
A lot of these patients are now surviving the hospitalization. That means they get hospitalized, 治疗他们的心脏病，然后从医院出来. Since that's happening more frequently, 大发娱乐需要知道这些病人出院后会发生什么. Are they going home and resuming their usual life? 或者他们是残疾的，仍然像他们在医院时一样生病?
Interviewer: What did you find amongst these patients? How are they doing when they leave the hospital?
Dr. Shah: In a publication that preceded this one, 大发娱乐发现三分之二这样的病人能挺过住院并出院. We took it up from there. So among these patients who survived the hospitalization, we found that, surprisingly, within a year over half . . . almost 60% of these patients will either die or be rehospitalized.
Interviewer: Oh gosh.
Dr. Shah: Yeah, so not great. 有趣的发现是，这种风险确实集中在眼前, post-hospital period. So within the first 60 days after discharge, 这是这些心源性休克患者最容易产生不良后果的时候, meaning death or hospitalization.
一个有趣的发现是实际上所有的心脏病患者, over 50% die or were rehospitalized within a year. That's all heart attack patients. 这有点令人惊讶，我认为大发娱乐必须深入研究一下，看看是什么导致了这种情况，以及大发娱乐能做些什么.
Interviewer: That's not common knowledge yet, right, until this paper?
Dr. Shah: Correct.
Interviewer: 你知道在这60天内发生了什么可能会让这些病人面临死亡的危险吗?
Dr. Shah: Yeah. 有一些关于出院后出院期的理论. One interesting idea is there's so-called post-hospital syndrome, especially among critically ill patients. 心源性休克的病人通常在重症监护室，他们病得很重. 发生的是他们变得虚弱，因为他们没有足够的营养在这段时间, they're lying in bed, their days and nights gets reversed.
他们日常生活的一切都改变了，他们变得非常虚弱. Critically ill patients, not just limited to cardiogenic shock patients, when they get home or when they get discharged to wherever they go, they're still very debilitated. 这种出院后综合症是一种可能性，与康复有关, physical therapy, occupational therapy could address that issue.
另一个问题是，心源性休克是一种没有足够的血液进入身体其他器官的情况，所以他们可能会肾功能衰竭. 他们可能有更少的血液流向他们的大脑，某种神经系统的影响. 所有这些因素加在一起会使病人非常虚弱，所以这也可能是一个多器官的问题.
Interviewer: 在心脏病发作的患者中，这个人群代表了多少百分比?
Dr. Shah: 大发娱乐使用的数据集叫做行动注册表，它来自美国心脏病学会. This is the largest registry of heart attack patients in the US. 在这一人群中，5%的心脏病发作患者会发生心源性休克.
Interviewer: You would think that if they have those serious problems, that they would be under a close watch once they're discharged. Do we know if that's happening?
Dr. Shah: Yeah. 有指导方针鼓励患者在心脏病发作后进行一周的随访. 这种情况经常发生，这是大发娱乐犹他大学积极研究的问题. Often, the patients . . . 心脏病发作后有一些标准的治疗方法这些病人可能无法得到一些治疗方法，因为, for example, 他们的肾脏不能很好地工作所以他们不能有某种程度上保护心脏的药物. They could have a follow-up, 但这并不一定意味着他们有资格或能够得到那些基于证据的治疗来大发娱乐心脏愈合.
Interviewer: What are the next steps? 你认为这些信息告诉了你什么是可以做的，什么是应该做的?
Dr. Shah: I think there are many things we can do from here. 我感兴趣的几件事集中在所谓的病人记录结果上. We measure these very quantitative metrics, "Did the patient die? Did they get hospitalized?" But there's much more to patient wellbeing than just that. We want to know, "Are they able to function? Do they feel like they're short of breath every day?" those sorts of symptoms.
大发娱乐只能通过询问病人，每次都询问每一个病人来得到答案. Especially in this population, 了解他们的日常生活是很有趣的，因为它可能与这些简单的指标所暗示的非常不同. 我认为这是后续研究中非常重要的一部分.
The other issue I think is important is, "Can we find a way that, while these patients are in the hospital, 这样大发娱乐就能在他们离开医院之前主动识别他们?“这对于计划后续治疗或大发娱乐患者和家属了解他们离开医院时会发生什么是非常有用的信息.
Announcer: Interesting, informative, and all in the name of better health. This is The Scope Health Sciences Radio.