CAJ | 학술논문

目的分析慢性阻塞性肺病(COPD)住院患者心血管疾病(CVD)及其相关疾病的发生率顺位、年龄及性别特征,探讨近10年COPD患者CVD发生率的演变趋势.方法对2000年1月1日至2010年3月20日解放军总医院、北京协和医院及北京医院住院病案数据库进行回顾性调查.结果 (1)入选患者4960例,男性3570例,女性1390例,平均年龄(72.2±10.4)岁.(2)合并CVD的COPD患者共2562例,CVD总发生率为48.8%,标化率为26.4%.标化率排名前三位为肺源性心脏病和肺循环疾病(15.8%)、心力衰竭(13.6%)和缺血性心脏病(10.6%).(3)男性COPD患者心绞痛、肺源性心脏病和肺循环疾病、急性肾功能衰竭等发生率较高(P＜0.05),而女性病例急性心肌梗死、心律失常(房颤/房扑)、心力衰竭、肺栓塞、高血压病、糖尿病等发生率较高(P＜0.05).(4)近10年COPD患者的心律失常发生率有随年龄增加而升高趋势,缺血性心脏病和心力衰竭发生率则逐年下降;COPD患者中CVD的女性比例呈上升趋势.结论 COPD住院患者中有近50%存在CVD及相关合并症,且不同年龄和性别患者CVD合并症发生率的变化趋势各具特点.
목적 분석만성조새성폐병(COPD)주원환자심혈관질병(CVD)급기상관질병적발생솔순위、년령급성별특정,탐토근10년COPD환자CVD발생솔적연변추세.방법 대2000년1월1일지2010년3월20일해방군총의원、북경협화의원급북경의원주원병안수거고진행회고성조사.결과 (1)입선환자4960례,남성3570례,녀성1390례,평균년령(72.2±10.4)세.(2)합병CVD적COPD환자공2562례,CVD총발생솔위48.8%,표화솔위26.4%.표화솔배명전삼위위폐원성심장병화폐순배질병(15.8%)、심력쇠갈(13.6%)화결혈성심장병(10.6%).(3)남성COPD환자심교통、폐원성심장병화폐순배질병、급성신공능쇠갈등발생솔교고(P＜0.05),이녀성병례급성심기경사、심률실상(방전/방복)、심력쇠갈、폐전새、고혈압병、당뇨병등발생솔교고(P＜0.05).(4)근10년COPD환자적심률실상발생솔유수년령증가이승고추세,결혈성심장병화심력쇠갈발생솔칙축년하강;COPD환자중CVD적녀성비례정상승추세.결론 COPD주원환자중유근50%존재CVD급상관합병증,차불동년령화성별환자CVD합병증발생솔적변화추세각구특점.
Objective To retrospectively explore the prevalence of cardiovascular disease (CVD) in inpatients with chronic obstructive pulmonary disease(COPD)in Beijing.Methods The COPD patients who were discharged from the General Hospital of the Liberation Army,Peking Union medical college Hospital and Beijing Hospital between January 1st,2000 to March 20th,2010,were investigated.The prevalence of CVD were calculated.The tendency of the prevalence of CVD by age or discharge year and the difference of the prevalence of CVD between male and female were estimated by using chi-square analysis.Results There were 4960 COPD patients who were in accordance with the inclusion criteria with 3570 males and 1390 females.The mean age was 72.2±10.4 years.Of the COPD patients,48.8% were diagnosed as cardiovascular diseases.The age-adjusted over-all prevalence of CVD was 26.4%.Chronic pulmonary heart disease and other disease of pulmonary artery(15.8%)was the most frequent diseases,followed by heart failure(13.6%),ischemic heart disease (10.6%).In COPD patients,male was more likely to have angina,pulmonary heart disease and other disease of pulmonary artery and acute kidney failure (P＜0.05),while less likely to get arrhythmia (atrial fibrillation/atrial flutter),heart failure,pulmonary embolism,hypertension and diabetes mellitus (P＜0.05).The prevalence of arrhythmia increased with age,however,the ischemic heart disease and heart failure decreased.The proportion of CVD decreased in male patients while increased in females.Conclusion The overall prevalence of CVD comorbidities was 48.8% in 4960 patients with COPD who were older than 40 years in Beijing.There were differences among the groups of various age and sex in the distribution of CVD comorbidities frequencies year by year.